Pacibekitug’s Phase II Triumph: Why Tourmaline Bio’s Selloff is a Buyer’s Bonanza

The recent selloff in Tourmaline Bio (TRML) following its Phase II TRANQUILITY trial data release on May 20, 2025, presents a rare opportunity to buy a breakthrough inflammation therapy at a deep discount. While shares plummeted 20% intraday—likely due to short-term profit-taking and overreactions to perceived “noise” in the data—the results underscored pacibekitug’s transformative potential in cardiovascular disease. Combined with BMO Capital Markets’ bullish analysis and the company’s robust financial war chest, TRML now stands at the cusp of a paradigm shift in chronic disease management. Here’s why investors should act now.

The Phase II Data: A Home Run for IL-6 Inhibition

The TRANQUILITY trial delivered unequivocal evidence that pacibekitug, Tourmaline’s anti-IL-6 monoclonal antibody, achieves profound reductions in high-sensitivity C-reactive protein (hs-CRP)—a key biomarker for cardiovascular risk. Key highlights:
- 50 mg quarterly dosing reduced hs-CRP by 86% from baseline, outperforming all comparator arms (p<0.0001 vs. placebo).
- 83% of patients achieved hs-CRP <2 mg/L at Day 90, a threshold strongly correlated with reduced heart attack and stroke risk.
- Safety profile mirrored placebo, with no dose-related adverse events, no neutropenia, and minimal injection site reactions.

Crucially, pacibekitug is the first IL-6 inhibitor to demonstrate such efficacy with quarterly dosing, a game-changer for patient adherence compared to rivals requiring monthly injections. BMO Capital Markets emphasized this in their Q2 analysis: “Pacibekitug’s deep, durable CRP reductions and favorable safety profile position it as a best-in-class therapy, with potential to redefine treatment paradigms in ASCVD and AAA.”

Why the Selloff Was Overblown

Market skepticism appears rooted in two misplaced concerns:
1. Timing of the secondary offering: The $172.5M offering occurred in January 2024, long before the Phase II results. This was a strategic move to fund pipeline expansion, not a sign of distress. With $416M market cap and a current ratio of 33.87 (per BMO), Tourmaline is financially bulletproof.

2. Perceived “small” CRP reductions vs. competitors: Critics cite a 73% placebo-adjusted CRP reduction versus 84% in a rival’s Phase III trial. But this misses the point: pacibekitug’s quarterly dosing eliminates adherence barriers, a critical advantage in chronic therapies. BMO notes, “The ability to achieve 80%+ reductions every 12 weeks—without monthly injections—makes pacibekitug uniquely scalable in real-world settings.”

The Billion-Dollar Prize: Phase III and Beyond

Tourmaline’s $175M secondary offering (2024) now fuels two pivotal programs:
- Phase III in ASCVD: Expected to launch by late 2025, targeting a $15B market. Positive hs-CRP data strongly correlate with reduced MACE (major adverse cardiac events), a endpoint BMO believes pacibekitug can hit.
- Phase 2 in AAA: Abdominal aortic aneurysm lacks approved therapies; IL-6 inhibition’s anti-inflammatory effects could slow aneurysm growth.

Long-term, pacibekitug’s broad IL-6 blockade—targeting both classical and trans-signaling pathways—opens doors to autoimmune diseases like thyroid eye disease, where Tourmaline is already advancing trials.

A Compelling Risk/Reward Proposition

At current levels, TRML trades at 7x 2027 peak sales estimates (per BMO’s $1.2B projection). This valuation ignores the ASCVD market’s $15B potential and the AAA opportunity. Meanwhile, the stock’s 20% YTD decline creates a margin of safety.

BMO maintains its Outperform rating and $35 price target, citing “a catalyst-rich 12 months with Phase III initiation, AAA data, and potential partnerships.” For investors, the path is clear: buy the dip in a therapy that could redefine cardiovascular care.

Act now—before the market catches up to pacibekitug’s promise.