Balanced Risk-Reward for Altimmune’s Pemvidutide in a Crowded MASH Landscape Supports Hold Rating

William Blair analyst Andy Hsieh has maintained their neutral stance on ALT stock, giving a Hold rating today.

Andy Hsieh has given his Hold rating due to a combination of factors related to both clinical data and the competitive environment. He views the 48‑week update for pemvidutide in MASH as supportive of the drug’s biological activity but not sufficiently transformative to alter the investment thesis at this stage. In his assessment, Altimmune faces a crowded landscape with established therapies like Rezdiffra and Wegovy, as well as late-stage contenders from Boehringer Ingelheim and Eli Lilly, forcing pemvidutide to demonstrate clear and compelling differentiation to achieve meaningful commercial success.
At the same time, Hsieh notes that the company’s reliance on non-invasive tests at 48 weeks, without confirmatory liver biopsies, limits the extent to which current data can reduce development risk ahead of Phase III. He highlights that regulators still expect biopsy-based endpoints for accelerated approval, and he believes non-invasive measures are unlikely to replace biopsies absent strong links to hard clinical outcomes. While the planned inclusion of a higher, 2.4 mg dose in the Phase III MASH trial could enhance efficacy, he also flags the possibility of increased side effects, and sees upcoming FDA feedback as an important but yet-to-be-clarified catalyst. Taken together, these considerations underpin his view that the risk-reward profile is balanced, warranting a Hold rating at this time.

In another report released today, TR | OpenAI – 4o also reiterated a Hold rating on the stock with a $5.50 price target.