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After a 7% increase in revenue for the second quarter, which came on the heels of a 10% gain in Q1, Johnson & Johnson has bumped up its annual sales guidance. The company now projects 2026 revenue at the midpoint to land at $101.1 billion, versus a prior midpoint estimate of $100.8 billion. Much of the credit for J&J’s recent performance can be attributed to the resilience of its immunology portfolio, which took a massive hit with the loss of patent protection in the United States for Stelara, its top-selling drug in 2024 at $10.4 billion. Stelara saw its sales decline to $6.7 billion last year. Despite this, J&J has now pieced together five straight quarters of at least 6% revenue growth. In Q2, there was more evidence of the slide of Stelara, with worldwide sales falling (PDF) 55% to $740 million. But compensating for nearly all of that decline was J&J’s new immunology juggernaut Tremfya, which pulled off a 72% sales increase for the period. While Stelara’s worldwide sales dropped by $913 million year over year, those for Tremfya increased by $862 million to $2.05 billion. “The major driver here is our performance in ulcerative colitis and in Crohn’s disease,” Jennifer Taubert, J&J’s innovative medicines chief, said during a conference call, pointing out that Tremfya is attracting more than half of the new patients in both inflammatory bowel disease (IBD) indications as it battles AbbVie’s rival IL-23 med Skyrizi. “We have got an awful lot of growth potential ahead for Tremfya in IBD,” Taubert added. “And as a reminder, back when we had Stelara here, over 75% of Stelara sales were in IBD. There is absolutely no reason why Tremfya can’t do that or even more.” Also in the immunology arena, J&J touted the launch of its newest Il-23 inhibitor, Icotyde, which was approved by the FDA four months ago for plaque psoriasis as a daily pill option in a market flooded with injected biologics. With the launch so new, the company did not specify sales but did say that Icotyde has attracted more than 18,000 prescriptions for 11,000 patients across 6,000 unique prescribers. “That tells us that there’s really good confidence in the product in both the efficacy and safety profile as well as the simplicity of the once-daily pill,” Taubert said. Icotyde and Tremfya give J&J "differentiated oral and biologic approaches across dermatology and potentially IBD," Citi analyst Geoffrey Meacham wrote in a note to clients. "Icotyde momentum and a traditionally stronger second half also contributed to the guidance raise." For the quarter, J&J’s sales came to $25.3 billion, which puts the company on track to top the $100 billion mark for the first time in its 140-year history, CEO Joaquin Duato pointed out on the conference call. He also highlighted the company’s 28 “platforms” that deliver at least $1 billion in sales. Doing much of the remaining heavy lifting for J&J in the second quarter were its oncology drugs, with the portfolio achieving a 17% year-over-year sales increase. Multiple myeloma powerhouse Darzalex was up 19% in the period to $4.2 billion. Meanwhile, J&J’s newer multiple myeloma treatments are also making major gains, with Talvey up 63% to $174 million, Tecvayli up 56% to $260 million and Carvykti up 49% to $657 million. For the quarter, J&J’s oncology drugs amassed sales of $7.4 billion altogether. “We’re on track to become the No. 1 oncology company by 2030 with sales projected to exceed $50 billion,” Duato said.