It was May 2013 when we first wrote about John Maraganore, CEO of Alnylam Pharmaceuticals. Back then we posited that he had navigated Alnylam to the brink of a big breakthrough with its ribonucleic acid interference (RNAi) platform. Considering it is almost five years later, and we have yet to see this “breakthrough,” you might be wondering if our definition of “brink” was calculated in dog years. Not quite. As you are well aware, the road to drug discovery and development is lengthy, expensive, and often filled with potholes and roadblocks. Such hazards can delay or prevent a company from ever reaching its aspired destination. For example, this past September a clinical hold was placed on all clinical studies involving fitusiran, Alnylam’s investigational RNAi therapeutic targeting antithrombin for the treatment of patients with hemophilia A and B.