Shares of Alnylam Pharmaceuticals (ALNY -0.28%) were sinking 9.5% lower as of 11:27 a.m. ET on Thursday after falling as much as 12.6% earlier in the day. The sell-off came after the drugmaker announced its fourth-quarter and full-year 2023 results.

Alnylam reported Q4 total revenue of $439.7 million, up 31% year over year. This result came in a little below the average analysts' estimate of $442.9 million.

The company posted a net loss in Q4 of $137.9 million, or $1.10 per share, based on generally accepted accounting principles (GAAP). Alnylam's non-GAAP net loss was $96.6 million, or $0.77 per share. The consensus Wall Street estimate was for a net loss of $1.32 per share.

What likely concerned investors more than Alnylam's mixed Q4 results

It's not unheard of for a biotech stock to fall on mixed quarterly results. However, there was another issue in Alnylam's Q4 update that likely concerned investors more than the narrow Q4 revenue miss.

The company announced an updated statistical analysis plan and revised timing for its Helios-B phase 3 study evaluating vutrisiran (Amvuttra) in treating rare genetic disease transthyretin amyloid cardiomyopathy (ATTR-CM). Alnylam will now focus on "outcome measures in overall and monotherapy populations." It tweaked secondary endpoints. Up to three months was also added to the trial.

Why would investors react negatively to this revised plan? BMO Capital Markets analyst Kostas Biliouris speculated in a note to investors that the changes to the clinical trial design could be viewed as a "lack of management's confidence" in the Helios-B results.

Is Alnylam stock a smart pick to buy on the dip?

I'm not concerned about Alnylam's small Q4 revenue miss. Three of the company's four approved products continue to deliver strong sales growth. Onpattro's sales are declining, but it's due to cannibalization by Amvuttra.

Perhaps Alnylam's management was concerned about the potential of failure with the initial design of the Helios-B study. However, they seem more confident of success with the changes to the trial.

Alnylam remains a risky stock that conservative investors will be better off avoiding. I think that more aggressive investors, though, could consider taking advantage of the opportunity presented by the current dip by scooping up some shares.