Poor Amgen (NASDAQ:AMGN). When the company started the five-year TREAT trial, it probably figured the results would just be the cherry on top of a growing Aranesp franchise. Instead, it's in a bit of a bind and really could have used a positive result from the trial of more than 4,000 patients with chronic kidney disease, anemia, and type-2 diabetes.

No such luck. The trial failed to show that Aranesp could extend the time it took to experience a cardiovascular event like a heart attack and also failed to show that it took longer for a patient to progress to dialysis.

That's about as weak as a clinical trial result can get without outright failure. It's not going to help sales, but it's probably not likely to hurt, either.

As with Johnson & Johnson's (NYSE:JNJ) anemia drug Procrit, Aranesp sales have been slipping away after a smaller study by J&J showed a higher risk of death in patients who were treated aggressively.

 

2006

2007

2008

First half 2009

Aranesp sales (in millions)

$4,121

$3,614

$3,137

$1,319

Year-over-year increase (decrease)

26%

(12%)

(13%)

(17%)

Source: Company press releases.

While positive results could have helped Anaresp, it's not the end of the world. Like Amylin Pharmaceuticals' (NASDAQ:AMLN) pancreatitis issues with Byetta or Elan's (NYSE:ELN) and Biogen Idec's (NASDAQ:BIIB) PML issues with Tysabri, drugmakers almost always have a backup plan for slow sales when side effects crop up.

For Amgen, that plan lies in its osteoporosis drug Prolia, which could hit the market late next year. Instead of the TREAT trial for Aranesp, the new cherry is Prolia's potential to treat cancer patients, for which Amgen could get marketing approval next year.

Elan is a Motley Fool Rule Breakers pick. The newsletter is always on the hunt for hot drug stocks and other cutting-edge picks. See all of our latest discoveries with a free 30-day trial.

Fool contributor Brian Orelli, Ph.D., doesn't own shares of any company mentioned in this article. Johnson & Johnson is a selection of the Income Investor newsletter. The Fool has a disclosure policy.