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Biogen’s (BIIB) Spinraza, a treatment for the rare and deadly spinal muscular atrophy, got off to a record-setting start, but U.S. growth is already waning, three quarters into the commercial launch.

Spinraza U.S. sales totaled $198 million in the third quarter, almost flat compared to the second quarter, setting off alarms among investors. Biogen’s shares are down 7 percent on Tuesday morning following the biotech firm’s third-quarter earnings report. Ionis Pharmaceuticals (IONS), which received royalties on Spinraza sales, fell 13.5 percent.

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