FORM 4 [X] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).         
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
                                                                                  
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

Howarth Alex G.
2. Issuer Name and Ticker or Trading Symbol

AKCEA THERAPEUTICS, INC. [ AKCA ]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

_____ Director                    _____ 10% Owner
__X__ Officer (give title below)    _____ Other (specify below)
Chief Operating Officer
(Last)          (First)          (Middle)

C/O AKCEA THERAPEUTICS, INC., 22 BOSTON WHARF ROAD, 9TH FLOOR
3. Date of Earliest Transaction (MM/DD/YYYY)

10/12/2020
(Street)

BOSTON, MA 02210
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

 
6. Individual or Joint/Group Filing (Check Applicable Line)

_X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 10/12/2020  U  66800 D$18.15 0 D  

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security3. Trans. Date3A. Deemed Execution Date, if any4. Trans. Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
6. Date Exercisable and Expiration Date7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)11. Nature of Indirect Beneficial Ownership (Instr. 4)
CodeV(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares
Stock Option (right to buy) $17.94 10/12/2020  D     300000   (1)12/1/2029 Common Stock 300000 $0.21 0 D  
Stock Option (right to buy) $12.76 10/12/2020  D     34200   (2)3/18/2030 Common Stock 34200 $5.39 0 D  

Explanation of Responses:
(1) This option, which provided that 25% of the shares would vest on December 2, 2020 and then in equal monthly installments over the next three years, was cancelled in connection with the merger of the Issuer with a wholly owned subsidiary of Ionis Pharmaceuticals, Inc. in exchange for a cash payment of $63,000.00, representing the difference between the exercise price of the option and the acquisition price of $18.15.
(2) This option, which provided that 1/4th of the shares would vest one year after March 19, 2020 and 1/48th of the shares would vest monthly thereafter over the next three years, was cancelled in connection with the merger of the Issuer with a wholly owned subsidiary of Ionis Pharmaceuticals, Inc. in exchange for a cash payment of $184,338.00, representing the difference between the exercise price of the option and the acquisition price of $18.15.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director10% OwnerOfficerOther
Howarth Alex G.
C/O AKCEA THERAPEUTICS, INC.
22 BOSTON WHARF ROAD, 9TH FLOOR
BOSTON, MA 02210


Chief Operating Officer

Signatures
/s/ Joshua F. Patterson, Attorney-in-Fact10/12/2020
**Signature of Reporting PersonDate

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