MDGL Strengthens MASH Franchise With New Genetic Approaches

Madrigal Pharmaceuticals MDGL announced an exclusive global licensing agreement with Suzhou Ribo Life Science Co. Ltd. (Ribo) and its subsidiary, Ribocure Pharmaceuticals AB (Ribocure), covering six preclinical small interfering RNA (siRNA) programs, further strengthening its pipeline of innovative and combination therapies for metabolic dysfunction-associated steatohepatitis (“MASH”).

Financial Highlights

Per the terms of the agreement, Madrigal obtained exclusive worldwide rights to develop, manufacture and commercialize the six siRNA candidates. Madrigal will pay Ribo an upfront payment of $60 million. Ribo will also receive up to $4.4 billion in aggregate milestone payments contingent upon the successful development and commercialization of these candidates, along with tiered royalties on net sales.

siRNA is a treatment approach in which small RNA molecules are delivered into hepatocytes to silence specific genes in MASH by selectively reducing the production of certain disease-causing proteins.

Madrigal anticipates submitting an investigational new drug application for each of the initial siRNA candidates to the FDA in 2026.

Over the past year, shares of Madrigal have risen 36.8% compared with the industry’s 2.8% growth.

MASH, previously known as NASH, is a serious liver disease that can lead to cirrhosis, liver failure, liver cancer and even death.

MDGL’s Rezdiffra Overview & Development Strategy in MASH

Madrigal is focused on developing combination therapies for MASH treatment. Rezdiffra is the first approved therapy for MASH. It is a once-daily, oral, liver-directed THR-β agonist, prescribed in conjunction with diet and exercise for the treatment of adults with MASH with moderate-to-advanced liver scarring (fibrosis).

The drug was commercially launched in the United States in April 2024 and received conditional marketing authorization in the European Union for MASH in August 2025.

MDGL is further evaluating Rezdiffra in a late-stage study for the treatment of patients with compensated MASH cirrhosis (F4c).

Madrigal intends to evaluate siRNA programs in combination with Rezdiffra to determine whether addressing disease drivers at the genetic level can enhance treatment outcomes.

Other Pipeline Updates

Beyond Rezdiffra, MDGL’s pipeline includes MGL-2086, an oral GLP-1 receptor agonist, ervogastat, a phase II oral DGAT-2 inhibitor, six preclinical siRNA programs and additional exploratory assets at various stages of development.

The company anticipates initiating first-in-human studies evaluating MGL-2086 in the second quarter of 2026.

MDGL acquired exclusive global rights to ervogastat from Pfizer PFE in January. By licensing it from Pfizer, the company intends to combine it with its approved therapy Rezdiffra, maximizing its clinical outcomes and commercial potential. Madrigal plans to conduct a drug-to-drug interaction study with Rezdiffra and consult the FDA on designing a phase II combination study for MASH patients this year.

Madrigal’s Zacks Rank & Stocks to Consider

MDGL currently carries a Zacks Rank #4 (Sell).

Some better-ranked stocks in the biotech sector are Exelixis EXEL and Alkermes ALKS, each currently sporting a Zacks Rank #1 (Strong Buy). You can see the complete list of today’s Zacks #1 Rank stocks here.

Over the past 60 days, estimates for Exelixis’ 2026 earnings per share have risen from $3.18 to $3.39. EXEL shares have surged 24.6% over the past year.

Exelixis’ earnings beat estimates in each of the trailing four quarters, with the average surprise being 24.95%.

Over the past 60 days, estimates for Alkermes’ 2026 earnings per share have increased from $1.54 to $1.91. ALKS shares have lost 3.1% over the past year.

Alkermes’ earnings beat estimates in three of the trailing four quarters and missed in the remaining one, with the average earnings surprise being 4.58%.

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This article originally published on Zacks Investment Research (zacks.com).

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