Madrigal Pharmaceuticals announced an exclusive global license agreement with Pfizer for the phase‑2 oral diacylglycerol O‑acyltransferase‑2 (DGAT‑2) inhibitor ervogastat, a promising candidate for metabolic dysfunction‑associated steatohepatitis (MASH). The deal includes a $50 million upfront payment and grants Madrigal rights to two additional early‑stage MASH pipeline assets from Pfizer, positioning the company to broaden its portfolio and pursue combination therapies with its approved product Rezdiffra.
Ervogastat works by blocking the final step in triglyceride synthesis, lowering hepatic triglyceride levels and reducing liver inflammation. In a phase‑2 study, 72 % of patients achieved at least a 30 % reduction in liver fat and 61 % achieved a 50 % reduction, with improvements in liver enzymes and stiffness and a favorable safety profile. Madrigal plans a drug‑to‑drug interaction study with Rezdiffra and will discuss a phase‑2 combination trial with the FDA in 2026, aiming to demonstrate additive antisteatotic and antifibrotic efficacy.
The agreement strengthens Madrigal’s competitive moat against emerging GLP‑1 agonists and other MASH candidates. By adding a complementary mechanism of action to Rezdiffra, the company can capture a larger share of the projected $7 billion MASH market by 2029 and potentially $20 billion by 2032. CEO Bill Sibold said the deal “aligns with our long‑term leadership ambition and positions us to unlock the full clinical and commercial value of ervogastat through a combination therapy program.” Professor Quentin Anstee added that the distinct pathways of Rezdiffra and ervogastat “offer a compelling scientific rationale for combination therapy.”
Financially, the $50 million upfront payment will be reflected in Madrigal’s Q4 2025 results, which already show a net loss of $465.9 million on revenue of $740.6 million. The company expects full‑year 2025 sales to exceed $1 billion, driven by Rezdiffra’s strong market uptake. The new license provides a potential source of milestone payments and royalties that could offset the upfront cost and support future growth.
Pfizer’s decision to end work on its ervogastat‑clesacostat combination in November 2025 made the asset available for licensing, underscoring a strategic shift away from that program. Madrigal will present more details on the agreement at the 44th Annual J.P. Morgan Healthcare Conference on January 12 2026, where it will outline the development timeline and potential milestone triggers for the new assets.
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