The pact between Madrigal Pharmaceuticals and Ruzhou Ribo Life Sciences could complement the former’s Rezdiffra, the first FDA-approved therapy for MASH. That drug made $287.3 million in the third quarter of 2025.
Madrigal Pharmaceuticals is leaning further into its liver disease portfolio, inking a preclinical partnership with Chinese biotech Suzhou Ribo Life Science for six investigational siRNA programs aimed at the liver.
Under the terms of the agreement, Madrigal is fronting $60 million and promising up to $4.4 million in certain milestone payments across all programs. Ribo, which entered the alliance via its subsidiary Ribocure Pharmaceuticals, will also be eligible for royalties on net sales.
Madrigal plans to test combination regimens of these siRNA therapies with its metabolic associated steatohepatitis (MASH) drug Rezdiffra, which scored the first FDA approval in the indication in March 2024. The company expects to start IND-enabling activities for initial candidates from the Ribo deal in 2026.
SiRNAs—small stretches of non-coding RNA that bind to a target mRNA molecule, in turn preventing its translation into a protein—offer a precision gene silencing approach to MASH, Madrigal said in its Wednesday release.
“SiRNAs are highly liver targeted, and there are several genes implicated in MASH that could be addressed with an mRNA-knockdown approach,” Chief Medical Officer David Soergel said in a statement. Combined with Rezdiffra, he added, Ribo’s siRNA approach “has the potential to create the next generation of MASH treatment.”
Madrigal did not provide specific data about Ribo’s preclinical siRNA candidates in its Wednesday release. It remains unclear which genes the partners plan to silence or what disease pathways they want to target. Madrigal did note, however, that with the Ribo deal it now has more than 10 MASH molecules addressing different drivers of the disease.
Madrigal’s MASH pipeline is anchored by Rezdiffra. Following the drug’s FDA approval, Madrigal continued to develop Rezdiffra, which is now in a late-stage study for compensated MASH cirrhosis. Data from this trial are expected in 2027, according to the biotech’s third quarter 2025 presentation.
In 2024, Rezdiffra reached more than 11,800 patients and delivered net sales of $180.1 million. In the third quarter of 2025, Rezdiffra’s net revenues surged to $287.3 million, compared to $62.2 million during the same period the year before. Madrigal is set to report its full year 2025 earnings report on Feb. 19.
Following in Rezdiffra’s footsteps in Madrigal’s pipeline is ervogastat, an orally available blocker of the DGAT protein that is currently in mid-stage development for MASH. Ervogastat came to Madrigal last month when it paid $50 million upfront to license the molecule from Pfizer, potentially opening up a complementary mechanism of treatment to Rezdiffra. Under this agreement, Pfizer could receive up undisclosed additional payments for certain milestones.
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