JPM26: Madrigal seeks early dominance in MASH by means of strategic acquisitions
Madrigal Prescribed drugs used its January 12 presentation on the J.P. Morgan Healthcare Convention 2026 to showcase its newly acquired property from Pfizer – ervogastat and two preclinical property – in addition to define its imaginative and prescient for dominance in metabolic dysfunction-associated steatohepatitis (MASH) remedy house by means of leveraging early industrial success. Its professed technique of pursuing mixture therapies whereas the market stays in its infancy may nicely end in Madrigal’s model changing into intrinsically linked to MASH remedy.
The industrial efficiency of Rezdiffra (resmetirom) offers clear validation for Madrigal’s objectives. Rezdiffra reached $287m in internet gross sales throughout Q3 2025, with annualised income exceeding $1bn within the sixth quarter post-launch. The ten,000+ prescribers and greater than 29,500 lively sufferers exhibit real and widespread medical uptake pushed by a differentiated once-daily oral profile. These metrics present that Madrigal has efficiently recognized and addressed unmet want in a traditionally difficult therapeutic space.
Entry deeper business intelligence
Expertise unmatched readability with a single platform that mixes distinctive information, AI, and human experience.
With the present MASH market at solely $180m throughout two accredited merchandise, Madrigal has a slim window to take a position from a place of power earlier than bigger pharmaceutical corporations with higher sources enter the house. By securing rights to complementary mechanisms, together with Pfizer’s DGAT-2 inhibitor ervogastat and the oral GLP-1 agonist MGL-2086, Madrigal is now positioning itself for a long-term presence in MASH.
Main pharmaceutical corporations are already quickly increasing their involvement within the MASH house, with Roche’s acquisition of 89bio, Novo Nordisk’s acquisition of Akero and GSK’s acquisition of efimosfermin from Boston Pharma. All three property are FGF21 analogs, belonging to a extremely potent, subcutaneously-administered drug class, which boasts spectacular MASH decision and fibrosis enchancment information, significantly in longer trials. As soon as accredited, these property may slim the marketplace for Rezdiffra, which underlines the significance of mixture approaches that might compound Rezdiffra’s results.
Critically, Madrigal is focusing solely on orally administered property that might probably be mixed with Rezdiffra right into a single pill. This method would maximise adherence and comfort for sufferers, whereas creating significant differentiation over rivals which are pursuing injectable property. The one-tablet technique demonstrates considerate consideration of real-world remedy dynamics in a power metabolic illness the place long-term adherence is important for profitable outcomes.
The newly introduced mixture of ervogastat and Rezdiffra has evident potential. DGAT-2 inhibition can block triglyceride synthesis whereas THR-β agonism enhances lipid oxidation, creating complementary exercise by means of distinct pathways. Ervogastat’s Section IIb information, which confirmed 61% of sufferers attaining ≥50% liver fats discount by MRI-PDFF, offers tangible proof of potent anti-steatotic exercise. Whereas Pfizer’s trial failed to realize statistical significance for ervogastat monotherapy, Madrigal is strategically selecting to not develop it as a monotherapy.
The oral GLP-1 technique showcases related sophistication by Madrigal. Not like Novo Nordisk’s Wegovy (semaglutide), Madrigal has opted to not pursue dramatic weight reduction that may invite tolerability issues, which it cited in its JPM presentation as a motive for Wegovy’s excessive discontinuation charges. As an alternative, Madrigal targets modest discount primarily based on compelling MAESTRO-NASH information displaying sufferers attaining ≥5% weight reduction demonstrated by meaningfully increased response charges of 39% versus 28% on the 80mg dose. By aiming for gradual, tolerable weight discount, the corporate optimises important fibrosis discount whereas sustaining the tolerability profile that has pushed Rezdiffra’s adoption.
Madrigal’s MASH F4c growth technique outlined at JPM 2026 demonstrates how indication growth and mixture improvement work synergistically. With roughly 245,000 cirrhotic sufferers dealing with 42-fold increased liver-related mortality threat, the addressable market is appreciable. Success within the Section III MAESTRO-NASH OUTCOMES trial in MASH F4 would considerably broaden Rezdiffra’s market alternative whereas creating superb circumstances for mixture remedy adoption if monotherapy proves inadequate for probably the most extreme sufferers.
Madrigal is executing a multifaceted technique that balances near-term industrial success with long-term model constructing. The corporate recognized an enormous unmet want, developed the primary accredited asset, executed a profitable launch, and is now leveraging that success to consolidate its market place. Regardless of being an organization that’s lower than two years into its first industrial launch, Madrigal seems set to develop into a mainstay within the MASH remedy house for the foreseeable future.
Enroll right here to obtain day by day updates on the newest healthcare business developments rising from the JP Morgan Healthcare convention 2026. Enroll right here to obtain a complete report after the convention.
