Madrigal strikes USD4.4B deal with Suzhou Ribo Life Science to advance liver disease treatments

USA—Madrigal Pharmaceuticals is making a major push into the liver disease market with a blockbuster agreement that could be worth up to USD 4.4 billion.

The Philadelphia-based company has partnered with Suzhou Ribo Life Science, a Chinese biotech firm, and its subsidiary, Ribocure Pharmaceuticals, to develop new treatments for metabolic dysfunction-associated steatohepatitis (MASH).

The deal structure

Under the terms of the agreement, Madrigal will pay USD 60 million upfront to secure development and commercialization rights to six of Ribo’s experimental therapies.

These treatments use a technology called silent interfering RNA, or siRNA, which works by turning off specific genes that produce proteins responsible for driving MASH.

Ribo stands to receive milestone payments tied to development progress, regulatory approvals, and commercial success that could total USD 4.4 billion.

 The Chinese company will also earn royalties on future sales of these treatments.

The partnership gives Madrigal additional flexibility to license other early-stage programs from Ribo’s pipeline down the road.

This includes several bispecific siRNA candidates that Ribo is currently developing, according to a company announcement.

Combining Forces with Rezdiffra

What makes this deal particularly strategic is Madrigal’s plan to combine these new siRNA therapies with Rezdiffra, its already-approved MASH treatment.

David Soergel, Madrigal’s chief medical officer, explained the rationale behind this approach.

“siRNAs are highly liver targeted, and there are several genes implicated in MASH that could be addressed with an mRNA-knockdown approach,” he said.

 “The precision of siRNA gene silencing, combined with Rezdiffra, has the potential to create the next generation of MASH treatment: genetically targeted therapies for patients with unmet needs.”

Ribo’s Platform Technology

At the heart of this collaboration sits Ribo’s GalSTAR platform, a specialized system designed to help develop RNA interference therapeutics that target disease-causing genes in liver conditions.

The platform has already attracted attention from major pharmaceutical players.

German drug giant Boehringer Ingelheim signed a USD2 billion deal with Ribo in 2024 to use the same technology for developing siRNA treatments for liver diseases.

Understanding MASH

MASH, which was previously called nonalcoholic steatohepatitis, occurs when fat builds up in the liver and triggers ongoing inflammation.

This chronic inflammation can eventually lead to scarring, liver cirrhosis, or even liver cancer.

The condition affects millions of people worldwide and represents a significant unmet medical need.

Madrigal’s MASH strategy

Madrigal made history in 2024 as the first company to win approval for a drug specifically designed to treat MASH.

That drug, Rezdiffra, works as a thyroid hormone receptor beta agonist. Since that breakthrough, the company has doubled down on its MASH focus.

It acquired Pfizer’s experimental drug ervogastat for USD50 million, along with two other preclinical compounds targeting the disease.

Madrigal believes combining ervogastat with Rezdiffra could deliver additional clinical benefits for patients.

Rezdiffra has quickly become a commercial success, generating USD287.3 million in revenue during the third quarter of 2025 alone.

Market analysts at GlobalData predict sales will surge to USD6.9 billion by 2032, though the drug will likely achieve blockbuster status when 2025 financial results are released.

Growing competition

Madrigal now faces competition from Novo Nordisk, whose blockbuster weight-loss drug Wegovy became the first GLP-1 receptor agonist approved for MASH in August 2025.

Novo Nordisk has continued expanding its presence in this market by acquiring MASH specialist Akero for up to USD 5.2 billion.

Despite increasing competition, the overall MASH market shows enormous growth potential.

GlobalData forecasts the market will reach USD20.3 billion by 2032, representing a compound annual growth rate of 38.2% from 2022.