Madrigal Pharmaceuticals is paying $120 million upfront for a preclinical GLP-1 receptor agonist that the biopharma plans to pair up with its approved fatty liver disease med Rezdiffra.
The GLP-1 drug, dubbed SYH2086, has been developed by China’s CSPC Pharmaceutical. Preclinical data have “exhibited excellent in vitro agonistic activity as well as in vivo glucose-lowering and weight-loss effects, with a linear pharmacokinetic profile over a wide dose range across multiple animal species, with no significant safety risks observed,” according to Madrigal’s July 30 release.
The idea is that SYH2086 can be paired with Rezdiffra, a selective thyroid hormone receptor agonist that became the first FDA-approved drug for metabolic dysfunction-associated steatohepatitis (MASH) last year. Since then, the drug has beaten analyst expectations by bringing in $137 million in sales for the first quarter of 2025.
“The clinical rationale for developing a combination therapy with Rezdiffra and an oral GLP-1 is clear: we want to optimize efficacy and tolerability in MASH by balancing the weight loss from a GLP-1 with the fibrosis and lipid reduction of Rezdiffra in a once-a-day pill,” Madrigal Chief Medical Officer David Soergel, M.D., said.
“In the pivotal phase 3 Maestro-NASH trial, even modest weight loss of 5% or more enhanced Rezdiffra’s antifibrotic benefit, so we are confident that combination therapy with SYH2086 has the potential to provide increased efficacy for patients with MASH,” Soergel added.
As well as the $120 million upfront price tag, today’s deal means CSPC could be in line for up to $2 billion in development, regulatory and commercial milestone payments as well as royalties on net sales. Madrigal will secure the global license for SYH2086, but CSPC can develop and commercialize other oral GLP-1 drugs in its home territory of China.
“This agreement to acquire global rights to SYH2086 aligns perfectly with our long-term goal to extend our leadership in MASH by building a pipeline anchored by Rezdiffra,” Madrigal’s CEO Bill Sibold said. “We believe a combination of Rezdiffra and SYH2086 has the potential to deliver a best-in-class oral treatment for patients with MASH.”
Rezdiffra is potentially facing competition from a GLP-1 agonist in the form of Novo Nordisk’s semaglutide—the ingredient in its blockbuster obesity drug Wegovy. The Danish drugmaker’s candidate proved its worth in a phase 3 MASH trial earlier this year.
In Madrigal’s first-quarter earnings in May, Sibold pointed out that about 25% of Rezdiffra takers are already on a GLP-1 product, suggesting that there’s still a need for other MASH treatments despite the GLP-1 drugs having been around for more than a decade, albeit not specifically for MASH.
Semaglutide is “only going to accelerate diagnosis and add to that” target, Sibold added at the time, suggesting Novo will expand the market to the benefit of Madrigal as well.
Madrigal isn’t the only company to see potential in CSPC’s pipeline, either. Last month, AstraZeneca—an existing partner of CSPC—handed $110 million in upfront cash to the Chinese company to start work on finding new oral drugs for a range of chronic diseases.