AstraZeneca will tap AI-focused insitro to find new targets for metabolic dysfunction-associated steatohepatitis and cardiomyopathies, following the Phase 3 failure of its Ionis-partnered Wainua in transthyretin-mediated amyloid cardiomyopathy.
AstraZeneca is offering as much as $1.5 billion to work with AI-focused insitro to find new medicines for metabolic dysfunction-associated steatohepatitis and cardiomyopathies.
The companies will search for new targets for drugs using insitro’s Virtual Human AI platform, which aims to identify causal disease biology. AstraZeneca will then advance the candidates through development.
Insitro will receive $40 million upfront and could see $1.46 billion in milestones, plus royalties later on, according to the company’s announcement on Thursday.
The new partnership will add to AstraZeneca’s work in metabolic dysfunction-associated steatohepatitis (MASH), which includes the Phase 1 anti-fibrotic asset AZD2389.
“We know that disease biology is incredibly complex and one of the most critical decisions in R&D is selecting the right target,” Sharon Barr, executive VP and head of BioPharmaceuticals R&D at AstraZeneca, said in a statement.
MASH had long confounded drugmakers until Madrigal Pharmaceuticals broke through, earning an FDA nod for Rezdiffra in 2024. The achievement brought Big Pharma back into the space, with Novo, Roche and GSK striking major deals. Novo has also earned an FDA nod in the indication for its mega-blockbuster semaglutide under the Wegovy brand.
AstraZeneca previously worked with Ionis Pharmaceuticals on a MASH candidate known as AZD2693. The asset was discontinued in November 2025 after it failed to live up to expectations in a Phase 2 trial.
On the cardiomyopathy side, AstraZeneca has a deeper bench, including Ionis-partnered Wainua, which was approved in December 2023 for hereditary transthyretin-mediated amyloidosis (hATTR-PN). The drug recently failed a Phase 3 trial that aimed to build a case for expansion into transthyretin-mediated amyloid cardiomyopathy (ATTR-CM), sending shockwaves across the industry.
Earlier in Phase 1 testing, AstraZeneca is developing AZD4063 for R14del dilated cardiomyopathy.
Insitro on the other hand has shaken hands with myriad Big Pharmas such as Bristol Myers Squibb and Eli Lilly, seeking to build out a pipeline of AI-generated candidates. But the path has not been easy, with insitro laying off 22% of staff in May 2025 in an effort to extend its cash runway during a period of “macroeconomic uncertainty,” the company said at the time.
