Madrigal will study SYH2086 in combination with Rezdiffra for metabolic dysfunction-associated steatohepatitis, aiming for clinical trials in early 2026.
Madrigal Pharmaceuticals is looking to China to deepen its metabolic expertise, partnering with Shijiazhuang-based CSPC Pharmaceutical Group Limited to advance an oral preclinical GLP-1 therapy for metabolic dysfunction-associated steatohepatitis.
Under the terms of the deal, announced Wednesday, Madrigal will pay an up-front fee of $120 million and put a potential $2 billion on the line for future development, regulatory and commercial milestones. CSPC will also be eligible for royalties on net product sales. The partners expect to complete the transaction by the end of 2025, pending relevant regulatory clearances.
The star of Wednesday’s collaboration is SYH2086, an orally available GLP-1 analog the companies say is a “derivative” of Eli Lilly’s orforglipron. The asset is still in preclinical development. According to the partners, preclinical data points to “excellent” activity for SYH2086, leading to glucose-lowering and weight-loss benefits in in vitro models.
Preclinical safety findings also identified no concerning signals, as per the companies’ release.
“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 CEO Bill Sibold said in a prepared statement on Wednesday. The biotech expects to start clinical MASH trials for SYH2086 in the first half of 2026.
In particular, Madrigal plans to test out a combination therapy of SYH2086 with Rezdiffra, Madrigal’s FDA-approved drug for MASH. According to chief medical officer David Soergel, such an approach could “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 estimates that the combination of Rezdiffra and SYH2086 could be a best-in-class MASH treatment.
Rezdiffra became the first—and is still so far the only—FDA-approved drug for MASH in March 2024. After its launch a month later, Rezdiffra in 2024 managed to reach more than 11,800 patients and generate sales of $180.1 million. The drug has maintained its market momentum into this year: as of March 31, upwards of 17,000 had been treated with Rezdiffra, according to Madrigal’s first-quarter report, with sales exceeding $137 million.
Madrigal expects Rezdiffra to hit blockbuster status in the coming year, according to its presentation at the 43rd J.P. Morgan Healthcare Conference in January.
Elsewhere in the MASH space, GSK in May bet $2 billion to acquire Boston Pharmaceuticals’ efimosfermin alfa, an investigational FGF21 analog that works by helping to lower fat, easing inflammation and reversing fibrosis in the liver. Efimosfermin alfa is primed for Phase III development.
