CONSHOHOCKEN, PA — Madrigal Pharmaceuticals, Inc. (Nasdaq: MDGL) reported first-quarter Rezdiffra sales of $311.3 million, more than doubling from a year earlier as physician adoption accelerated for the company’s liver disease treatment, while Madrigal expanded its pipeline through new licensing and siRNA development deals.
Net revenue increased 127% from $137.3 million in the prior-year quarter. The company said more than 42,250 patients were receiving Rezdiffra as of March 31, roughly 2.5 times the number reported a year earlier.
Rezdiffra, known chemically as resmetirom, is currently the only FDA-approved liver-directed therapy for metabolic dysfunction-associated steatohepatitis, or MASH.
Madrigal also announced a licensing agreement earlier this month with Arrowhead Pharmaceuticals, Inc. for global rights to ARO-PNPLA3, an experimental small interfering RNA therapy targeting a genetic mutation associated with advanced liver fibrosis in certain MASH patients.
The company said Phase 1 data for the therapy showed up to a 46% reduction in liver fat at the highest tested dose among patients carrying the PNPLA3 I148M mutation.
In February, Madrigal also added six preclinical siRNA programs intended to support development of combination therapies targeting MASH.
Chief Executive Officer Bill Sibold pointed to continued physician adoption and growing patient demand for Rezdiffra as drivers of the company’s commercial performance.
“Rezdiffra has achieved blockbuster status on a trailing-12-month net sales basis,” Sibold said in a statement.
Despite revenue growth, Madrigal reported a first-quarter net loss of $94.4 million, or $3.25 per share, compared with a loss of $73.2 million, or $2.61 per share, a year earlier.
Research and development expenses more than doubled to $108.7 million, largely due to $54.3 million in one-time business development expenses tied to pipeline expansion efforts.
Selling, general and administrative expenses rose to $268.5 million from $167.9 million as the company expanded its endocrinology sales force and increased direct-to-consumer marketing for Rezdiffra.
Madrigal ended the quarter with $817.9 million in cash, cash equivalents, restricted cash and marketable securities, down from $988.6 million at the end of 2025.
The company also said Phase 1 testing for its oral GLP-1 candidate MGL-2086 remains on track to begin during the second quarter, while a drug interaction study involving ervogastat and resmetirom is expected to start in the fourth quarter.
Madrigal plans to present eight abstracts later this month at the European Association for the Study of the Liver Congress in Barcelona, including additional analyses related to cardiovascular markers and one-year real-world efficacy data for Rezdiffra.
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