CONSHOHOCKEN, PA — Madrigal Pharmaceuticals Inc. (Nasdaq: MDGL) reported a 71% increase in second-quarter revenue as adoption of its liver-disease drug Rezdiffra expanded, though higher commercial and research spending widened the biotechnology company’s quarterly loss.
Net revenue rose to $364.3 million from $212.8 million a year earlier, driven by U.S. demand for Rezdiffra, the company’s treatment for metabolic dysfunction-associated steatohepatitis, or MASH.
More than 49,000 patients were taking Rezdiffra as of June 30, more than double the number a year earlier. Madrigal indicated that active patients surpassed 50,000 in July.
Rezdiffra generated nearly $1.3 billion in net sales over the preceding 12 months, according to Chief Executive Officer Bill Sibold.
“We’re still at the beginning of one of the largest opportunities in biotechnology,” Sibold stated, citing low diagnosis and treatment rates in the MASH market.
Madrigal posted a second-quarter net loss of $57.9 million, or $1.99 per share, compared with a loss of $42.3 million, or $1.50 per share, in the prior-year quarter.
The latest loss included $25 million in upfront business-development expenses, equal to 86 cents per share.
Operating expenses increased to $420.6 million from $260 million. The 2026 total included $35.4 million in stock-based compensation, compared with $25.2 million a year earlier.
Selling, general and administrative expenses climbed to $289.4 million from $196.9 million as Madrigal expanded its endocrinology sales force and invested in marketing, including a direct-to-consumer campaign.
Research and development spending rose to $91.2 million from $54.1 million, primarily because of the $25 million business-development charge.
Cost of sales increased to $40 million from $9.1 million. Madrigal attributed the increase to higher royalties owed to Roche as Rezdiffra sales grew and a write-down of certain work-in-process inventory.
The company held $838.9 million in cash, restricted cash and marketable securities as of June 30, down from $988.6 million at the end of 2025.
Madrigal also expanded its intellectual-property portfolio with three new U.S. patents covering resmetirom, Rezdiffra’s active ingredient.
Two patents relate to the drug’s approved use in patients with F2-F3 MASH, including dosing with certain CYP2C8 inhibitors and limits on concurrent rosuvastatin use. Madrigal expects those patents to provide protection into 2045 and 2042, respectively.
A third patent covers administration of resmetirom to treat well-compensated cirrhosis, or F4c, and is expected to provide protection into 2042.
The company advanced MGL-2086, an experimental oral GLP-1 receptor agonist, into a Phase 1 trial in June. Madrigal is evaluating the drug as a potential once-daily combination treatment with Rezdiffra.
Initial dosing began in healthy volunteers to assess safety and dose response. Madrigal cited Phase 3 findings indicating that weight loss of at least 5% may enhance Rezdiffra’s antifibrotic effect as support for the combination strategy.
Separately, real-world data presented in May showed that nearly half of Rezdiffra-treated patients achieved at least a 25% improvement in liver stiffness after an average follow-up of about nine months, according to the company.
Madrigal also reported that the share of higher-risk F4c patients in a clinical analysis declined to 54.5% after two years from 75% at baseline.
Additional analyses found that Rezdiffra reduced several lipoproteins associated with cardiovascular risk, including LDL cholesterol and lipoprotein(a), regardless of patients’ baseline statin use.
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