Madrigal Pharmaceuticals Reports First-Quarter 2026 Financial Results and Provides Corporate Updates
- First-quarter 2026 Rezdiffra® (resmetirom) net sales of
$311.3 million , representing year-over-year growth of 127% - As of
March 31, 2026 , more than 42,250 patients on Rezdiffra, up 2.5x from 1Q25, reflecting continued strong physician adoption and high patient demand - Advances pipeline with global licensing agreement for a clinical-stage siRNA asset targeting a mutation in the PNPLA3 gene, a genetically validated driver of MASH
- MGL-2086 (oral GLP-1) Phase 1 trial on track to initiate in 2Q26; ervogastat/resmetirom drug-drug interaction study on track to initiate in 4Q26
- Reports cash, cash equivalents, restricted cash and marketable securities of
$817.9 million as ofMarch 31, 2026 - Company to host conference call today,
May 6, 2026 , at8 a.m. EDT
Sibold continued: “We also strengthened our pipeline with a clinical stage siRNA asset targeting a mutation in the PNPLA3 gene that predisposes a significant portion of people with MASH to advanced liver fibrosis, including progression to cirrhosis. This new asset advances our strategy to develop next-generation combination therapies across the spectrum of disease. With our strong cash position and intellectual property protection for Rezdiffra expected into 2045, we are well-positioned to maintain our leadership in MASH, supported by the differentiated clinical profile of Rezdiffra as the only approved liver-directed therapy for this disease, our growing commercial success and an expanding, industry-leading MASH pipeline.”
First Quarter 2026 and Recent Corporate Updates
- Madrigal adds clinical-stage siRNA asset targeting PNPLA3 mutation
- On
May 5 , Madrigal announced a licensing agreement with Arrowhead Pharmaceuticals, Inc. for global rights to ARO-PNPLA3, a clinical stage GalNAc-conjugated small interfering RNA (siRNA) asset designed to reduce expression of PNPLA3, a genetically validated driver of MASH. - ARO-PNPLA3 targets MASH patients who are homozygous for a mutation in the PNPLA3 gene, which is highly prevalent among Hispanic patients and represents approximately 30% of patients with moderate to advanced fibrosis (consistent with stages F2 and F3).
- Data from a Phase 1 trial of ARO-PNPLA3 demonstrated up to a 46% reduction in liver fat (as measured by MRI-PDFF) at 12 weeks following a single dose at the highest dose level tested in PNPLA3 I148M homozygous patients.
- On
- Expanded pipeline with global rights to six pre-clinical siRNA programs
- In
February 2026 , Madrigal expanded its MASH pipeline with six innovative siRNA programs, providing the potential for a genetically targeted approach, combined with the broad efficacy of Rezdiffra, to create the next generation of MASH therapies. - Preclinical development is underway.
- In
- Strong scientific presence at the upcoming
EASL Congress - Madrigal will present 8 abstracts at the
European Association for the Study of Liver (EASL) Congress , taking placeMay 27-30, 2026 , inBarcelona, Spain . - Accepted abstracts include a poster featuring a secondary analysis from Madrigal’s MAESTRO-NASH/NAFLD1 trials showing that Rezdiffra reduced Lp(a) and LDL-C in patients with MASH, supporting its potential to reduce cardiovascular risk independent of baseline statin use, as well as two posters sharing real-world efficacy data for patients on Rezdiffra for up to one year.
- Madrigal will present 8 abstracts at the
First-Quarter 2026 Financial Results
- Total Revenues: First-quarter 2026 net revenues were
$311.3 million , an increase of 127% compared to$137.3 million in the comparable prior year period. - Operating Expenses: First-quarter 2026 operating expenses were
$404.1 million , inclusive of$34.0 million in non-cash stock-based compensation expense, compared to operating expenses of$216.6 million , inclusive of$20.9 million in non-cash stock-based compensation expense for the prior year period. First-quarter operating expenses also included one-time, upfront business development expenses of$54.3 million for strategic pipeline expansion.- Cost of Sales: First-quarter 2026 cost of sales was
$26.8 million compared to$4.5 million in the comparable prior year period. This was inclusive of non-cash stock-based compensation expense. - R&D Expenses: First-quarter 2026 R&D expenses were
$108.7 million compared to$44.2 million in the comparable prior year period, both inclusive of non-cash stock-based compensation expense. The increase in R&D expenses was primarily due to one-time, upfront business development expenses of$54.3 million . - SG&A Expenses: First-quarter 2026 SG&A expenses were $268.5 million compared to $167.9 million in the comparable prior year period, both inclusive of non-cash stock-based compensation expense. The increase was primarily due to continued investment in commercial activities for Rezdiffra, including headcount for the endocrinology field force expansion that began in the fourth quarter of 2025, as well as marketing efforts, including a direct -to-consumer (DTC) campaign.
- Cost of Sales: First-quarter 2026 cost of sales was
- Net Loss: First-quarter 2026 net loss was
$94.4 million or$3.25 per share (basic and diluted) compared to a net loss of$73.2 million or$2.61 per share (basic and diluted) in the comparable prior year period. Net loss in 2026 was inclusive of one-time, upfront business development expenses of$54.3 million , or$1.87 per share.
- Cash, Cash Equivalents,
Restricted Cash and Marketable Securities : As ofMar. 31, 2026 , Madrigal had cash, cash equivalents, restricted cash, and marketable securities of$817.9 million , compared to$988.6 million as ofDec. 31, 2025 .
Conference Call and Webcast
At
About MASH
Metabolic dysfunction-associated steatohepatitis (MASH) is a serious liver disease that can progress to cirrhosis, liver failure, liver cancer, the need for liver transplantation, and premature mortality. MASH is the leading cause of liver transplantation in women and the second leading cause of all liver transplantation in the
Once patients progress to MASH with moderate to advanced liver fibrosis (consistent with stages F2 to F3 fibrosis), the risk of adverse liver outcomes increases dramatically: these patients have a 10 to 17 times higher risk of liver-related mortality as compared to patients without fibrosis. Patients with MASH who progress to cirrhosis face a 42 times higher risk of liver-related mortality, underscoring the need to treat MASH before complications of cirrhosis develop. MASH is also an independent driver of cardiovascular disease, the leading cause of mortality for patients.
As disease awareness improves and disease prevalence increases, the number of diagnosed patients with F2 to F4c MASH is growing.
About Madrigal
Forward Looking Statements
This press release includes “forward-looking statements” made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, as amended, including statements related to the expected growth of Rezdiffra sales in 2026, expectations regarding patent protection for Rezdiffra, Madrigal’s clinical development plans and timelines for its pipeline, Madrigal’s leadership position in the MASH sector, the potential size of the MASH market, the potential benefit of Rezdiffra in patients with compensated MASH cirrhosis and the potential benefit of siRNAs in the treatment of MASH. Forward-looking statements are subject to a number of risks and uncertainties including, but not limited to: the assumptions underlying the forward-looking statements; our ability to successfully commercialize Rezdiffra in the
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(tables follow)
| Condensed Consolidated Statement of Operations | |||||||
| (in thousands, except share and per share amounts) | |||||||
| (unaudited) | |||||||
| Three Months Ended | |||||||
| 2026 | 2025 | ||||||
| Revenues: | |||||||
| Product revenue, net | $ | 311,337 | $ | 137,250 | |||
| Operating expenses: | |||||||
| Cost of sales | 26,847 | 4,513 | |||||
| Research and development | 108,692 | 44,172 | |||||
| Selling, general and administrative | 268,521 | 167,876 | |||||
| Total operating expenses1 | 404,060 | 216,561 | |||||
| Loss from operations | (92,723 | ) | (79,311 | ) | |||
| Interest income | 8,243 | 9,370 | |||||
| Interest expense | (7,819 | ) | (3,297 | ) | |||
| Other expense, net | (2,092 | ) | - | ||||
| Net loss | $ | (94,391 | ) | $ | (73,238 | ) | |
| Basic and diluted net loss per common, Series A | |||||||
| preferred, and Series B preferred share | $ | (3.25 | ) | $ | (2.61 | ) | |
| Basic and diluted weighted average number of shares outstanding2 | 29,032,422 | 28,085,234 | |||||
| (1) Amounts include non-cash stock-based compensation expense as follows: | |||||||
| Cost of sales | $ | 96 | $ | - | |||
| Research and development | $ | 7,865 | $ | 5,215 | |||
| Selling, general and administration | $ | 26,057 | $ | 15,716 | |||
| Total stock-based compensation | 34,018 | 20,931 | |||||
| (2) Basic and diluted weighted average number of shares outstanding are inclusive of common stock (22,959,235), previously issued prefunded warrants (3,605,790), previously issued Series A and Series B convertible preferred shares outstanding (2,369,797) and earned PSUs (97,600). |
|||||||
| Condensed Consolidated Balance Sheets | |||||||
| (in thousands) | |||||||
| (unaudited) | |||||||
| 2026 | 2025 | ||||||
| Cash, cash equivalents, restricted cash and marketable securities | $ | 817,926 | $ | 988,649 | |||
| Trade receivables, net | 187,356 | 134,476 | |||||
| Other current assets | 177,025 | 122,645 | |||||
| Other non-current assets | 45,020 | 13,819 | |||||
| Total assets | $ | 1,227,327 | $ | 1,259,589 | |||
| Liabilities and Equity | |||||||
| Current liabilities | $ | 338,259 | $ | 310,288 | |||
| Long-term liabilities | 345,614 | 346,612 | |||||
| Stockholders’ equity | 543,454 | 602,689 | |||||
| Total liabilities and stockholders’ equity | $ | 1,227,327 | $ | 1,259,589 | |||
Source: Madrigal Pharmaceuticals, Inc.