Madrigal Pharmaceuticals has entered into an exclusive global license agreement with Suzhou Ribo Life Science Co. Ltd. and its subsidiary Ribocure Pharmaceuticals AB for six preclinical siRNA programs aimed at treating MASH.[1][2][3] Under the agreement, Ribo will receive a subscription payment of US$60 million, and total payments may reach US$4.4 billion upon achievement of milestones, plus royalties on net sales.[1][2][4] siRNAs represent a precise method of gene silencing in MASH by selectively reducing the production of disease-driving proteins, particularly in liver cells.[1][3] Madrigal plans to test combinations of these siRNA therapies with its drug Rezdiffra, which is a mainstay treatment for MASH and received FDA approval in March 2024.[2][1] Activities to prepare the IND for the first candidates will begin in 2026.[2][3] The deal expands Madrigal's MASH pipeline to more than 10 programs in various stages of development, including a Phase 3 study of Rezdiffra in compensated MASH cirrhosis with data expected in 2027.[1][2]