Madrigal Pharmaceuticals(US:MDGL) ZACKS·2026-02-20 16:01Core Insights - Madrigal Pharmaceuticals (MDGL) reported a Q4 2025 loss of $2.57 per share, significantly missing the Zacks Consensus Estimate of earnings of 4 cents, primarily due to a sharp increase in operating expenses [1][6] - The company generated total revenues of $321.1 million in Q4 2025, driven entirely by product sales of its MASH drug Rezdiffra, surpassing the Zacks Consensus Estimate of $313 million [2][6] - Madrigal shares fell by 11.1% following the mixed earnings results, which did not meet investor expectations [3] Financial Performance - In Q4 2025, research and development expenses surged to $116.3 million, more than quadrupling from previous levels, mainly due to upfront payments for business development transactions [5] - Selling, general and administrative expenses nearly doubled to $240 million, attributed to increased commercial launch activities for Rezdiffra [7] - For the full year 2025, Madrigal recorded total revenues of $958.4 million, all from Rezdiffra sales, exceeding the Zacks Consensus Estimate of $950.8 million [8] Product and Market Updates - Rezdiffra received accelerated approval from the FDA and EU as the first therapy for MASH, targeting adults with noncirrhotic MASH with moderate to advanced liver fibrosis [4][9] - The drug's commercial launch has been strong, with over 36,250 patients receiving treatment by the end of 2025, up from over 29,500 at the end of Q3 2025 [4] - Ongoing studies, including the pivotal phase III MAESTRO-NASH biopsy study, aim to provide long-term safety and efficacy data to support full approval for Rezdiffra [11][12] Pipeline Developments - A second phase III outcomes study (MAESTRO-NASH OUTCOMES) is evaluating Rezdiffra's effectiveness in patients with compensated MASH cirrhosis, with top-line data expected in 2027 [12] - Positive two-year data from the open-label extension of the MAESTRO-NAFLD-1 study supports Rezdiffra's potential benefits for patients with compensated MASH cirrhosis [13]