Madrigal Pharmaceuticals, Inc. (NASDAQ:MDGL) shares fell 5.39% in premarket trading Thursday after the company reported fourth-quarter results that topped revenue expectations but delivered a larger-than-forecast loss.
The biotechnology firm, which develops therapies for metabolic dysfunction-associated steatohepatitis (MASH), posted quarterly revenue of $321.1 million, ahead of the $310.82 million consensus estimate.
However, earnings per share came in at -$2.57, missing analyst projections of -$0.60. The sharper-than-expected loss weighed on investor sentiment despite the revenue outperformance.
For full-year 2025, Madrigal generated $958.4 million in net sales from Rezdiffra (resmetirom), a sharp increase from $180.1 million in 2024. The company said more than 36,250 patients were receiving Rezdiffra as of the end of 2025.
“2025 marked a defining year for Madrigal. We solidified our position as the undisputed leader in MASH highlighted by nearly $1 billion in Rezdiffra sales in its first full year of launch,” said Bill Sibold, Chief Executive Officer of Madrigal. “And we’re just getting started – having penetrated only a fraction of a market that we believe has decades of growth ahead.”
Madrigal ended the year with $988.6 million in cash, cash equivalents, restricted cash and marketable securities, up from $931.3 million at the close of 2024. The increase was largely driven by the establishment of a new credit facility in July 2025 that included a $350 million initial term loan.
Operating expenses climbed significantly, reaching $380.7 million in the fourth quarter compared with $170.3 million in the same period a year earlier. For the full year, operating costs rose to $1.26 billion from $678 million in 2024, reflecting higher commercial spending related to Rezdiffra’s launch and upfront payments tied to business development deals.
Madrigal has continued to broaden its MASH pipeline, advancing more than 10 programs at various stages of development. These include exclusive global licensing agreements for an oral GLP-1 receptor agonist and ervogastat, a Phase 2 oral DGAT-2 inhibitor that the company intends to evaluate in combination with Rezdiffra.