Madrigal Pharmaceuticals added a siRNA approach to its NASH/MASH pipeline by acquiring six preclinical siRNA candidates from Ribo Life Science and Ribocure in a deal that could reach $4.4 billion in milestones. The transaction follows Madrigal’s commercial launch of resmetirom and signals a strategic effort to build a diversified therapeutic arsenal against metabolic‑associated steatohepatitis. Madrigal will integrate the siRNA assets into its R&D engine to pursue complementary mechanisms of liver disease treatment. Financial terms include a multi‑stage payout structure tied to development, regulatory and sales milestones. The agreement highlights growing industry interest in combining small molecules, biologics, and oligonucleotides to tackle complex metabolic liver diseases.