In the highly competitive race to follow Madrigal to market in metabolic dysfunction-associated steatohepatitis (MASH), perhaps the two most closely watched drug classes are the GLP-1 agonists, which already have staked out primary positions in diabetes and obesity, and FGF21 analogs, a class that has demonstrated strong antifibrotic activity, including reversal of late-stage (F4) fibrosis, aka cirrhosis, in one mid-stage trial.
Key Takeaways
- Boston Pharmaceuticals is trying to catch up in MASH with FGF21 class competitors Akero and 89bio, with plans to begin a Phase III program this year.
- Akero and 89bio already are running multi-trial Phase III programs for their FGF21 analogs, efruxifermin and pegozafermin, with data expected between 2026 and 2028
The primary players in the FGF21 space are Akero Therapeutics, whose Phase III efruxifermin became the first MASH drug to show a benefit in cirrhotic patients with Phase IIb data reported on 27 January, and 89bio, which last year followed Akero into Phase III with pegozafermin. Right behind them is privately held Boston Pharmaceutical, which is compiling 48-week data from its
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