Boehringer Ingelheim GmbH / Yuhan Corporation

Nonalcoholic Steatohepatitis (NASH/MASH)

$7.9B Global NASH treatment market 2024 (~$5.6B North America share)

Disease Overview

NASH (now called MASH) is a progressive form of fatty liver disease in which fat accumulation drives inflammation and fibrosis, ultimately progressing to cirrhosis, hepatocellular carcinoma and liver failure. It is closely tied to obesity, type 2 diabetes and metabolic syndrome and remains one of the leading indications for liver transplant in the US. Despite an addressable population in the millions, the disease is silent for years, making diagnosis and treatment difficult.

Competitive Landscape

At deal time (July 2019) there was no approved NASH therapy and the field was a high-stakes race among Intercept's obeticholic acid (Ocaliva, ultimately rejected by FDA in NASH in 2020 and 2023), Genfit's elafibranor (failed Phase 3 in 2020), Madrigal's resmetirom, Gilead's selonsertib (failed) and a wave of GLP-1 and FGF21 candidates including Akero's efruxifermin and 89bio's pegozafermin. Boehringer's bet on Yuhan's YH25724 was an attempt to leapfrog single-mechanism rivals by combining GLP-1 (metabolic and weight effects) with FGF21 (anti-fibrotic, lipid lowering) in one fusion protein using Genexine's HyFc half-life extension. The strategic logic: as Novo Nordisk's semaglutide and Lilly's tirzepatide were expanding into liver indications, dual incretin/FGF21 agonists offered a differentiated path. Madrigal's Rezdiffra ultimately became first to market in March 2024, redefining the competitive bar. Boehringer terminated the YH25724/BI 3006337 program in March 2025 and returned rights to Yuhan, illustrating how quickly the NASH landscape consolidated around oral THR-beta and incretin classes.