Seven years after the biotechnology firm launched, Akero Therapeutics is slated to be acquired by the Danish pharmaceutical giant Novo Nordisk in a deal worth up to $5.2 billion.
Novo has agreed to pay $54 per share to buy Akero—or about $4.7 billion up front. The rest will come once the US Food and Drug Administration approves Akero’s drug candidate efruxifermin for compensated cirrhosis due to metabolic dysfunction–associated steatohepatitis, or MASH. MASH is a liver disease that’s projected to impact 122 million US adults by 2050 (JAMA Network Open 2025, DOI: 10.1001/jamanetworkopen.2024.54707).
Efruxifermin is a fibroblast growth factor 21 (FGF21) analog in late-stage clinical trials for liver fibrosis and cirrhosis associated with MASH. In earlier studies, the drug candidate reduced precirrhotic MASH by 49% and compensated cirrhosis by 29%, compared with placebo, which showed reductions of 19% and 11%, respectively.
Novo Nordisk executives see efruxifermin as a complement to the company’s existing metabolic disease portfolio, including the weight-loss drug Wegovy, or semaglutide, which the FDA has approved for treating MASH. In a press release, Novo CEO Mike Doustdar suggests that efruxifermin could be used “alone or together with Wegovy” to address liver damage.
“This acquisition embodies Novo Nordisk’s relentless ambition to move faster, go further, and ultimately deliver on our commitment to pursue leadership in diabetes, obesity and their associated comorbidities,” Doustdar says in the statement.
The move comes as Novo continues to lag behind in its race against rival weight-loss drug developer Eli Lilly and Company. Doustdar became CEO this year, after Novo ousted its previous chief executive over concerns that the firm had lost its first-mover advantage. Novo also recently entered high-dollar partnerships with the start-ups Deep Apple Therapeutics and Septerna, both of which will work to develop small molecules for weight loss—an advantage over Wegovy, which is taken as an injection.
Leerink Partners analyst Thomas J. Smith writes in a research note published Thursday that the Akero acquisition is 2025’s third major deal built around FGF21 for MASH. It follows GSK’s $1.2 billion purchase of Boston Pharmaceuticals’ efimosfermin in May and Roche’s $3.5 billion agreement to buy 89Bio in September. “Overall, this third MASH deal of the year highlights the strategically attractive, multibillion dollar commercial opportunity expected to emerge in the coming decade,” Smith says.
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