In the high-stakes world of biotech investing, balancing risk and reward is everything. While clinical-stage Nektar Therapeutics (NKTR) shone in 2025 thanks to positive Phase 2 data for its eczema drug rezpegaldesleukin, investors seeking steadier growth may find a smarter choice in Madrigal Pharmaceuticals (MDGL)—a company that has already cleared the crucial commercialization hurdle.
Nektar’s appeal lies in rezpegaldesleukin, an immunology asset with strong mid-stage results in a multibillion-dollar market. Yet that potential is a double-edged sword. The company has no marketed products, runs consistent net losses, and hinges entirely on the success of this single pipeline candidate.
Biotech is a brutal arena: even promising Phase 2 data can’t prevent a late-stage trial failure from wiping out shareholder value. The recent collapse of aTyr Pharmaceuticals—whose lead candidate failed in Phase 3 after encouraging earlier results—serves as a fresh warning. For Nektar, the stock carries substantial upside, but also a very real risk of a devastating downturn. It’s suited only for those with a high-risk tolerance.
In contrast, Madrigal has already crossed the make-or-break threshold from clinical promise to commercial reality. Its drug Rezdiffra gained FDA approval in 2024 as the first therapy indicated for metabolic dysfunction-associated steatohepatitis (MASH) in the U.S., securing a first-mover advantage in a vast, underserved market.
Commercial validation is key to de-risking an investment. Rezdiffra has launched impressively, generating $287.3 million in net sales in Q3 alone, and is on track to reach blockbuster status next year. With millions of potential patients in the U.S. and limited competition, its growth story may just be beginning.
Although Rezdiffra remains under accelerated approval and must confirm efficacy in post-marketing studies, its strong prescription trends already signal solid market acceptance. Importantly, as a first-in-class therapy addressing an unmet need, it faces far less regulatory and competitive pressure than Nektar, which is aiming to challenge entrenched rivals like Dupixent in the crowded eczema space.
For most investors, proven commercial success offers a safer margin than clinical potential alone. Nektar’s story is about what could happen; Madrigal’s is built on what has happened—regulatory approval and accelerating revenue. While chasing innovation is exciting, allocating capital to biotech companies that have already passed their biggest inflection point may be the more prudent strategy.
