Danish pharmaceutical company Novo Nordisk A/S (CPH:NOVO-B) (NYSE:NVO) on Thursday announced a definitive agreement to acquire Akero Therapeutics (NASDAQ:AKRO) for USD54 per share in cash, or USD4.7bn, with an additional contingent value right of USD6 per share (USD0.5bn) tied to potential US regulatory approval of its lead therapy.

The acquisition, unanimously approved by Akero's board of directors, is expected to close around the turn of the year pending regulatory approvals.

Akero's lead candidate, efruxifermin (EFX), a fibroblast growth factor 21 analogue, is in phase 3 development for metabolic dysfunction-associated steatohepatitis (MASH) in patients with moderate to advanced liver fibrosis and compensated cirrhosis. EFX is the only treatment to demonstrate significant fibrosis regression in phase 2 trials among cirrhotic patients, with results showing notable improvements over placebo, Novo Nordisk said.

This acquisition aligns with Novo Nordisk's strategy to expand its presence in obesity- and diabetes-related comorbidities, given the strong overlap between MASH, type 2 diabetes, and obesity. Novo Nordisk plans to explore EFX as a potential standalone or combination therapy with its obesity drug Wegovy (semaglutide).

Financially, the transaction will be primarily debt financed and is not expected to affect Novo Nordisk's 2025 operating profit outlook. However, free cash flow is projected to decline by approximately USD4bn, and 2026 operating profit growth could be reduced by around three percentage points due to increased R&D spending.