Q1 2026 was a quarter of concentration for autoimmune, fewer deals, and bigger checks. Across R&D partnerships, M&A, and venture, total capital rose while deal counts fell, with capital flowing to proven platforms and validated biology. The sector is backing quality over coverage.
R&D Partnerships had 15 deals worth $11.7 billion, up from $10 billion, even as volume fell from 20. Upfronts climbed, median $73 million (from $42 million), average $85 million (from $56 million). Fewer, larger, better funded. Earendil and Sanofi, bispecific antibodies for autoimmune and inflammatory disease (up to $160 million upfront, up to $2.4 billion in milestones, low double-digit royalties); Quotient and Merck, IBD via somatic genomics ($20 million upfront, up to $2.2 billion); Repertoire and Eli Lilly, immune tolerance across autoimmune diseases ($85 million upfront, up to $1.8 billion, plus royalties).
M&A activity was the quarter’s biggest mover, 4 deals (from 3), but total value, including contingents, tripled to $4.9 billion (from $1.5 billion). Cash excluding contingents hit $1.8 billion (from $1.5 billion); average upfront reached $904 million (from $764 million). Large caps bought next-generation modalities, pulling B-cell immunotherapies from oncology into autoimmune. Deals to know, Eli Lilly and Orna, a CD19 in vivo CAR-T (ORN-252) for B cell autoimmune disease (up to $2.4 billion); Gilead and Ouro, OM-336, a Phase II BCMAxCD3 T cell engager ($1.7 billion upfront, up to $500 million contingent, with Galapagos co funding half at 20% to 23% royalties); Embecta and Owen Mumford, drug delivery across obesity, autoimmune, and anaphylaxis (about $133 million upfront, up to $66 million).
Venture Funding had 10 rounds raised $1.1 billion, topping the $1 billion from 16 rounds in Q4 2025. Fewer but larger, the average round nearly doubled to $113 million (from $65 million). Capital concentrated in higher conviction, more mature assets. Deals to know: Earendil Labs, $787 million for autoimmune, inflammatory, and oncology biologics (lead HXN-1001, a Phase 2 ready anti-TL1A antibody); Pinnacle Medicines, $89 million series B for oral peptides in immunology and cardiometabolic disease ($134 million to date); QuantX Biosciences, $85 million series B for oral small molecules in immunology and inflammation, led by STAT6 and IL-17 inhibitors ($130 million to date).
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Autoimmune R&D Partnerships
Autoimmune R&D partnerships maintained strong momentum in Q1 2026, with 15 deals generating $11.7 billion in total deal value. Upfront cash and equity reached $73 million, while average and median upfront payments increased to $85 million and a median of $73 million, respectively, indicating stronger financial commitment despite lower deal volume. In Q4 2025, partnership activity was higher at 20 deals with $10 billion in total deal value. However, upfront cash and equity totaled only $42 million, and both average ($56 million) and median ($42 million) upfront payments were below Q1 2026 levels.
Prominent Autoimmune R&D Partnerships in Q1 2026
Earendil Labs development and commercialization deal with Sanofi – January 2026
Earendil Lab entered a strategic partnership with Sanofi, granting the company exclusive worldwide rights to develop and commercialize multiple bispecific antibodies for autoimmune and inflammatory diseases. The collaboration combines Earendil’s AI-driven protein modeling and high-throughput validation platform with Sanofi’s development, regulatory, and commercial capabilities. Under the agreement, Sanofi will lead the development and commercialization of all bispecific antibody candidates generated through the partnership. Earendil Labs is eligible to receive up to $160 million in upfront and near-term payments for early program achievements, with additional potential payments of up to $2.4 billion in development and commercial milestones, plus low double-digit tiered royalties.
Quotient Therapeutics development and commercialization deal with Merck – March 2026
Quotient Therapeutics entered a discovery collaboration with Merck focused on identifying and developing novel drug targets for inflammatory bowel disease (IBD) using Quotient’s somatic genomics platform. The agreement provides Merck with rights to discover, develop, and commercialize therapies arising from the collaboration. Under the terms of the deal, Quotient Therapeutics will receive $20 million upfront and is eligible for up to $2.2 billion in development, regulatory, and commercial milestone payments.
Repertoire Immune Medicines development and commercialization deal with Eli Lilly – January 2026
Repertoire Immune Medicines entered a collaboration with Eli Lilly to develop tolerizing therapies for multiple autoimmune diseases using Repertoire’s DECODE platform, which maps T cell receptor and epitope interactions. The partnership aims to advance antigen-specific immunotherapies designed to address the underlying drivers of autoimmune disease. Under the agreement, Repertoire will lead early discovery and development activities, while Eli Lilly will assume responsibility for clinical development, manufacturing, regulatory activities, and commercialization. Repertoire will receive $85 million upfront and is eligible for up to $1.8 billion in development and commercial milestone payments, in addition to tiered royalties.
Autoimmune M&AÂ
Autoimmune M&A activity slightly improved in Q1 2026, with deal volume increasing to 4 transactions from 3 in Q4 2025. Total M&A value, including contingents, rose sharply to $4.9 billion from $1.5 billion, reflecting higher activity and significantly larger deal sizes. Cash paid excluding contingents increased to $1.8 billion in Q1 2026 versus $1.5 billion in Q4 2025, while average and median upfront cash and equity payments rose to $904 million from $764 million. Overall, autoimmune M&A activity strengthened in early 2026 compared to the previous quarter.
Prominent Autoimmune M&A in Q1 2026
Eli Lilly acquiring Orna Therapeutics – February 2026
Eli Lilly agreed to acquire Orna Therapeutics, gaining access to a portfolio of in vivo cell and gene therapy assets, including ORN-252, a clinical-ready CD19-targeting in vivo CAR-T therapy for B-cell-driven autoimmune diseases. The acquisition also includes an undisclosed anti-CD19/anti-BCMA in vivo CAR therapy for B-cell malignancies, additional discovery-stage programs targeting sickle cell disease, beta thalassemia, and infectious diseases, as well as Orna’s proprietary circular RNA (oRNA) platform and lipid nanoparticle (LNP) delivery technology. Under the terms of the transaction, Orna shareholders are eligible to receive up to $2.4 billion, including an upfront payment and undisclosed clinical development milestone payments. The acquisition strengthens Eli Lilly’s position in next-generation in vivo therapies and highlights continued strategic interest in RNA, gene-editing, and cell therapy platforms with applications across autoimmune, oncology, hematology, and infectious diseases.
Gilead acquiring Ouro Medicines – March 2026
Gilead agreed to acquire Ouro Medicines, adding OM-336 (gamgertamig), a BCMAxCD3 T-cell engager being developed for autoimmune diseases. The Phase II asset is currently in early clinical testing and is expected to enter registrational studies in 2027, strengthening Gilead’s presence in the growing autoimmune immunotherapy market. Under the terms of the transaction, Ouro Medicines will receive $1.7 billion in upfront cash and is eligible for up to $500 million in contingent milestone payments. Following the acquisition, Gilead and Galapagos entered advanced discussions to jointly develop OM-336. Galapagos will fund development through the initiation of registrational studies, after which both companies will share registrational study costs equally. Gilead will lead global commercialization, excluding Greater China, where Keymed Biosciences retains commercialization rights. Galapagos will fund 50% of the upfront and milestone payments and is eligible to receive royalties of 20%-23% on net sales. The arrangement also provides Galapagos with the flexibility to allocate up to $500 million of its cash toward additional investments or share repurchases.
Embecta acquiring Owen Mumford Holdings – March 2026
Embecta agreed to acquire Owen Mumford Holdings, a privately held medical device company specializing in healthcare delivery and home-based treatment solutions. The acquisition is intended to expand Embecta’s drug-delivery device capabilities and broaden its reach beyond diabetes into high-growth markets, including obesity, autoimmune diseases, and anaphylaxis. Owen Mumford brings a portfolio of device technologies, intellectual property, and established pharmaceutical partnerships that are expected to strengthen Embecta’s innovation capabilities and global commercial presence. The transaction supports Embecta’s strategy to evolve into a more diversified medical supplies company while enhancing its long-term growth profile. Under the terms of the agreement, Owen Mumford will receive GBP 100 million (approximately $133 million) upfront and is eligible for up to GBP 50 million (approximately $66 million) in commercial milestone payments.
Autoimmune Venture Activity
Autoimmune venture financing remained strong in Q1 2026, with 10 funding rounds raising $1.1 billion. Despite fewer rounds, total capital raised slightly exceeded the previous quarter, indicating higher capital deployment per transaction. In Q4 2025, 16 funding rounds generated $1 billion, reflecting greater deal volume but a lower overall funding total than in early 2026. Overall, the data indicate a shift from a larger number of smaller financings in late 2025 to fewer, larger venture rounds in Q1 2026, with a selective investment environment.
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Prominent Autoimmune Venture Activity in Q1 2026
Earendil Labs – Series Unspecified – $787M – March 2026
Earendil Labs secured a $787 million financing to accelerate the development of biologic therapies for autoimmune, inflammatory, and oncology indications. The company’s lead asset, HXN-1001, is a Phase 2-ready half-life-extended anti-TL1A antibody, while additional pipeline candidates, HXN-1002 and HXN-1003, are next-generation bispecific antibodies partnered with Sanofi. The financing was backed by Dimension Capital, DST Global, INCE Capital, Luminous Ventures, Miracle Capital, Sanofi, and the Biotech Development Fund. Earendil plans to advance multiple programs into the clinic, with several IND filings expected across 2026 and 2027.
Pinnacle Medicines – Series B – $89M – March 2026
Pinnacle Medicines completed an oversubscribed $89 million series B financing to advance its oral peptide platform focused on immunology and cardiometabolic diseases. The company’s pipeline includes programs targeting asthma and COPD, inflammatory bowel disease, atopic dermatitis, obesity, and cardiovascular disorders, supported by a broader portfolio of bispecific peptide candidates. The round was co-led by LAV and Foresite Capital, with participation from Quan Capital, Hankang Capital, RA Capital Management, Logos Capital, and existing investor OrbiMed. Total funding raised to date has reached $134 million.
QuantX Biosciences – Series B – $85M – February 2026
QuantX Biosciences closed an oversubscribed $85 million series B financing to advance its pipeline of oral small-molecule therapies for immunology and inflammatory diseases. The company’s lead programs include a best-in-class STAT6 inhibitor and an IL-17 inhibitor, both targeting clinically validated pathways in inflammatory disease. The financing was co-led by LAV and Sanofi Ventures, with participation from Hongshan and existing investors. Total funding raised to date stands at $130 million. Proceeds will support continued clinical development of the lead assets and expansion of the company’s discovery pipeline.
Also check out Neurology R&D Partnerships, M&A and Venture Funding – Q1 2026 Review
