Hormonal
Resmetirom, a thyroid hormone receptor beta (THRβ) agonist, is the first FDA-approved drug specifically for MASH, demonstrating significant improvement in both steatohepatitis and fibrosis in patients with advanced liver fibrosis.
Resmetirom is the first FDA-approved drug specifically for MASH. It works by targeting thyroid hormone receptors in the liver to reduce fat and inflammation. It is particularly effective for patients with advanced fibrosis, but note that about 70% of patients may not respond. It is a valuable option for those who do not respond to GLP-1RAs or SGLT2-is, or who need liver-specific treatment.
Resmetirom, a THRβ selective agonist developed specifically for MASH treatment, became recently the first agent to be approved by the FDA with this indication. The phase III study MAESTRO-NASH... exhibited improvement of steatohepatitis and fibrosis in 25-30% of the treatment arm compared to 10-14% of the control arm.
Why this rating
Based on a large phase III trial (MAESTRO-NASH) with 966 patients.
Source
Targeting Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): Available and Future Pharmaceutical Options
Emmanouil Koullias et al. · Cureus · 2025
DOI 10.7759/cureus.76716
More from this paper
- Lifestyle interventions (caloric restriction and exercise) are the foundation of MASLD treatment but often fail to achieve sufficient or sustained weight loss, necessitating pharmaceutical intervention.Strong
- GLP-1 receptor agonists (GLP-1RAs) and sodium-glucose co-transporter-2 inhibitors (SGLT2-is) significantly improve hepatic steatosis and steatohepatitis in patients with MASLD, primarily through weight loss and glycemic control, with some agents also demonstrating antifibrotic properties.Good
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