Hormonal
Resmetirom (THR-β agonist) improves biopsy-confirmed MASH resolution and fibrosis without causing significant weight loss, acting through a lipid-centric mechanism.
If you have MASH, resmetirom is a daily pill that targets liver fat and inflammation directly. It works even if you don't lose weight, making it a distinct option from weight-loss drugs.
Resmetirom improved both MASH resolution and fibrosis at 52 weeks, with marked low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) reductions but minimal weight change.
Why this rating
Supported by Phase 3 RCTs (MAESTRO-NASH) with high certainty for histological endpoints, though indirect comparison limits cross-drug certainty.
Source
THR-β Agonists vs Incretin Therapies for Noncirrhotic Metabolic Dysfunction-Associated Steatohepatitis (MASH): A Biopsy-Anchored Systematic Review With Grading of Recommendations Assessment, Development and Evaluation (GRADE) Certainty
Amirah A Alzaki et al. · Cureus · 2026
DOI 10.7759/cureus.106038
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