Lipids & metabolic liver disease
Role of Resmetirom, a Liver-Directed, Thyroid Hormone Receptor Beta-Selective Agonist, in Managing Nonalcoholic Steatohepatitis: A Systematic Review and Meta-Analysis
Authors' conclusion
Resmetirom improves hepatic fat content, liver enzymes, and fibrosis biomarkers in NASH patients. Resmetirom generally does not affect thyroid function and is well-tolerated.
Study context
- Population
- Patients with nonalcoholic steatohepatitis (NASH)
- Participants
- 2,231 patients3 randomized controlled trials (RCTs)
- Comparison
- Resmetirom vs placebo
- Outcome
- Changes from baseline in hepatic fat content, liver histology incl. NASH resolution, and noninvasive markers of hepatic fibrosis
Pooled result
As reported in the abstract
Change from baseline in hepatic fat content (MRI proton density fat fraction)
Each group vs placeboMD, % (95% CI)P value
Resmetirom 80 mg
−27.76(−32.84 to −22.69)
P < 0.00001Resmetirom 100 mg
−36.01(−41.54 to −30.48)
P < 0.00001Further pooled results
| Outcome | MD (dBm) (95% CI) | P value | |
|---|---|---|---|
| Change from baseline in FibroScan controlled attenuation parameterResmetirom 80 mgvs Placebo | −21.45 (−29.37 to −13.52) | P < 0.00001 | |
| Change from baseline in FibroScan controlled attenuation parameterResmetirom 100 mgvs Placebo | −25.51 (−33.53 to −17.49) | P < 0.00001 | |
| −40−20020Difference, dBm (linear scale) |
Liver histology
- Resmetirom 80 mg outperformed placebo in NASH resolution and ≥2-point NAFLD activity score reduction
Cytokeratin-18 (M30)
- Resmetirom 80 mg and 100 mg superior to placebo in cytokeratin-18 (M30) reduction
Liver enzymes, lipids, thyroid hormones
- Greater reductions in liver enzymes, lipids and reverse triiodothyronine with resmetirom; no impact on triiodothyronine
Safety
- Nausea and diarrhea more common with resmetirom than placebo; other adverse events comparable
Original publication
Role of Resmetirom, a Liver-Directed, Thyroid Hormone Receptor Beta-Selective Agonist, in Managing Nonalcoholic Steatohepatitis: A Systematic Review and Meta-Analysis. Endocr Pract. Published 1 May 2024. doi:10.
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