A Perfect MASH Comparing Resmetirom and GLP-1 Agonists for Metabolic-Associated Steatohepatitis: What Does the Current Evidence Suggest?

Metabolic dysfunction-associated steatotic liver disease (MASLD) has become one of the most common causes of chronic liver disease recently due to the rise of metabolic disorders such as diabetes and obesity. It will continue to have a major impact on health care systems globally given its association with cardiovascular disease and liver-related complications such as cirrhosis and hepatocellular carcinoma. In recent years, promising pharmacotherapies have emerged to address MASLD and fibrosis, such as resmetirom and glucagon-like-1 receptor agonists. There are ongoing studies to better understand resmetirom, glucagon-like-1 receptor agonists, and other possible pharmacotherapies. We discuss the current available literature on resmetirom, glucagon-like-1 receptor agonists, their safety and efficacy among patients with MASLD. Furthermore, we propose an algorithm to guide clinicians on which currently available pharmacological therapy to select for effective management of MASLD.