Resmetirom for Steatotic Liver Disease: Does Data Support Widespread Use?

Metabolic dysfunction-associated steatohepatitis with significant fibrosis is the aggressive form of steatotic liver disease that can progress to cirrhosis and its complications. Resmetirom is a liver-directed thyroid hormone receptor beta agonist that recently received accelerated approval by the FDA based on the results of the MAESTRO trial that demonstrated reasonable safety and efficacy in achieving both MASH resolution and fibrosis regression based on histological assessment. In this review, we discuss the resmetirom clinical development program, the use of noninvasive tests to select and monitor patients for treatment, and different aspects of the utility of resmetirom in the real world.