Resmetirom, a selective thyroid receptor β agonist, has met both primary histological endpoints in the phase 3 MAESTRO-NASH trial. The trial involved 966 patients with biopsy-proven NASH and at least three metabolic risk factors. Patients were randomly assigned to receive resmetirom 80 mg or 100 mg per day, or placebo. At week 52, NASH resolution with no worsening of fibrosis occurred in 26% of patients in the 80 mg group and 30% of patients in the 100 mg group compared to 10% in the placebo group. Fibrosis improvement of at least one stage was seen in 24% of the 80 mg group and 26% of the 100 mg group, compared to 14% of the placebo group. The rate of treatment-emergent adverse events was balanced between the three groups, with diarrhoea and nausea as the most common adverse events.

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