High Persistence and Favorable Safety Observed With Resmetirom in Real-World MASH Cohort
Resmetirom demonstrated high treatment persistence and a favorable safety profile in a large real-world cohort of patients with metabolic dysfunction–associated steatohepatitis (MASH), according to a retrospective study evaluating 12-month outcomes. The findings provide early insight into durability and tolerability outside clinical trials.
Investigators analyzed 326 adults initiating resmetirom, with approximately two-thirds receiving doses of 80 mg or less and one-third receiving 100 mg. About 40% of patients were also treated with glucagon-like peptide-1 (GLP-1) receptor agonists. Persistence rates remained high over time, with 96% of patients continuing therapy at 3 months, 94% at 6 months, and 94% at 12 months. The Kaplan–Meier curve showed minimal early discontinuation.
Safety outcomes were consistent with prior studies. The most common adverse events were gastrointestinal, including diarrhea (11%) and abdominal discomfort (9%). Serious adverse events were rare. The authors noted that “resmetirom showed high 12-month treatment persistence with minimal early discontinuation,” and was “generally well tolerated.”
Biochemical and metabolic improvements were observed. Patients receiving doses of 80 mg or less had greater reductions in total cholesterol and triglycerides at 3 months, as well as larger decreases in aspartate aminotransferase and alanine aminotransferase at 12 months. Improvements in noninvasive markers of fibrosis were modest overall, though patients receiving concomitant GLP-1 therapy showed greater improvement in FIB-4 scores at 6 months.
Changes in liver stiffness and controlled attenuation parameter did not differ significantly by dose or GLP-1 use at 12 months, suggesting that structural liver changes may require longer follow-up.
Reference
Sandhu JS, Woods P, Sandhu M, et al. Real-world persistence, tolerability, and non-invasive treatment response to resmetirom in patients with MASH at a tertiary liver center in north Texas. Presented at: Digestive Disease Week; May 2–5, 2026; Chicago, Illinois.
