Study wrapper · #1118
Resmetirom and semaglutide: next-generation therapies for metabolic-associated steatohepatitis. Opportunities, challenges and issues.
Editor's note
The approvals rested on histological endpoints measured over relatively short trial windows, and the reviewers are direct about what that leaves unanswered: how long therapy should continue, how response should be tracked without repeat biopsy, and whether liver histology changes translate into fewer hard outcomes. That gap between surrogate endpoint and clinical benefit is the central open question for this class in liver disease. Useful as a map of the current evidence, not as new data.
Plain-language abstract
A narrative review of the two drugs now approved for metabolic-associated steatohepatitis with moderate-to-severe liver fibrosis: resmetirom, which acts directly on the liver through thyroid hormone receptor beta, and semaglutide, which acts systemically by reducing weight and improving metabolism. Both produced resolution of the liver condition and improvement in fibrosis in a meaningful share of patients, with gastrointestinal side effects the main tolerability concern. The authors flag unresolved questions about patient selection, noninvasive monitoring tests, therapy duration, and equitable access.