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Resmetirom is an orally administered small molecule that acts as a selective thyroid hormone receptor-beta (THR-β) agonist. It is indicated for the treatment of adults with noncirrhotic nonalcoholic steatohepatitis (NASH), also known as metabolic dysfunction-associated steatohepatitis (MASH), with moderate to advanced liver fibrosis (stages F2-F3), but not cirrhosis. Resmetirom works by selectively activating THR-β in the liver, which regulates genes involved in lipid metabolism, leading to reduced hepatic fat accumulation and improved markers of fibrosis and inflammation. Its liver specificity is partly due to uptake via organic anion transporting polypeptides 1B1. The drug was developed by Madrigal Pharmaceuticals and received FDA accelerated approval in March 2024 under the brand name Rezdiffra[2][3][5][7][8].
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