Ayesh Hazem, Beran Azizullah, Suhail Sajida, Ayesh Suhail, Niswender Kevin
Deaconess Health System, Evansville, IN, USA.
Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA.
J Basic Clin Physiol Pharmacol. 2025 Jan 9;36(1):3-11. doi: 10.1515/jbcpp-2024-0140. eCollection 2025 Jan 1.
Metabolic-Associated Steatohepatitis-Related Liver Disease (MASLD) and, its progressive form, Metabolic-Associated Steatohepatitis (MASH) pose significant global health challenges. Current therapeutic strategies targeting metabolic abnormalities have shown promise but lack specificity for the liver. Thyroid hormones, particularly thyroid hormone receptor beta (THR-β) agonists like resmetirom, offer a targeted approach to liver-related pathways.
A network meta-analysis (NMA) comparing different doses of resmetirom to placebo for MASLD and MASH was conducted. PubMed, Scopus, Cochrane, and Web of Science were searched for relevant randomized controlled trials (RCTs). Efficacy outcomes included histological, radiological, and biochemical parameters, while safety outcomes comprised adverse events and treatment discontinuation.
Resmetirom demonstrated dose-dependent efficacy in histological and radiological assessments, with the 100 mg dose showing superior MASH resolution and hepatic fat reduction. Biochemical markers indicated improved liver function with resmetirom treatment. However, adverse events, particularly diarrhea and nausea, were more prevalent in the resmetirom group, leading to higher treatment discontinuation rates.
Resmetirom shows promise as a therapeutic option for MASLD and MASH management, with significant improvements in liver health parameters. However, safety concerns warrant careful monitoring in clinical practice. Further research is needed to optimize its long-term safety and efficacy.
代谢相关脂肪性肝炎相关肝病(MASLD)及其进展形式代谢相关脂肪性肝炎(MASH)给全球健康带来了重大挑战。目前针对代谢异常的治疗策略已显示出前景,但缺乏对肝脏的特异性。甲状腺激素,特别是像瑞美替昂这样的甲状腺激素受体β(THR-β)激动剂,为肝脏相关通路提供了一种靶向治疗方法。
进行了一项网络荟萃分析(NMA),比较不同剂量的瑞美替昂与安慰剂治疗MASLD和MASH的效果。检索了PubMed、Scopus、Cochrane和科学网,以查找相关的随机对照试验(RCT)。疗效结果包括组织学、放射学和生化参数,而安全性结果包括不良事件和治疗中断情况。
瑞美替昂在组织学和放射学评估中显示出剂量依赖性疗效,100mg剂量在MASH缓解和肝脏脂肪减少方面表现更优。生化指标表明瑞美替昂治疗可改善肝功能。然而,不良事件,尤其是腹泻和恶心,在瑞美替昂组中更为普遍,导致更高的治疗中断率。
瑞美替昂作为MASLD和MASH管理的治疗选择显示出前景,肝脏健康参数有显著改善。然而,安全性问题在临床实践中需要仔细监测。需要进一步研究以优化其长期安全性和疗效。