Hasan Abdul Haseeb, Abid Muhammad Ali, Abid Muhammad Hafi, Suhail Laiba, Nazir Abubakar
Department of Medicine King Edward Medical University Lahore Pakistan.
Department of Medicine Faisalabad Medical University Faisalabad Pakistan.
Health Sci Rep. 2025 Jan 22;8(1):e70394. doi: 10.1002/hsr2.70394. eCollection 2025 Jan.
Non-Alcoholic Steatohepatitis (NASH), a severe form of Non-Alcoholic Fatty Liver Disease (NAFLD), is characterized by inflammation and fibrosis in the liver, often progressing to cirrhosis and hepatocellular carcinoma. Despite its rising prevalence and significant disease burden, effective pharmacological treatments have been limited to lifestyle modifications and surgical interventions. Recently, resmetirom, a thyroid hormone receptor-β agonist, received FDA approval for treating NASH, offering new hope to patients. This review explores the current understanding of NASH and the role of resmetirom as a breakthrough therapeutic option.
This study is a comprehensive literature review analyzing peer-reviewed articles, clinical trial data, and public health reports. No original analyses were conducted, and no statistical software was utilized in this review.
Resmetirom demonstrated efficacy in resolving NASH without fibrosis progression and improving fibrosis scores in patients with biopsy-confirmed NASH. In a randomized Phase 3 trial, significant histological improvements were observed in 25.9% and 29.9% of patients receiving 80 and 100 mg doses, respectively, compared to 9.7% in the placebo group. Similar trends were noted in fibrosis improvement, with 24.2% and 25.9% of patients showing ≥ 1 stage improvement compared to 14.2% in the placebo group. Adverse effects, including nausea and diarrhea, were reported more frequently in the treatment groups, but the rates of serious adverse events were comparable across groups.
The approval of resmetirom marks a significant advancement in the treatment of NASH, addressing the limitations of lifestyle-based interventions. As the obesity epidemic drives the increasing prevalence of NASH, resmetirom provides a promising therapeutic option, paving the way for improved patient outcomes and future research.
非酒精性脂肪性肝炎(NASH)是一种严重的非酒精性脂肪性肝病(NAFLD),其特征为肝脏炎症和纤维化,常进展为肝硬化和肝细胞癌。尽管其患病率不断上升且疾病负担沉重,但有效的药物治疗一直局限于生活方式改变和手术干预。最近,甲状腺激素受体-β激动剂瑞美替昂获得美国食品药品监督管理局(FDA)批准用于治疗NASH,为患者带来了新希望。本综述探讨了目前对NASH的认识以及瑞美替昂作为突破性治疗选择的作用。
本研究是一项全面的文献综述,分析了同行评审文章、临床试验数据和公共卫生报告。本综述未进行原创分析,也未使用统计软件。
瑞美替昂在解决NASH且无纤维化进展以及改善经活检证实的NASH患者的纤维化评分方面显示出疗效。在一项随机3期试验中,接受80毫克和100毫克剂量的患者分别有25.9%和29.9%观察到显著的组织学改善,而安慰剂组为9.7%。在纤维化改善方面也观察到类似趋势,接受治疗的患者分别有24.2%和25.9%显示≥1期改善,而安慰剂组为14.2%。治疗组报告的不良反应(包括恶心和腹泻)更为频繁,但各组严重不良事件的发生率相当。
瑞美替昂的获批标志着NASH治疗取得了重大进展,克服了基于生活方式干预的局限性。随着肥胖流行导致NASH患病率不断上升,瑞美替昂提供了一个有前景的治疗选择,为改善患者预后和未来研究铺平了道路。