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A New Hope for the Patients of Non-Alcoholic Steatohepatitis: FDA Gives Green Signal for Resmetirom Use.非酒精性脂肪性肝炎患者的新希望:美国食品药品监督管理局批准使用Resmetirom
Health Sci Rep. 2025 Jan 22;8(1):e70394. doi: 10.1002/hsr2.70394. eCollection 2025 Jan.
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A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis.一项评估 Resmetirom 治疗伴有肝纤维化的 NASH 的 3 期随机对照试验。
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Resmetirom: A Systematic Review of the Revolutionizing Approach to Non-alcoholic Steatohepatitis Treatment Focusing on Efficacy, Safety, Cost-Effectiveness, and Impact on Quality of Life.雷斯美洛:关于非酒精性脂肪性肝炎治疗的革命性方法的系统评价,重点关注疗效、安全性、成本效益及对生活质量的影响
Cureus. 2024 Sep 22;16(9):e69919. doi: 10.7759/cureus.69919. eCollection 2024 Sep.
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Budget impact of resmetirom for the treatment of adults with non-cirrhotic non-alcoholic steatohepatitis (NASH) with moderate to advanced liver fibrosis (consistent with stages F2 to F3 fibrosis).治疗伴有中度至进展性肝纤维化(符合 F2 至 F3 纤维化阶段)的非肝硬化非酒精性脂肪性肝炎(NASH)成人患者的雷美替胺的预算影响。
J Med Econ. 2024 Jan-Dec;27(1):1108-1118. doi: 10.1080/13696998.2024.2393952. Epub 2024 Aug 22.
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Safety and efficacy of resmetirom in the treatment of patients with non-alcoholic steatohepatitis and liver fibrosis: a systematic review and meta-analysis.瑞美替昂治疗非酒精性脂肪性肝炎和肝纤维化患者的安全性和有效性:一项系统评价和荟萃分析
Ann Med Surg (Lond). 2024 May 22;86(7):4130-4138. doi: 10.1097/MS9.0000000000002195. eCollection 2024 Jul.
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Design of the phase 3 MAESTRO clinical program to evaluate resmetirom for the treatment of nonalcoholic steatohepatitis.用于评估resmetirom治疗非酒精性脂肪性肝炎的3期MAESTRO临床项目设计
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Resmetirom: An Orally Administered, Smallmolecule, Liver-directed, β-selective THR Agonist for the Treatment of Non-alcoholic Fatty Liver Disease and Non-alcoholic Steatohepatitis.瑞美替隆:一种口服的小分子、肝脏靶向、β 选择性甲状腺激素受体激动剂,用于治疗非酒精性脂肪性肝病和非酒精性脂肪性肝炎。
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Health-related quality of life (HRQL) assessments in a 52-week, double-blind, randomized, placebo-controlled phase III study of resmetirom (MGL-3196) in patients with metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis.在一项为期52周、双盲、随机、安慰剂对照的III期研究中,对患有代谢功能障碍相关脂肪性肝炎(MASH)和纤维化的患者进行与健康相关的生活质量(HRQL)评估,该研究使用resmetirom(MGL-3196)。
Hepatology. 2025 Apr 1;81(4):1318-1327. doi: 10.1097/HEP.0000000000001084. Epub 2024 Sep 6.
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Estimation of the Eligible Population For Resmetirom Among Adults in the United States for Treatment of Non-Cirrhotic NASH with Moderate-to-Advanced Liver Fibrosis.在美国,为治疗非肝硬化性 NASH 伴中重度肝纤维化的成年人,估算有资格使用雷美替胺的人群。
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Resmetirom's approval: Highlighting the need for comprehensive approaches in NASH therapeutics.雷美替胺获批:凸显 NASH 治疗中全面方法的必要性。
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Antioxidants (Basel). 2025 May 29;14(6):653. doi: 10.3390/antiox14060653.
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Resmetirom: The First Disease-Specific Treatment for MASH.雷斯美洛:非酒精性脂肪性肝炎的首个疾病特异性治疗药物。
Int J Endocrinol. 2025 Feb 26;2025:6430023. doi: 10.1155/ije/6430023. eCollection 2025.

本文引用的文献

1
The Burden of Nonalcoholic Steatohepatitis: A Systematic Review of Epidemiology Studies.非酒精性脂肪性肝炎的负担:流行病学研究的系统评价
Gastro Hep Adv. 2022 Jul 19;1(6):1049-1087. doi: 10.1016/j.gastha.2022.06.016. eCollection 2022.
2
Role of Resmetirom, a Liver-Directed, Thyroid Hormone Receptor Beta-Selective Agonist, in Managing Nonalcoholic Steatohepatitis: A Systematic Review and Meta-Analysis.Resmetirom 作为一种肝脏靶向、甲状腺激素受体β选择性激动剂,在治疗非酒精性脂肪性肝炎中的作用:系统评价和荟萃分析。
Endocr Pract. 2024 Jul;30(7):631-638. doi: 10.1016/j.eprac.2024.04.016. Epub 2024 May 1.
3
A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis.一项评估 Resmetirom 治疗伴有肝纤维化的 NASH 的 3 期随机对照试验。
N Engl J Med. 2024 Feb 8;390(6):497-509. doi: 10.1056/NEJMoa2309000.
4
Non-Alcoholic Steatohepatitis (NASH) - A Review of a Crowded Clinical Landscape, Driven by a Complex Disease.非酒精性脂肪性肝炎(NASH)- 复杂疾病驱动下拥挤临床领域的综述
Drug Des Devel Ther. 2021 Sep 22;15:3997-4009. doi: 10.2147/DDDT.S315724. eCollection 2021.
5
Pathophysiological mechanisms and clinical evidence of relationship between Nonalcoholic fatty liver disease (NAFLD) and cardiovascular disease.非酒精性脂肪性肝病 (NAFLD) 与心血管疾病之间关系的病理生理机制和临床证据。
Rev Cardiovasc Med. 2021 Sep 24;22(3):755-768. doi: 10.31083/j.rcm2203082.
6
Drugs for Non-alcoholic Steatohepatitis (NASH): Quest for the Holy Grail.用于非酒精性脂肪性肝炎(NASH)的药物:对圣杯的探寻。
J Clin Transl Hepatol. 2021 Feb 28;9(1):40-50. doi: 10.14218/JCTH.2020.00055. Epub 2020 Dec 9.
7
The effect of adiponectin in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) and the potential role of polyphenols in the modulation of adiponectin signaling.脂联素在非酒精性脂肪性肝病(NAFLD)发病机制中的作用及多酚对脂联素信号转导的调节作用。
Biomed Pharmacother. 2020 Nov;131:110785. doi: 10.1016/j.biopha.2020.110785. Epub 2020 Sep 29.
8
Common and Rare Complications of Bariatric Surgery.减重手术的常见和罕见并发症。
Endocrinol Metab Clin North Am. 2020 Jun;49(2):329-346. doi: 10.1016/j.ecl.2020.02.003. Epub 2020 Apr 16.
9
NAFLD and increased risk of cardiovascular disease: clinical associations, pathophysiological mechanisms and pharmacological implications.非酒精性脂肪性肝病与心血管疾病风险增加:临床关联、病理生理机制及药理学意义
Gut. 2020 Sep;69(9):1691-1705. doi: 10.1136/gutjnl-2020-320622. Epub 2020 Apr 22.
10
Nonalcoholic Steatohepatitis: A Review.非酒精性脂肪性肝炎:综述。
JAMA. 2020 Mar 24;323(12):1175-1183. doi: 10.1001/jama.2020.2298.

非酒精性脂肪性肝炎患者的新希望:美国食品药品监督管理局批准使用Resmetirom

A New Hope for the Patients of Non-Alcoholic Steatohepatitis: FDA Gives Green Signal for Resmetirom Use.

作者信息

Hasan Abdul Haseeb, Abid Muhammad Ali, Abid Muhammad Hafi, Suhail Laiba, Nazir Abubakar

机构信息

Department of Medicine King Edward Medical University Lahore Pakistan.

Department of Medicine Faisalabad Medical University Faisalabad Pakistan.

出版信息

Health Sci Rep. 2025 Jan 22;8(1):e70394. doi: 10.1002/hsr2.70394. eCollection 2025 Jan.

DOI:10.1002/hsr2.70394
PMID:39846038
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11752137/
Abstract

BACKGROUND AND AIMS

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景与目的

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。

方法

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。

结果

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。

结论

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。