Investigational Liver Drug Also Effective in Patients With H
In an open-label part of the MAESTRO-NAFLD-1 study, treatment with 100 mg of the investigational agent resulted in a 20% reduction in liver volume by week 52 among patients with hypothyroidism taking thyroxine. Resmetirom was only working in the liver to correct that blockage from T4 to T3.

This open-label analysis included 171 participants with confirmed NAFLD-1: 95 of whom were euthyroid and 76 were hypothyroid treated with thyroxine. Thyroxine-treated patients tended to be female, older, and have greater risk for atherosclerotic cardiovascular disease. Compared with euthyroid individuals, thyroxine-treated patients also tended to have more advanced NASH fibrosis measures, including Fibrosis-4 score (0.9 for euthyroid vs 1.2), NAFLD score (-1.2 vs -0.8), and Enhanced Liver Fibrosis scores (8.9 vs 9.4).

At baseline, hypothyroid patients were on an average thyroxine dose of 109 g. Half were taking a stain, and 15.8% and 17.1% were taking a GLP-1 receptor agonist and SGLT2 inhibitor, respectively. Treatment with resmetirom effectively reduced liver fat among patients with hypothyroidism and nonalcoholic fatty liver disease (NAFLD), according to a phase III trial.