Abigail Brooks is a strategic content lead overseeing 

She joined MJH Life Sciences in August 2023 shortly after graduating from Monmouth University where she earned her BA in Communication with a concentration in Public Relations/Journalism and later an MA in Interactive Digital Media. She enjoys traveling, running, and reading books. She can be reached at abrooks@mjhlifesciences.com.

 showed resmetirom (Rezdiffra) improved or stabilized liver stiffness in most patients with 

metabolic dysfunction-associated steatohepatitis (MASH)

 treated in routine practice, according to Madrigal Pharmaceuticals.¹ Across several retrospective analyses, 37% to 55% of patients with paired liver stiffness measurements (LSM) achieved an improvement of at least 25% at approximately 1 year.¹

Madrigal announced the findings, drawn from electronic health record, claims, and pharmacy databases, on November 5, 2026, alongside poster presentations at the American Association for the Study of Liver Diseases (AASLD) meeting in Denver, Colorado.¹

“Not every medicine delivers the same results in real-world clinical practice that we see in carefully controlled clinical trials, particularly when treating a complex, chronic disease like MASH,” Parvez Mantry, MD, at The Liver Institute at Methodist Dallas Medical Center, said in a statement. “What makes these findings so encouraging is the remarkable consistency of improvement we're seeing across multiple real-world studies of Rezdiffra, involving different patient populations and clinical settings. For physicians treating MASH, this growing body of evidence provides important reassurance that the benefits observed in these trials are translating into everyday patient care.”

The oral thyroid hormone receptor-beta (THR-β) agonist received US Food and Drug Administration (FDA) accelerated approval in March 2024 for adults with noncirrhotic MASH and moderate to advanced fibrosis (F2–F3), based on results from the phase 3 MAESTRO-NASH trial.

 In the new real-world analyses, up to 53% of patients were receiving glucagon-like peptide-1 (GLP-1)–based therapy alongside resmetirom.¹

How Did Resmetirom Affect Liver Stiffness in Real-World Practice?

In a retrospective Truveta cohort of 150 patients with paired LSM, 55% achieved an improvement of at least 25% at 12 months, and 48.0% achieved an improvement of at least 30%. Overall, 93% of patients improved or remained stable, and 67% moved to a lower predefined LSM range. Across the broader Truveta analysis, mean LSM decreased by 2.5 kPa from baseline at 12 months.¹

A subgroup analysis of 2,488 Truveta patients stratified by diabetes, obesity, GLP-1 receptor agonist use, and statin use showed statistically significant improvements in mean LSM and liver fat across subgroups.¹ Between 89% and 98% of patients in each subgroup improved or remained stable.

Results were directionally consistent in other datasets. In Trio Health data, 45% of 195 patients achieved an LSM improvement of at least 25% at 12 months, and 44% of a separate group of 347 patients with documented fibrosis stages improved by at least one stage.¹ In a Gastro Health/Latica cohort, 32 of 46 patients with baseline LSM between 10 and less than 20 kPa moved below 10 kPa at follow-up, while 37% of 35 patients at Methodist Dallas Medical Center achieved an improvement of at least 25% .¹

What Cardiometabolic and Safety Findings Were Reported with Resmetirom?

In the Truveta analysis, mean alanine aminotransferase (ALT) decreased by 16.2 U/L, LDL cholesterol by 15.5 mg/dL, and triglycerides by 41.0 mg/dL from baseline at 12 months; Madrigal described all of these changes as statistically significant.¹ In Trio Health data, 48% of patients had an ALT reduction of at least 20%, and 54% had a clinically meaningful reduction in controlled attenuation parameter (CAP) of more than 40 dB/m.¹ Claims-based Optum Market Clarity data also showed statistically significant reductions in liver enzymes and select cardiometabolic measures at 12 months.¹

In the Gastro Health/Latica cohort, 11% of patients experienced at least one adverse event. The most frequent were diarrhea (7%), nausea (4%), pruritus (2%), and vomiting (2%).¹ Resmetirom carries warnings for hepatotoxicity and gallbladder-related events and is not recommended with gemfibrozil.¹

Persistence analyses included a retrospective CVS Healthspire pharmacy cohort of 11,469 patients, along with claims-based data.¹ Up to 89% of patients remained on therapy at 6 months and up to 72% at 12 months, using a 60-day treatment-gap definition.¹

"These new data represent an important expansion of the real-world evidence supporting [resmetirom] as a foundational therapy for patients with MASH," said David Soergel, MD, Chief Medical Officer of Madrigal. "Across multiple studies and diverse patient populations, we are seeing robust improvements in noninvasive measures of liver health consistent with the positive results observed in the pivotal Phase 3 trial of [resmetirom]. The findings also provide encouraging evidence that most patients are staying on therapy over time. Together, these results reinforce the strong real-world effectiveness, safety and tolerability profile of [resmetirom], and provide valuable insight into how the medication is being used in everyday clinical practice.”

Madrigal Pharmaceuticals. Madrigal announces new real-world data at AASLD 2026 demonstrating improvements in liver stiffness and cardiometabolic health markers with Rezdiffra. GlobeNewswire. Published November 5, 2026. Accessed November 5, 2026. 

https://www.globenewswire.com/news-release/2026/11/05/3396655/0/en/madrigal-announces-new-real-world-data-at-aasld-2026-demonstrating-improvements-in-liver-stiffness-and-cardiometabolic-health-markers-with-rezdiffra.html

Harrison SA, Bedossa P, Guy CD, et al. A phase 3, randomized, controlled trial of resmetirom in NASH with liver fibrosis. N Engl J Med. 2024;390(6):497-509. doi:10.1056/NEJMoa2309000

Articles

Real-world data at AASLD 2026 show 37% to 55% of patients with MASH on resmetirom (Rezdiffra) improved liver stiffness by 25% or more at about one year.

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Real-World Resmetirom Data Show Liver Stiffness Gains in MASH

Victoria Johnson joined MJH Life Sciences in 2020 and has written for NeurologyLive, CGTLive, and is now an assistant managing editor for HCPLive and RheumatologyLive. She doesn’t have enough time for her various hobbies. You can reach her at vjohnson@mjhlifesciences.com.

A single nasal dose of ETH47, an investigational messenger RNA (mRNA) therapy encoding interferon lambda (IFNλ), reduced peak rhinovirus load 40-fold and showed a numerical trend toward lower respiratory symptoms vs placebo in adults with 

, according to topline phase 2a data announced by Ethris on November 5, 2026.

The primary endpoint, lower respiratory symptom score (LRSS), showed what Ethris described as a "consistent numerical trend" toward improvement, and the company did not report 

 ETH47 is designed to induce local IFNλ expression in the airway to bolster innate antiviral defense, targeting virus-triggered exacerbations not directly addressed by current maintenance therapy.

 In a phase 1 study of 40 healthy volunteers, ETH47 produced dose-dependent IFNλ in nasal lining fluid with no systemic exposure.

"Viral infections remain a major driver of asthma exacerbations, yet today's treatments don't directly address the virus," said Sebastian Johnston, MBBS, PhD, professor of respiratory medicine, Imperial College London, and director and chief medical officer, VirTus Respiratory Research.

ETH47 effects on viral load and LRSS in the rhinovirus challenge model

The randomized, placebo-controlled trial (ISRCTN21576805) enrolled 50 adults aged 18 to 65 years with symptomatic asthma receiving inhaled corticosteroids, with or without a long-acting β2-agonist.

 Participants received a single nasal dose of ETH47 or placebo 1 day before challenge with rhinovirus A16 and were followed through day 42 at the Imperial Clinical Respiratory Research Unit and the Medicines Evaluation Unit in the UK.

 The release did not report the ETH47 dose or the number of participants in each arm.

According to Ethris, ETH47 reduced viral load 40-fold at day 2, the time of peak replication.

 Peak LRSS was 14% lower and LRSS area under the curve (AUC) was 58% lower with ETH47 vs placebo.

Episodes meeting a mild exacerbation definition, an LRSS rise of at least 2 points, were 30% lower when sustained over 2 consecutive days and 56% lower over 3 days.

 Jackson Cold Score AUC was 53% lower, and the proportion of participants developing a cold was 37% lower.

ETH47 safety and exploratory IFNλ exposure-response findings

Ethris reported no severe or serious adverse events (AEs), no systemic exposure, and no anti-DMG-PEG antibodies after the single nasal dose.

 Local IFNλ expression was detected in nearly all dosed participants at 6 hours.

ETH47 is an investigational nasally administered mRNA therapy from Ethris designed to induce local IFNλ expression in the airway to strengthen innate antiviral defense in patients with asthma.

Ethris reported a consistent numerical trend toward improvement in lower respiratory symptom score, the primary endpoint, but did not report statistical significance for this or any other outcome.

In 50 adults with asthma challenged with rhinovirus A16, a single ETH47 dose reduced peak viral load 40-fold and lowered LRSS AUC by 58% vs placebo, with no serious adverse events.

Challenge-related respiratory treatment-emergent AEs were 73% lower and rescue medication use was 65% lower with ETH47.

 Spirometry showed numerical improvements, according to the company.

In an exploratory exposure-response analysis, effects were greater in participants with higher IFNλ exposure, including a more than 100-fold viral load reduction on days 2 and 3, a 19-fold lower peak viral load, and a 46% lower peak LRSS.

 The release did not state how many participants were in this subgroup or how higher exposure was defined.

"The clear relationship between exposure and effect will inform dose and regimen optimization in the next study," said Carsten Rudolph, PhD, cofounder and chief executive officer, Ethris.

Ethris plans a multiple-ascending-dose phase 1 study in patients with asthma and chronic obstructive pulmonary disease (COPD), a phase 2a rhinovirus challenge study in COPD, and phase 2b field studies in both populations.

 The company is also developing a spray-dried dry powder formulation designed for room-temperature stability.

Ethris. Ethris reports positive topline phase 2a data for nasal mRNA candidate ETH47 in asthma patients challenged with rhinovirus. Published November 5, 2026. Accessed November 5, 2026. https://www.globenewswire.com/news-release/2026/11/05/3396091/0/en/ethris-reports-positive-topline-phase-2a-data-for-nasal-mrna-candidate-eth47-in-asthma-patients-challenged-with-rhinovirus.html

Ethris. Ethris presents positive topline phase 1 data with mRNA lead candidate ETH47 for uncontrolled asthma. Published January 30, 2025. Accessed November 5, 2026. https://www.businesswire.com/news/home/20250130943965/en/Ethris-Presents-Positive-Topline-Phase-1-Data-with-mRNA-Lead-Candidate-ETH47-for-Uncontrolled-Asthma

In a 50-patient rhinovirus challenge study, a single nasal ETH47 dose cut peak viral load 40-fold, though the primary endpoint was not significant.

Asthma

The HCPLive asthma page is a comprehensive resource for clinical news and insights on asthmatic disease. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for allergic and severe asthma, and more.

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Nasal mRNA ETH47 Lowers Rhinovirus Load in Asthma Challenge Study

Seladelpar (Livdelzi) achieved alkaline phosphatase (ALP) normalization in 75.4% of patients with 

 and baseline ALP below 1.67 times the upper limit of normal (ULN), compared with 16.1% on placebo, in the phase 3 IDEAL trial. Gilead Sciences announced the Week 52 results, which are being presented at 

, hosted by the American Association for the Study of Liver Diseases (AASLD), November 5–9 in Denver, Colorado.

“People with PBC whose alkaline phosphatase remains elevated but below 1.67 times the upper limit of normal have been largely excluded from previous pivotal trials of second-line therapies,” Cynthia Levy, MD, University of Miami Miller School of Medicine, said in a statement.

 “IDEAL provides randomized, placebo-controlled evidence that seladelpar can improve biochemical response in this population. These findings can inform individualized treatment discussions, taking into account each individual’s risk of disease progression, symptoms, and potential benefits and risks of additional therapy.”

According to Gilead, IDEAL is the first trial of seladelpar in patients with inadequately controlled disease within this ALP range. The company noted a threshold of 1.67× ULN has historically been required for inclusion in PBC randomized trials, leaving patients below this cutoff largely unstudied.

The oral peroxisome proliferator-activated receptor delta (PPAR-δ) agonist received accelerated approval from the US Food and Drug Administration (FDA) in August 2024, based on ALP reduction in the phase 3 RESPONSE trial.

How Did Seladelpar Perform in the IDEAL Trial?

IDEAL is a randomized, double-blind, placebo-controlled phase 3 trial of 96 adults aged 18 to 75 years with PBC. Eligible patients had ALP above the ULN but below 1.67× ULN despite 12 months of ursodeoxycholic acid (UDCA), or were intolerant to UDCA. The Week 52 analysis included 65 participants on seladelpar and 31 on placebo.

The primary objective compared ALP normalization at Week 52 between arms. Normalization was defined as a composite of ALP ≤1.0× ULN and a decrease of at least 15% from baseline. Seladelpar met this endpoint in 75.4% (49/65) of participants, compared with 16.1% (5/31) on placebo.

The response came early. At one month, 52.3% of participants on seladelpar had reached ALP normalization, compared with 6.5% on placebo, and Gilead reported the response held through Week 52.

What is the Safety Profile of Seladelpar in IDEAL?

According to Gilead, the safety profile of seladelpar in IDEAL was consistent with earlier studies, and no new safety concerns were identified. Adverse event incidence was generally similar between treatment arms. Serious adverse events occurred in 3.1% of participants on seladelpar and 12.9% of those on placebo, and none were considered related to study drug.

Exploratory endpoints included other markers of cholestasis and liver injury, but the release did not give results for these measures. The IDEAL data have been accepted for publication in the Journal of Hepatology.

The current US prescribing information includes a warning for fractures, which occurred in 4% of seladelpar-treated patients and no placebo-treated patients in earlier trials. It also warns of dose-related transaminase elevations above 3× ULN at daily doses of 50 mg and 200 mg; the recommended dose is 10 mg once daily. The most common adverse reactions include headache (8%), abdominal pain (7%), nausea (6%), abdominal distension (6%), and dizziness (5%).

“The IDEAL study evaluated the impact of initiating second-line treatment in people living with PBC who have lower levels of baseline ALP elevation compared to prior clinical trials,” said Swati Tole, MD, MS, Senior Vice President, Clinical Development, Inflammation, Gilead Sciences.

“A significantly greater proportion of people with elevated ALP levels, but below the threshold typically studied, achieved ALP normalization with Livdelzi, supporting ALP normalization as an achievable treatment goal. Together with the broader Livdelzi clinical program, IDEAL reinforces the importance of continuing to raise expectations for PBC care across a wide range of patients.”

Gilead stated it is discussing the IDEAL results with global regulatory authorities. Under its accelerated approval, seladelpar has not demonstrated a survival benefit or prevention of liver decompensation, and continued approval may depend on confirmatory trials.

Gilead Sciences. Positive phase 3 IDEAL study results further support Livdelzi’s (seladelpar) impact on achieving ALP normalization goals in second-line treatment across a broad population of people living with PBC. Published November 2026. Accessed November 5, 2026. 

https://www.gilead.com/news/news-details/2026/positive-phase-3-ideal-study-results-further-support-livdelzis-seladelpar-impact-on-achieving-alp-normalization-goals-in-second-line-treatment-across-a-broad-population-of-people-living-with

Hirschfield GM, Bowlus CL, Mayo MJ, et al. A phase 3 trial of seladelpar in primary biliary cholangitis. N Engl J Med. 2024;390(9):783-794. doi:10.1056/NEJMoa2312100

In the phase 3 IDEAL trial, 3 in 4 patients with PBC and ALP below 1.67× ULN reached ALP normalization on seladelpar at 52 weeks, compared with 16.1% on placebo.

Cholangitis

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IDEAL: Seladelpar Achieves ALP Normalization in Second-Line PBC

Martina J. Porter, MD, is a dermatologist at Beth Israel Deaconess Medical Center.

In "HS Biologics: IL-17 vs TNF Inhibition, Bimekizumab Tunnel Data, and Early Treatment," the panel explores how pathway differences and EADV data influence biologic selection and timing.

HS Biologics: IL-17 vs TNF Inhibition, Bimekizumab Tunnel Data, and Early Treatment

The panel is asked how TNF-alpha and IL-17 inhibitors differ in the inflammatory pathways they target and how they are used differently in HS. The panel explains that TNF inhibitors offer broader inhibition and are a strong choice with comorbid inflammatory bowel disease, but they require awareness of possible exacerbation of congestive heart failure or links to multiple sclerosis. For patients with draining tunnels, an IL-17 agent, particularly one covering IL-17F, may be preferable because IL-17F is highly enriched in the epithelium lining sinus tracts. Panelists describe favoring TNF inhibitors for nodular phenotypes. The panel adds that growing data suggest meaningful differences among the three biologics.

Attention then turns to bimekizumab data presented at EADV from the BE HEARD studies, which tracked draining tunnel counts over three years. The mean baseline count was roughly 3.8 to 4, and the three-year change was a decrease of more than three. The analyses were also stratified by disease duration and prior biologic use.

That leads to a case for treating earlier. The panel pushes back on reserving biologics for the worst cases, noting that the risks of a drug stay constant while the benefit shrinks over time, so the best risk-benefit ratio comes from early, aggressive treatment. When patients are separated by disease duration, the response rate cited roughly halves, from 46% to 23%, in longer-standing disease. Patients with longer disease still deserve treatment and can improve, but the needle moves more with earlier treatment. The panel suggests the data may support using biologics sooner, in milder disease, and potentially reducing comorbidities. Even when tunnels resolve, scarring remains in functional areas that need soft, pliable tissue, so early aggressive treatment is described as tissue sparing.

In "HS Long-Term Outcomes: Durable Response, Tunnel Regression, and Monitoring," the panel will examine longer-term secukinumab data and how clinicians monitor patients over time.

Videos

Pathway biology and new draining tunnel data shape how the panel positions TNF and IL-17 inhibitors. The discussion also makes the case that earlier treatment improves response and preserves functional tissue.

Video Series

"HS Surgery: De-Roofing Alongside Biologic Therapy" takes up the question of how procedures fit into HS care alongside advanced therapy.

HS Surgery: De-Roofing Alongside Biologic Therapy

The panel is asked how it views surgical procedures such as de-roofing and whether they help with pain, drainage, and quality of life. The panel describes disease management as two parallel tracks. Medical management includes counseling and escalation to biologics or oral small molecules, while surgical intervention can run alongside it. The surgical conversation should be raised at every follow-up visit, particularly when draining tunnels or localized inflammation could be controlled by a de-roofing procedure. The panel notes that data now support performing these procedures, and even larger surgeries, while patients remain on therapy. For a time, whether to take patients on and off their biologic around surgery was a major open question. The paradigm has shifted to treating on drug, which has improved outcomes because inflammation stays controlled while the patient heals. Remaining on biologics throughout is considered safe and probably better for healing, with no breaks needed.

For listeners who do not perform de-roofing, the panel emphasizes that it requires little time or equipment. It requires willingness, and procedures can be as small or as extensive as a clinician is comfortable with, always within scope of practice. Anyone who can perform an excision or electrodessication and curettage can de-roof, because the tools and tissue planes are the same. Clinicians can stop and ask for help if they reach an area outside their comfort zone. For larger operations, regional HS surgery experts and referral centers can perform graft placements, while smaller de-roofings are handled in the department.

The panel also covers coding. De-roofing uses the same CPT codes as certain plastic surgery procedures, which are limited to three anatomic areas: axilla, inguinal region, and buttocks. For the chest or back, clinicians approximate the closest area.

Our next episode, "HS Biologics: IL-17 vs TNF Inhibition, Bimekizumab Tunnel Data, and Early Treatment," turns to how TNF and IL-17 inhibitors differ and what newly presented tunnel data suggest.

Medical and surgical management work in parallel in HS. The panel argues for treating through surgery on biologics and explains why de-roofing is within reach for community clinicians.

October 2026 pulmonology highlights include FDA accelerated approval of Voceryq for recurrent respiratory papillomatosis and CHEST 2026 data.

COPD

COPD condition center page, resources on the topics of medical news and expert insight into chronic obstructive pulmonary disease can be found. Content includes articles, interviews, videos, podcasts, and breaking news on COPD research, treatment, and drug development.

7 Pulmonology Headlines You Missed in October

Marat Fudim, MD, discusses his analysis of a US cohort from the POSEIDON study, which found a potential association between CVI and HF severity.

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

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Strategic Alliance Partnership

Higher Cardiovascular Inflammation Prevalent Across All Heart Failure Subtypes

Tim Smith joined the MJH Life Sciences team in 2022 and is currently an associate editor for 

. He is also the executive producer of two podcasts: 

. Previously, he was the producer of the Lungcast podcast. He graduated from UC Berkeley and worked in multimedia journalism as a staff writer prior to joining MJH. You can contact him at tsmith@mjhlifesciences.com.

HCPLive previews GOLD 2026 in Philadelphia, November 5-6, with sessions on the 2027 GOLD Report, mucus plugging, and exacerbations, plus expert interviews.

Conference Preview: 2026 GOLD International COPD Conference

Bradley Dixon, MD, discusses VALIANT+VALE data showing sustained proteinuria reduction and stable eGFR through 76 weeks in adolescents with C3G or IC-MPGN.



Nephrology

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C3 Glomerulopathy

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Chronic Kidney Disease

Could Earlier Complement Inhibition Preserve Kidney Function in C3G?

Pegcetacoplan Sustains Proteinuria Reduction at 76 Weeks in Adolescents

Tobias Uhe, MD, is a specialist in internal medicine and cardiology and a senior physician at the University of Leipzig.

Tobias Uhe, MD, discusses the results of the Find-AF 2 Watch trial, examining 2 different smart watches as AF monitors in patients with a recent ischemic stroke.

Arrhythmia

Stroke

On the HCPLive stroke page, resources on the topics of medical news and expert insight into CVA can be found. Content includes articles, interviews, videos, podcasts, and breaking news on stroke medicine, and more.

Smart Watches Detect Atrial Fibrillation After Stroke, Sensitivity Depends Episode Duration

Gregory Bensch, MD, and Bay Area allergy clinicians discuss where ruxolitinib, tapinarof, and roflumilast creams fit after topical corticosteroids.

Atopic Dermatitis

Atopic Dermatitis condition center page, audiences can find a variety of coverage mediums for medical news and updates, including articles, video interviews, podcasts, and breaking news on dermatitis research, treatment, and drug development.

Dermatology

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Examining Topical Therapy for Atopic Dermatitis: Clinical Forum Perspectives

Chelsie Derman is an associate editor for 

who covers allergy and  psychiatry. She joined MJH Life Sciences in September 2023 after graduating from The College of New Jersey with a bachelor’s degree in journalism and professional writing. In her free time, she enjoys creative writing and reading.

October 2026 allergy news: FDA approvals for berotralstat pellets and remibrutinib, RAPIDe-3 data in HAE, alpha-gal syndrome, and Viaskin Peanut Patch.


Food Allergy

Anaphylaxis

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7 Allergy Headlines You Missed in October 2026

Shakar Kutal is a doctoral researcher at Helsinki University Hospital.

Shakar Kutal, a doctoral researcher at Helsinki University, discusses his study evaluating the role of dietary factors in early-onset CIS among young adults.

Adherence to Plant-Based Mediterranean Diet May Reduce Cryptogenic Stroke Risk

Skin clearance and route of administration drove treatment choices among 202 patients with psoriasis in the ENCOMPASS-PP discrete choice experiment.

Plaque Psoriasis

The HCPLive plaque psoriasis page is a resource for medical news and expert insights on psoriasis. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for psoriatic disease, and more.

Latest News

Real-World Resmetirom Data Show Liver Stiffness Gains in MASH

Nasal mRNA ETH47 Lowers Rhinovirus Load in Asthma Challenge Study

IDEAL: Seladelpar Achieves ALP Normalization in Second-Line PBC

HS Biologics: IL-17 vs TNF Inhibition, Bimekizumab Tunnel Data, and Early Treatment

HS Surgery: De-Roofing Alongside Biologic Therapy