Understanding Resmetirom's Potential Based on MAESTRO-NASH

The discussion highlights how the advent of an approved therapy for MASH, formerly known as NASH, might impact the management of the disease. Recorded prior to the approval of resmetirom, the discussion centers around how the MAESTRO-NASH trial might inform use of the agent in real-world settings.

The trial results, recently published in the New England Journal of Medicine, indicate significant improvements in key clinical outcomes compared to a placebo, with around 25% of patients experiencing improvement and even higher rates with higher doses of the medication. The conversation also touches on the practical aspects of prescribing and monitoring patients on the medication. Both Arab and Banerjee agree that when the drug becomes available, they would consider prescribing it, especially for high-risk MAFLD populations

Later, the pair discuss the importance of monitoring for both efficacy and side effects, including gastrointestinal symptoms and muscle-related issues. Monitoring liver enzymes, liver function tests, and non-invasive fibrosis assessments like transient elastography are recommended, with consideration for potential changes in cardiovascular outcomes over time. Additionally, Arab and Banerjee emphasize the need for long-term follow-up given the gradual nature of fibrosis improvement.

Editor’s Note: This conversation was recorded on March 14, 2024 prior to the FDA’s approval of resmetirom.

Arab has no relevant disclosures to report. Banerjee’s disclosures include Perspectum Ltd.