Resmetirom is a thyroid hormone receptor-beta agonist used to treat noncirrhotic nonalcoholic steatohepatitis (NASH) with moderate to advanced liver fibrosis in adults. On March 14, 2024, it was approved by the FDA as the first treatment of liver fibrosis due to noncirrhotic non-alcoholic steatohepatitis (NASH), which is a form of non-alcoholic fatty liver disease (NAFLD).
- Mechanism
- Curator reviewed · 11 references
Thyroid hormones, such as FT4 and free triiodothyronine (FT3), are key regulators of lipid metabolism in the liver. Thyroid hormone receptor-beta (THR-β) is the major form of the thyroid hormone receptor in the liver, and stimulation of this receptor reduces intrahepatic triglycerides.
Many patients with non-alcoholic fatty liver disease (NAFLD) present with impaired thyroid function, such as hypothyroidism, rendering it a significant risk factor for NAFLD. Hypothyroidism has also been linked to dysregulated adipose tissue lipolysis and increased free fatty acid release from the adipose to the liver, promoting hepatic insulin resistance. Increased circulating levels of proinflammatory adipokines, which contribute to hepatic inflammation and fibrosis, may also be observed.
Resmetirom is a partial agonist of THR-β that promotes lipophagy and hepatic fatty acid β-oxidation, thereby reducing liver fat. It is approximately 28 times more selective than FT3 for THR-β versus thyroid hormone receptor-alpha (THR-α), which is mainly expressed in the heart and bones.
- Primary indication
- Resmetirom is indicated in conjunction with diet and exercise for the treatment of adults with noncirrhotic nonalcoholic steatohepatitis (NASH) with moderate to advanced liver fibrosis (consistent with stages F2 to F3 fibrosis).Curator reviewed · 2 structured indications
- Formula / weight
- C17H12Cl2N6O4 · 435.22 g/mol (avg)
- First approval
- United States, 2024
- Also known as
- 1,2,4-Triazine-6-carbonitrile, 2-[3,5-dichloro-4-[[1,6-dihydro-5-(1-methylethyl)-6-oxo-3-pyridazinyl]oxy]phenyl]-2,3,4,5-tetrahydro-3,5-dioxo- · 2-[3,5-Dichloro-4-[[1,6-dihydro-5-(1-methylethyl)-6-oxo-3-pyridazinyl]oxy]phenyl]-2,3,4,5-tetrahydro-3,5-dioxo-1,2,4-triazine-6-carbonitrile
- Code names
- MGL-3196 · VIA-3196
- Brand names
Resolves to
FDBYIYFVSAHJLY-UHFFFAOYSA-NSMILESCC(C)C1=CC(OC2=C(Cl)C=C(C=C2Cl)N2N=C(C#N)C(=O)NC2=O)=NNC1=OWhat you can answer from here — as of April 03, 2024
Which drugs share a target with Resmetirom, and which of those have an active Phase 3 trial?
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