Resmetirom (Rezdiffra)
Hormones · Liver-selective THR-β agonist
Tier B
What this is
Madrigal Pharmaceuticals. First-ever approved drug for MASH/NASH — landmark approval after decades of failed candidates (e.g., obeticholic acid, elafibranor, selonsertib). Target population: MASH with F2/F3 fibrosis, ~6-7% of US adults. Prescribed by hepatology; expensive (~$47K/year list). Particularly relevant for biohacker readers given the strong overlap between metabolic syndrome and liver fat that Attia and others discuss frequently.
Mechanism
Liver-selective thyroid hormone receptor beta (THR-β) agonist; activates hepatic lipid catabolism, mitochondrial biogenesis, and autophagy without systemic hyperthyroid effects; first FDA-approved drug targeting metabolic dysfunction-associated steatohepatitis (MASH)
Dose & route
80-100 mg PO once daily (weight-based)
Citations
- https://doi.org/10.1056/NEJMoa2309000
- https://pubmed.ncbi.nlm.nih.gov/41895606/
- https://pubmed.ncbi.nlm.nih.gov/40868953/
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