Non-invasive Identification of MASLD Patients Eligible for Resmetirom Treatment

Le résumé fourni par la source

Background and Aims Based on phase-3 trial data, the liver-directed thyroid hormone receptor (THR)-β agonist resmetirom obtained the conditional approval for the treatment of MASH patients with moderate to advanced (F2/F3) fibrosis. Recently, vibration-controlled transient elastography (VCTE) with values between 10 and 19.9 kPa was recommended to identify MASLD patients eligible for resmetirom treatment. Methods In a real-world multicenter study, we evaluated the utility of VCTE for identifying patients with resmetirom indication. VCTE was performed in 291 biopsy-proven MASLD patients, who were not pre-selected for pharmacotherapy trials. In addition, we evaluated the Agile 3+score, which considers VCTE in combination with routine clinical and laboratory parameters, in MASLD patients with VCTE values of 10 to 19.9 kPa. Results We show that VCTE values<10 kPa were mainly associated with no or low fibrosis, while VCTE values≥20 kPa primarily indicated advanced fibrosis or cirrhosis. Among MASLD patients with VCTE values of 10–19.9 kPa, a substantial subset did not meet the label criteria for resmetirom treatment, despite lacking features of cirrhosis such as thrombocytopenia/portal hypertension. The use of the Agile 3+score reduced the proportion of patients with VCTE of 10 to 19.9 kPa, who were off-label for resmetirom treatment. Conclusion In MASLD patients with VCTE values of 10–19.9 kPa and no features of cirrhosis, additional diagnostic tools may be needed to minimize misclassification and optimize the identification of patients eligible for resmetirom treatment. Publication History Article published online: 26 January 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.