Can resmetirom be used to treat cirrhosis?

Resmetirom - Rezdiffra's indications focus on adults with non-alcoholic steatohepatitis (NASH) accompanied by moderate to severe liver fibrosis stages, that is, stage F2 to F3. Without intervention, these people are prone to develop cirrhosis and decompensated liver disease, so early treatment is crucial. Resimeterol can improve liver fat deposition and inflammation, slow down the process of fibrosis, thereby reducing the risk of developing cirrhosis. However, this drug is currently not recommended for patients with cirrhosis who have entered the decompensated stage.

Patients with decompensated cirrhosis are often accompanied by serious complications such as portal hypertension, ascites, esophageal and gastric varices, and bleeding. These people have poor liver function reserve and severely limited drug metabolism. The use of resmetirol may increase the risk of drug accumulation and bring additional burden. Therefore, the instructions clearly state that the drug should not be used in patients with decompensated cirrhosis.

For patients with early or intermediate fibrosis, rismetirol combined with diet control and exercise intervention can effectively prevent disease progression and is an active line of defense. Once it develops into the cirrhosis stage, especially the decompensated stage, it is still necessary to rely on other symptomatic treatments or wait for liver transplantation. Of note, future studies in patients with compensated cirrhosis may still be possible to explore the potential range of applications of resmetirob.

Therefore, the clinical positioning of rismetirol is more towards prevention and delay, rather than direct treatment of established cirrhosis. For NASH patients, early screening and intervention are particularly important. Only when the disease has not entered the irreversible stage can resmetirol be used to maximize its efficacy and clinical value.

Reference materials:https://www.drugs.com/monograph/resmetirom.html