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u200b Resmetirol is a highly selective thyroid hormone receptor beta (THR-β) agonist.
Resmetirol is a thyroid hormone receptor-β (THR-β) agonist that needs to be combined with diet and exercise for the treatment of adults with non-cirrhotic non-alcoholic steatohepatitis (NASH) with moderate to advanced liver fibrosis (stage F2-F3). This indication is based on the accelerated approval pathway and requires subsequent clinical trials to verify clinical benefit. It is contraindicated in patients with decompensated cirrhosis.
Recommended dose of : Adjust according to actual body weight. Those weighing <100kg should take 80mg orally daily, and those weighing ≥100kg should take 100mg daily. They can be taken before or after meals.
Dose adjustment :
CYP2C8 inhibitor combined with : strong inhibitors (such as gemfibrozil) are prohibited; moderate inhibitors (such as clopidogrel) need to be reduced to 60 mg (<100kg) or 80mg (≥100kg).
Liver dysfunction : Avoid use by patients with moderate to severe liver damage (Child-Pugh B/C grade).
Attention when taking medicine : Swallow the whole tablet. If you miss a dose, there is no need to make up for it. Take the next dose according to the originally planned time.
Common adverse reactions (≥5%) include diarrhea (14-33%), nausea (9-18%), pruritus (4-10%), vomiting (4-8%), constipation (4-8%), abdominal pain (4-7%), and dizziness (1-4%). Be wary of the following serious risks:
Hepatotoxicity : It may cause drug-induced autoimmune hepatitis (DI-ALH). Liver function needs to be monitored. If symptoms such as fatigue and jaundice occur, stop taking the drug immediately.
Gallbladder-related events : The incidence of gallstones and cholecystitis increases, and treatment needs to be interrupted in the event of an acute attack.
Drug interactions : Combination with statins may increase the risk of rhabdomyolysis, and the dose of statin needs to be limited (such as simvastatin ≤ 20 mg/day).
Monitoring requirements :
Regularly check liver function, thyroid function (FT4 may decrease), and gallbladder ultrasound.
The drug needs to be stopped before and after surgery: stop 24 days before elective surgery, and restart after the wound has healed.
Contraindications : There are no absolute contraindications, but strong CYP2C8 inhibitors (such as gemfibrozil) or OATP inhibitors (such as cyclosporine) are contraindicated.
Special groups :
Pregnant women : Animal experiments show embryotoxicity, contraception is required until 1 month after stopping the drug.
Lactation : Avoid breastfeeding during treatment and within 1 month of stopping the drug.
Store away from light at 20-25°C (short-term 15-30°C allowed), and keep out of the reach of children.