Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and the Emerging Role of Resmetirom: A Comprehensive Review

Abstract

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), previously referred to 
as nonalcoholic fatty liver disease (NAFLD), is increasingly recognized as the hepatic 
manifestation of metabolic syndrome. In 2023, international hepatology societies updated the 
nomenclature from NAFLD to MASLD, emphasizing metabolic dysfunction as the central 
pathophysiologic driver. This spectrum of liver disease ranges from benign steatosis to 
steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Despite its high global 
prevalence, MASLD has historically lacked approved pharmacologic therapies. Recent 
advances in therapeutics have introduced  Resmetirom, a selective thyroid hormone 
receptor-beta (THR-β) agonist, which has shown promising results in reducing hepatic fat 
and improving histological endpoints. This review explores the epidemiology, pathogenesis, 
diagnosis, and therapeutic potential of Resmetirom in the treatment of MASLD.