Real-World Resmetirom Results Rival Trials: Parvez Mantry, MD

Real-world use of resmetirom in a diverse, high-risk population is producing results that mirror, and in some ways exceed, those seen in clinical trials, according to Parvez Mantry, MD, medical director of Liver Institute Research at Methodist Dallas Medical Center. His team presented its real-world data at AASLD’s The Liver Meeting 2026, drawing on more than 2.5 years of experience treating patients with metabolic dysfunction-associated steatohepatitis (MASH).

Real-World Resmetirom Use

The Methodist Dallas cohort now includes more than 600 patients, a group that has grown largely because of encouraging results and patient feedback. Mantry described them as more diverse and at higher risk for cirrhosis and adverse liver outcomes than trial participants, who undergo 2 biopsies and are tightly characterized. More than 90% have tolerated resmetirom, and noninvasive tests (NITs) show stable or improving disease.

Nearly 300 patients also take a glucagon-like peptide-1 (GLP-1) receptor agonist, compared with about 15% of patients in the MAESTRO trials. Early MAESTRO data linked an extra 5% to 10% weight loss with substantially higher response to resmetirom, a pattern Mantry is seeing in practice without more adverse events.

“The drugs are complementary to each other, and we have resmetirom, which is the foundational therapy of MASH, and then we have a GLP, which really aids in weight loss,” he said.

Monitoring Without Biopsy

The team uses blood tests and transient elastography at 6 months, 1 year, and every 6 months after that. Most patients are doing well and are encouraged to continue lifestyle changes. For the minority still progressing, clinicians reinforce lifestyle measures or consider clinical trials, since no second-line therapies are available.

“The beauty of this platform is that we probably have to do biopsies in less than 5% of these individuals, which is a big win-win for these patients,” Mantry said.