Comparing Resmetirom with Semaglutide and tirzepatide In the context of NAFLD/NASH (MASLD/MASH)

Understanding how these very different drugs work in the context of steatotic liver disease

At the end of 2024 there are three drugs available for patients dealing with obesity and its consequences for liver disease.  Resmetirom marketed as Rezdiffra (Madrigal) is a liver specific drug and Semaglutide marketed as Wegovy (Novo Nordisk) and Tirzepatide marketed as Mounjaro by (Eli Lilly) are both focused on weight loss outside the liver. 

Resmetirom, developed by Madrigal Pharmaceuticals is for the treatment of nonalcoholic steatohepatitis (NASH). Resmetirom is a selective thyroid hormone receptor beta (THR-β) agonist, and its mechanism of action is distinct from both Semaglutide and Tirzepatide. Both of these drugs are GLP-1 agonists directed at type 2 diabetes through reduction of obesity. A comparison of their mechanisms and actions in table form but a more expansive report is available by clicking on the table.