Soon an effective treatment to reduce fatty liver? The promising results of a new molecule, resmetirom, have just been revealed at the European Congress of Hepato-Gastroenterology, from October 14 to 17 in Copenhagen (Denmark),
Increasingly common in France, fatty liver, or fatty liver disease, is now the main cause of liver disease in our country and seems on the verge of overtaking excessive alcohol consumption in Europe. This metabolic liver disease, which can lead to persistent inflammation progressing to cirrhosis or even liver cancer, is mainly due to an unhealthy lifestyle, including the consumption of “junk food” and a sedentary lifestyle.
Around 20% to 25% of adults suffer from it, particularly overweight people and diabetics. Over time, in 10% of cases, it evolves into an inflammatory form called non-alcoholic steatohepatitis (NASH), characterized by fibrosis of liver tissue, that is to say excessive formation of scar tissue. This is the stage preceding cirrhosis.
Weight loss, the only current effective “treatment”
Currently, no specific drug treatment has been approved for this disease. The only advice that doctors can give is to lose at least 10% of your weight, to hope to reverse the disease and reduce the risk of cirrhosis. This involves a low-calorie diet, in particular by reducing carbohydrates, and regular physical activity to stimulate the metabolism.-
If incretins (GLP-1 analogues), already used to treat type 2 diabetes, are serious candidates, research is finally coming to fruition, with the good results of an oral molecule, resmetirom, an “agonist selective for thyroid hormone β receptors. This molecule appears to promote fat metabolism in the liver and reduce the toxicity of lipids stored in liver cells.-
Disappearance of liver fat in 30% of participants
During the European Hepato-Gastroenterology Congress, the results of the international MAESTRO-NASH clinical trial carried out in 200 experimental centers were eagerly awaited. After one year of treatment, liver fat had disappeared in 30% of participants (at a dose of 80 mg per day), and fibrosis had regressed in 26% of them. In addition, various biomarkers have been improved, including the reduction of liver enzymes.
Regarding tolerability, side effects such as diarrhea and nausea were mainly present at the start of treatment, without serious consequences.
Resmetirom therefore has real potential to reduce liver steatosis and its complications. The MAESTRO-NASH trial should shed light on the future place of this new drug in the treatment of “fatty liver”, once it has received approval from European health authorities.