Indications Anailiva tablet is indicated, in conjunction with diet and exercise, for the treatment of adults with noncirrhotic nonalcoholic steatohepatitis (NASH) with moderate to advanced liver fibrosis (consistent with stage F2 to F3).

Stages of Liver Damage Pre-hepatic: Reversible fatty liver, restoration is possible.

Pharmacology Resmetirom is a partial agonist of the thyroid hormone receptor-beta (THR-β). It produces 93% of the maximum response compared to triiodothyronine (T3), with an EC50 of 0.2 μM. THR-β is the major form in the liver, and stimulation reduces intrahepatic triglycerides.

Dosage & Administration

For patients weighing <100 kg: 80 mg orally once daily.
For patients weighing >100 kg: 100 mg orally once daily. Resmetirom can be administered with or without food.

Drug Interactions

Strong/Moderate CYP2C8 inhibitors (e.g., Gemfibrozil, Clopidogrel) increase risk of adverse reactions.
OATP1B1 and OATP1B3 inhibitors (e.g., Cyclosporine) are not recommended.
Statins: Resmetirom increases plasma concentrations of atorvastatin, pravastatin, rosuvastatin, and simvastatin.
- Rosuvastatin & Simvastatin: Max 20 mg/day.
- Pravastatin & Atorvastatin: Max 40 mg/day.

Side Effects Diarrhea, nausea, vomiting, abdominal pain, dizziness, pruritus, constipation.

Pregnancy & Lactation

Pregnancy: No available data; risk of birth defects or miscarriage unknown.
Lactation: Unknown if present in human milk; benefits of breastfeeding should be weighed against maternal need for therapy.

Precautions & Warnings

Hepatotoxicity: Monitor liver function; discontinue if suspected.
Gallbladder-related events: Cholelithiasis, cholecystitis, pancreatitis observed. Interrupt treatment if suspected.

Use in Special Populations

Pediatric: Safety not established.
Geriatric: Higher incidence of adverse reactions in patients ≥65 years.
Renal impairment: Mild/moderate impairment – same dose as normal. Severe impairment – not studied.
Hepatic impairment: Avoid in decompensated cirrhosis; moderate/severe impairment increases risk.