REAL-WORLD CLINICAL CHARACTERISTICS AND FACTORS ASSOCIATED WITH CONCURRENT GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONIST (GLP-1 RA) THERAPY AMONG PATIENTS WITH METABOLIC DYSFUNCTION-ASSOCIATED STEATOHEPATITIS (MASH) PRESCRIBED RESMETIROM
Author(s)
Sammy Saab, MD, MPH1, Yestle Kim, MSc, PharmD2, Dave Lewandowski, MBA3, Taylor Ryan, MHI3, Jessamine Winer-Jones, PhD4, John O'Donnell, MPP, PhD5, Mac Bonafede, MPH, PhD6;
1Pfleger Liver Institute, Los Angeles, CA, USA, 2Madrigal Pharmaceuticals, Jersey City, NJ, USA, 3Veradigm, Chicago, IL, USA, 4Veradigm, Sr. Manager, Publications, Chapel Hill, NC, USA, 5Madrigal Pharmaceuticals, Thornton, PA, USA, 6Veradigm Life Sciences, Brentwood, NH, USA
1Pfleger Liver Institute, Los Angeles, CA, USA, 2Madrigal Pharmaceuticals, Jersey City, NJ, USA, 3Veradigm, Chicago, IL, USA, 4Veradigm, Sr. Manager, Publications, Chapel Hill, NC, USA, 5Madrigal Pharmaceuticals, Thornton, PA, USA, 6Veradigm Life Sciences, Brentwood, NH, USA
OBJECTIVES: This retrospective study examines the real-world characteristics of US adults with MASH initiating resmetirom with or without concomitant GLP-1 RA therapy and predictors of concomitant therapy.
METHODS: Patients ≥18 years old with ≥1 pharmacy claim (earliest=index date) for resmetirom between March 14, 2024 and August 31, 2025 were identified in the Veradigm Network EHR linked to Komodo claims. Patients were required to have: non-missing age or sex; continuous enrollment ≥1 year pre-index (baseline) and 6 months post-index (follow-up); and no evidence of baseline cirrhosis, decompensated cirrhosis, liver transplant, or hepatocellular carcinoma. Patients were stratified by receipt of GLP-1 RA during follow-up. Adherence to resmetirom was measured by proportion of days covered (PDC). Multivariable logistic regression assessed factors associated with concomitant use of resmetirom and GLP-1 RAs. Covariates included age, sex, race, ethnicity, region, payer, fibrosis-4 score, baseline GLP-1 RA use, and baseline metabolic comorbidities.
RESULTS: Of 599 adults initiating resmetirom, 232 (38.7%) had ≥1 GLP-1 RA prescription during follow-up. Patients were, on average, 59 years old and majority female. Metabolic comorbidities were more common among patients who received a concomitant GLP-1 RA (hyperlipidemia: 81.5% vs 70.3%, p=0.002; hypertension: 76.3% vs 68.4%, p=0.037; obesity: 75.4% vs 51.8%, p<0.001; and type 2 diabetes (T2D): 90.9% vs 39.8%, p<0.001). The most common GLP-1 RAs were semaglutide (51.7%) and tirzepatide (42.7%). Both cohorts had a mean resmetirom PDC of 0.73. In the model, the factors significantly associated with higher odds of receipt of a concomitant GLP-1 RA were baseline GLP-1 RA use and baseline obesity. Baseline GLP-1 RA use was strongly correlated with baseline T2D, but sensitivity analyses confirmed baseline use, not T2D, was the significant predictor.
CONCLUSIONS: Resmetirom adherence was similar irrespective of concomitant GLP-1 RA use. Prior GLP-1 RA use and baseline obesity were significantly associated with concomitant GLP-1 RA use in the follow-up period.
METHODS: Patients ≥18 years old with ≥1 pharmacy claim (earliest=index date) for resmetirom between March 14, 2024 and August 31, 2025 were identified in the Veradigm Network EHR linked to Komodo claims. Patients were required to have: non-missing age or sex; continuous enrollment ≥1 year pre-index (baseline) and 6 months post-index (follow-up); and no evidence of baseline cirrhosis, decompensated cirrhosis, liver transplant, or hepatocellular carcinoma. Patients were stratified by receipt of GLP-1 RA during follow-up. Adherence to resmetirom was measured by proportion of days covered (PDC). Multivariable logistic regression assessed factors associated with concomitant use of resmetirom and GLP-1 RAs. Covariates included age, sex, race, ethnicity, region, payer, fibrosis-4 score, baseline GLP-1 RA use, and baseline metabolic comorbidities.
RESULTS: Of 599 adults initiating resmetirom, 232 (38.7%) had ≥1 GLP-1 RA prescription during follow-up. Patients were, on average, 59 years old and majority female. Metabolic comorbidities were more common among patients who received a concomitant GLP-1 RA (hyperlipidemia: 81.5% vs 70.3%, p=0.002; hypertension: 76.3% vs 68.4%, p=0.037; obesity: 75.4% vs 51.8%, p<0.001; and type 2 diabetes (T2D): 90.9% vs 39.8%, p<0.001). The most common GLP-1 RAs were semaglutide (51.7%) and tirzepatide (42.7%). Both cohorts had a mean resmetirom PDC of 0.73. In the model, the factors significantly associated with higher odds of receipt of a concomitant GLP-1 RA were baseline GLP-1 RA use and baseline obesity. Baseline GLP-1 RA use was strongly correlated with baseline T2D, but sensitivity analyses confirmed baseline use, not T2D, was the significant predictor.
CONCLUSIONS: Resmetirom adherence was similar irrespective of concomitant GLP-1 RA use. Prior GLP-1 RA use and baseline obesity were significantly associated with concomitant GLP-1 RA use in the follow-up period.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD105
Topic
Health Service Delivery & Process of Care
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Gastrointestinal Disorders