Early Adoption and Prescribing Patterns of Resmetirom: A Multi‐Institutional National Analysis

ABSTRACT Resmetirom received FDA approval in March 2024 as the first therapy for noncirrhotic MASH with moderate‐to‐advanced fibrosis. This retrospective cohort study used the TriNetX Research Network to assess early prescribing patterns among 3712 patients across 44 healthcare organisations. The mean age was 57.6 years, 57% were female, and the mean BMI was 33.9 kg/m 2 . The cohort was predominantly White (73.8%), with representation from Hispanic/Latino (11.7%) and Asian (8.1%) populations. MASLD and MASH diagnoses were documented in 72% and 56% of patients, while 15% carried cirrhosis codes. Common comorbidities included dyslipidaemia (55%), hypertension (52%) and type 2 diabetes (41%). GLP‐1 receptor agonists were commonly prescribed, with semaglutide ( n = 1124), tirzepatide ( n = 842), dulaglutide ( n = 391) and liraglutide ( n = 203) representing the most frequently used agents. Among 19 643 treatment‐eligible patients (1057 treated and 18 586 untreated), 5.4% received resmetirom. Treated patients were more frequently Asian or Hispanic and more likely to be prescribed GLP‐1 receptor agonists, statins, metformin or ARBs (all p < 0.01). Early prescribing demonstrates preferential use among individuals with higher metabolic burden but reveals potential miscoding or off‐label use and significant underutilization among eligible populations.