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MGL-3196

Phase 3

NASH - Nonalcoholic Steatohepatitis | Small molecule | Metabolic |Madrigal Pharmaceuticals, Inc.|Last Updated: Jun 4, 2026

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials1
Total Enrollment1,759

FDA Designations

No designations recorded

Clinical trial landscape

MGL-3196 · 10 trials · 6 indications

Phase 3 1Phase 2 2Phase 1 7
NCT03900429A Phase 3 Study to Evaluate the Efficacy and Safety of MGL-3196 (Resmetirom) in Patients With NASH and FibrosisNASH - Nonalcoholic Steatohepatitis
ACTIVE NOT_RECRUITING1,759 Analytics
PHASE3ACTIVE NOT_RECRUITING
A Phase 3 Study to Evaluate the Efficacy and Safety of MGL-3196 (Resmetirom) in Patients With NASH and Fibrosis
NASH - Nonalcoholic SteatohepatitisUnlock trial analytics

Study Endpoints

Primary Endpoints

Week 52 Dual Primary Objectives: To determine the effect of 80 or 100 mg MGL-3196 vs matching placebo on liver biopsy (NASH CRN score) at Week 52 compared with Baseline
52 weeks

1. Proportion with resolution of NASH (ballooning 0, inflammation 0,1) associated with at least 2-point reduction in NAFLD Activity Score (NAS) without worsening of fibrosis stage OR 2. Proportion with at least a 1-point improvement in fibrosis stage with no worsening of NAS

Month 54 Primary Objective: Time to experiencing an adjudicated Composite Clinical Outcome event (Final Primary Endpoint, at 54 months)
up to 54 months

The Composite Clinical Outcome is composed of all-cause mortality, liver transplant, and significant hepatic events (including hepatic decompensation events \[ascites, encephalopathy, or gastroesophageal variceal hemorrhage\], histological progression to cirrhosis, and a confirmed increase of MELD score from \<12 to ≥15).

Mean Percent Change in LDL-C From Baseline To Week 12
Baseline up to Week 12

LDL-C was determined by ultracentrifugation or direct measure. Least-squares (LS) mean was provided for the comparison of MGL-3196 versus placebo and it used a linear model with percent change from baseline as the dependent variable and treatment as a factor.

Percent Change From Baseline To Week 12 In Hepatic Fat Fraction Assessed By Magnetic Resonance Imaging Proton Density Fat Fraction (MRI-PDFF)
Week 12

The primary endpoint was relative change in MRI-PDFF assessed hepatic fat fraction compared with placebo at Week 12 in participants who had both a baseline and Week 12 MRI-PDFF. Least squares (LS) mean was provided for the statistical comparison of MGL-3196 versus placebo.

AUC from the time of dosing of clopidogrel as affected by single and multiple daily dosing with MGL-3196 100 mg/day in healthy subjects
14 days
Pharmacokinetics (Cmax) of clopidogrel as affected by chronic dosing with MGL-3196 100 mg/day in healthy subjects
14 days
AUC from the time of dosing of pioglitazone as affected by chronic dosing with MGL-3196 100 mg/day in healthy subjects
17 days
Plasma pharmacokinetics - Cmax
16 days

Cmax after administration

Plasma pharmacokinetics - Tmax
16 days

Tmax after administration

Plasma pharmacokinetics - AUC (0-last)
16 days

AUC (0-last) after administration

Plasma pharmacokinetics - t1/2
16 days

t1/2 after administration

Effect on the incidence of adverse events
16 days
Area under the curve from the time of dosing extrapolated to infinity (AUC(0-inf))
48 hours

comparison between MGL-3196 capsules and MGL-3196 tablets

Mass Balance of [14C] MGL-3196
Approximately 10 Days

Measurement of the total radioactivity collected from blood, urine, and feces

Area under the curve from the time of dosing extrapolated to infinity (AUC(0-inf)) of Atorvastatin as affected by MGL-3196
72 hours
Area under the curve from the time of dosing extrapolated to infinity (AUC(0-inf)) of Rosuvastatin as affected by MGL-3196
72 hours
AUC(0-inf) of Simvastatin as affected by MGL-3196
24 hours

Secondary Endpoints

Week 52 Key Secondary Objective: To determine the effect of once-daily, oral administration of MGL-3196 80 or 100 mg versus matching placebo on the percent change from Baseline at 24 weeks in directly measured low-density lipoprotein cholesterol (LDL-C)
24 weeks
Mean Change From Baseline to Week 12 of Free Thyroxine (T4)
Baseline up to Week 12
Mean Change From Baseline to Week 12 of Free Triiodothyronine (T3)
Baseline up to Week 12
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Matching PlaceboPLACEBO_COMPARATORPlacebo Daily
80 mg MGL-3196ACTIVE_COMPARATOR80 mg daily
100 mg MGL-3196ACTIVE_COMPARATOR100 mg daily
MGL-3196EXPERIMENTALStudy Drug
PlaceboPLACEBO_COMPARATORMatching Placebo
MGL-3196 100 mg tablet plus Clopidogrel 75 mg tabletEXPERIMENTAL -
MGL-3196 100 mg tablet plus Pioglitazone 15 mg tabletEXPERIMENTALMGL-3196 administered orally plus Pioglitazone administered orally on 2 separate days
40 mg MGL-3196 TabletEXPERIMENTALMultiple cohorts (normal, varying hepatic impairment, NASH non-cirrhosis, and NASH cirrhosis) evaluated
60 mg MGL-3196 TabletEXPERIMENTALMultiple cohorts (normal, varying hepatic impairment, NASH non-cirrhosis, and NASH cirrhosis) evaluated
80 mg MGL-3196 TabletEXPERIMENTALMultiple cohorts (normal, varying hepatic impairment, NASH non-cirrhosis, and NASH cirrhosis) evaluated
100 mg MGL-3196 TabletEXPERIMENTALMultiple cohorts (normal, varying hepatic impairment, NASH non-cirrhosis, and NASH cirrhosis) evaluated
Capsule then TabletACTIVE_COMPARATORMGL-3196 Capsule on Day 1 followed by MGL-3196 Tablet on Day 5
Tablet then CapsuleACTIVE_COMPARATORMGL-3196 Tablet on Day 1 followed by MGL-3196 Capsule on Day 5
TreatmentEXPERIMENTALMGL-3196

Interventions

NameTypeDescription
MGL-3196DRUGTablet
PlaceboDRUGMatching Tablets
Liver BiopsyPROCEDUREA procedure in which a needle is inserted into the liver to collect a tissue sample
MGL-3196 (resmetirom)DRUGOral
ClopidogrelDRUGAfter one-day washout period after Day 1, loading dose of 300 mg clopidogrel administered on Day 3 and then, at approximately the same time each morning, 75 mg clopidogrel administered on Days 4 to 11
Pioglitazone 15mgDRUGPioglitazone 15 mg tablet administered orally on 2 separate days, initially on one day alone and again after MGL-3196 has been dosed to steady-state
MGL-3196 TabletDRUGMGL-3196 in Tablet form
MGL-3196 CapsuleDRUGMGL-3196 in Capsule form
AtorvastatinDRUG -
SimvastatinDRUG -
RosuvastatinDRUG -
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites247

Inclusion Criteria: 1. Must be willing to participate in the study and provide written informed consent. 2. Male and female adults ≥ 18 years of age. 3. Suspected or confirmed diagnosis of NASH fibrosis suggested by the historical data. Meet one of the following criteria that is consistent with NAS...

Countries:United StatesAustraliaAustriaBelgiumCanadaFranceGermanyHungaryIsraelItalyMexicoPolandPuerto RicoSpainSwitzerlandUnited KingdomDenmarkNetherlandsNorway
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Recent Changes (Last 90 Days)

MEDIUMJul 5, 2026NCT03038022TRIAL_REMOVED: changed
MEDIUMJul 5, 2026NCT03038022TRIAL_REMOVED: changed
MEDIUMJul 5, 2026NCT03038022TRIAL_REMOVED: changed

Frequently asked questions about MGL-3196

What is MGL-3196?

MGL-3196 is an investigational small molecule being developed by Madrigal Pharmaceuticals for the treatment of non-alcoholic steatohepatitis (NASH), heterozygous familial hypercholesterolemia, and hepatic impairment. It is also known as resmetirom. The drug is currently in clinical development and has not been approved by the FDA.

What is MGL-3196 used for in NASH?

MGL-3196 is being studied for the treatment of non-alcoholic steatohepatitis (NASH) with fibrosis. A Phase 3 study is evaluating its efficacy and safety in patients with NASH and fibrosis, and a completed Phase 2 study assessed its effects in patients with NASH.

Who makes MGL-3196?

MGL-3196 is developed by Madrigal Pharmaceuticals, Inc., a biopharmaceutical company traded on the NASDAQ under the ticker symbol MDGL. The company is conducting clinical trials to evaluate the drug's safety and efficacy in several liver-related conditions.

What phase is MGL-3196 in?

MGL-3196 is in Phase 3 clinical development for NASH with fibrosis, based on an active Phase 3 trial. It has also completed Phase 1 and Phase 2 studies for other indications, including heterozygous familial hypercholesterolemia and hepatic impairment.

What clinical trials is MGL-3196 in?

MGL-3196 is being evaluated in a Phase 3 trial (NCT03900429) for NASH with fibrosis, which is active but not recruiting. Completed trials include a Phase 2 study in NASH (NCT02912260), a Phase 2 study in heterozygous familial hypercholesterolemia (NCT03038022), and a Phase 1 study in hepatic impairment (NCT04643795).

Is MGL-3196 the same as resmetirom?

Yes, MGL-3196 is also known as resmetirom. The Phase 3 trial for NASH and fibrosis uses the name resmetirom in its title, confirming that both names refer to the same investigational drug developed by Madrigal Pharmaceuticals.