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Resmetirom

Phase 3

Non-Alcoholic Fatty Liver Disease | Small molecule | Metabolic |Madrigal Pharmaceuticals, Inc.|Last Updated: May 27, 2026

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindCONTROLLEDDMCBiomarker
Total Trials2
Total Enrollment2,153
FDA Designations
No designations recorded
Clinical Trials (2)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT04951219A Phase 3 Study to Evaluate Safety and Biomarkers of Resmetirom (MGL-3196) in Patients With Non-alcoholic Fatty Liver Disease (NAFLD), MAESTRO-NAFLD-Open-Label-Extension (MAESTRO-NAFLD-OLE)PHASE3 ACTIVE NOT_RECRUITING 810Jul 9, 2021Apr 1, 2027May 27, 202676 United States, Puerto Rico
NCT04197479A Phase 3 Study to Evaluate Safety and Biomarkers of Resmetirom (MGL-3196) in Non Alcoholic Fatty Liver Disease PatientsPHASE3 COMPLETED 1,343Dec 16, 2019Jan 6, 2023Sep 5, 202377 United States, Puerto Rico
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Study Endpoints
Primary Endpoints
The effect of once daily, oral administration of resmetirom on the incidence of adverse events.
52 weeks
The effect of once daily, oral administration of 80 or 100 mg resmetirom versus placebo on the incidence of adverse events.
52 weeks
Secondary Endpoints
Percent change in the hepatic fat fraction as determined by MRI-PDFF from baseline
16 weeks
Percent change in LDL-C from baseline
28 weeks
The effect of once daily, oral administration of 80 or 100 mg resmetirom versus placebo on the percent change in low density lipoprotein C (LDL-C) from baseline to Week 24
24 weeks
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Study Design & Arms
AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Double-blind 80 mg DailyEXPERIMENTALFor patients assigned to double-blind treatment and who completed Week 52 and 56 of MAESTRO-NAFLD-1, double-blind resmetirom 80 mg for first 12 weeks followed by open-label resmetirom 100 mg for weeks 12-52
Double-blind 100 mg DailyEXPERIMENTALFor patients assigned to double-blind treatment and who completed Week 52 and 56 of MAESTRO-NAFLD-1, double-blind resmetirom 100 mg for first 12 weeks followed by open-label resmetirom 100 mg for weeks 12-52
Open-labelEXPERIMENTALFor patients assigned to open-label treatment and who completed Week 52 and 56 of MAESTRO-NAFLD-1, open-label resmetirom at same dose as MGL-3196-14 for an additional 52 weeks. NASH cirrhosis patients may receive open-label resmetirom for up to an additional 66 months (ie, 52 weeks in MGL-3196-14 and up to 66 months in MGL-3196-18).
Open-Label 80 mgEXPERIMENTALFor patients with NASH cirrhosis who were screen failures from MGL-3196-11, open-label resmetirom 80 mg for up to 66 months.
Open Label 100 mgEXPERIMENTALFor patients without NASH cirrhosis who were screen failures from MGL-3196-11, open-label resmetirom 100 mg for 52 weeks
Open-Label 40 mgEXPERIMENTALFor NASH cirrhosis patients who enter MGL-3196-18 directly or were screen failures from MGL-3196-19, open-label resmetirom 40 mg for up to 66 months.
Open label: resmetiromEXPERIMENTAL100 mg daily
Double blinded: matching placeboPLACEBO_COMPARATORPlacebo daily
Double blinded: resmetirom 80 mgEXPERIMENTAL80 mg daily
Double blinded: resmetirom 100 mgEXPERIMENTAL100 mg daily
Interventions
NameTypeDescription
ResmetiromDRUGTablet
PlaceboDRUGMatching tablets
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites76

Inclusion Criteria: * For patients who completed MAESTRO-NAFLD-1, completed the Week 52 visit, and completed the Week 56 visit within 90 days of the Extension Day 1 visit, and are willing to participate in MAESTRO-NAFLD-OLE and provide written informed consent. * For patients who screen failed MAES...

Countries:United StatesPuerto Rico
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Recent Changes (Last 90 Days)
MEDIUMMay 28, 2026NCT04951219Enrollment: 1000 → 810
MEDIUMMay 28, 2026NCT04951219Enrollment: 1000 → 810
LOWMay 26, 2026NCT04951219primaryCompletionDate: changed
LOWMay 24, 2026NCT04951219studyFirstPostDate: changed