Abstract Body (Do not enter title and authors here): Background: Resmetirom is useful in improving liver parameters in patients with nonalcoholic steatohepatitis (NASH) or metabolic dysfunction-associated steatohepatitis (MASH). However, its beneficial effects on lipid panel parameters are unclear.

Methods: We searched PubMed and ClinicalTrials.gov using the search term resmetirom. Among the studies identified, we looked for randomized-controlled trials with information on resmetirom and lipid panel. We identified four studies which compared resmetirom 80 mg to placebo, and performed a meta-analysis. A random effects model was utilized when heterogeneity was detected (p-value for heterogeneity<0.1)

Results: Our study shows that resmetirom, significantly improved lipid parameters of low-density lipoprotein cholesterol (LDL-C) (mean difference [MD] -13.01, 95% confidence interval (CI) -15.38 to -10.64, p<0.0001), triglycerides (MD -30.61, 95% CI -48.30 to -12.93, p=0.0007), apolipoprotein B (MD -18.78, 95% CI -24.90 to -12.66, p<0.0001), lipoprotein (a) (MD -24.89, 95% CI -38.67 to -11.11, p=0.0004). There was an improvement in high-density lipoprotein cholesterol (HDL-C), but it was not statistically significant (MD 1.32 95% CI -0.49 to 3.14, p=0.15).

Conclusion: Resmetirom, used to treat NASH (or MASH), can significantly improve lipid panel parameters, potentially offering cardiovascular benefits. To fully understand its impact on cardiovascular health, large-scale randomized controlled trials focusing on cardiovascular outcomes are necessary.