Resmetirom Outperformed Semaglutide in Cardiac Study

A new analysis showed lower mortality and MACE rates for patients treated with resmetirom compared to semaglutide.

Updated on Oct. 12, 2026 in Heart Disease

Resmetirom Outperformed Semaglutide in Cardiac Study

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A propensity-matched TriNetX analysis found that patients treated with resmetirom had a lower risk of major adverse cardiovascular events (MACE) and all-cause mortality than those taking semaglutide. The findings were presented at the American College of Gastroenterology 2026 Annual Scientific Meeting.

Why it matters

The study addresses a critical gap in comparative cardiovascular outcome data for patients managing MASLD or MASH with hepatic fibrosis. By evaluating these therapies, researchers aim to better understand heart health implications for those living with these metabolic conditions.

A TriNetX analysis compared 4,253 resmetirom patients against 4,253 matched semaglutide users, finding resmetirom patients had a MACE hazard ratio of 0.50 at one year and 0.61 at two years. Mortality hazard ratios for resmetirom patients were 0.29 at one year and 0.33 at two years compared to the semaglutide group.

The players

American College of Gastroenterology

This is a professional medical association that promotes the highest standards of gastroenterological care through research and education.

FDA

The Food and Drug Administration is the federal agency responsible for protecting public health by ensuring the safety and efficacy of human drugs.

The details

Investigators used the TriNetX Global Collaborative Network to identify adults with MASLD or MASH and performed 1:1 propensity score matching based on demographics, comorbidities, and medications. While heart failure risk was significantly lower in the resmetirom group at one year, rates of myocardial infarction and atrial fibrillation showed no significant difference between the two treatments.

March 2024: Resmetirom received FDA approval for noncirrhotic MASH.
August 2025: Semaglutide received FDA approval for the MASH population.
October 9-14, 2026: The study results were presented at the ACG 2026 Annual Scientific Meeting.

The Big Picture

This study provides a comparative analysis of two therapies that gained market access through the FDA's accelerated approval pathway for MASH therapies. As new treatments for hepatic fibrosis emerge, this data helps clinicians differentiate the cardiac safety profiles of these specialized medications.

Patients currently being treated for MASLD or MASH should discuss these cardiovascular findings with their healthcare providers to evaluate their specific treatment plan. Clinicians may use this comparative data to better weigh the potential heart health benefits when selecting between available FDA-approved therapies.

The takeaway

Patients diagnosed with MASH or MASLD benefit from ongoing research that clarifies how specific pharmaceutical interventions impact long-term heart health. Consulting with a specialist remains the best way to determine which medication aligns with your overall cardiovascular risk profile.