{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:04:19Z","timestamp":1782975859196,"version":"3.54.5"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>The MAESTRO\u2010NASH phase 3 trial reported that a 52\u2010week treatment of Resmetirom is effective in improving fibrosis and metabolic dysfunction\u2010associated steatohepatitis (MASH) in patients with MASH and F2 or F3 fibrosis, while data on the impact on 5\u2010year and long\u2010term clinical outcomes are still lacking. We simulated the transition probabilities of disease progression in MASLD patients with F2 or F3 fibrosis and the effect of Resmetirom treatment on clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A meta\u2010analysis of literature data formed transition matrices for fibrosis stages and complications, defined as compensated (CC) and decompensated cirrhosis (DC), hepatocellular carcinoma (HCC) and mortality\u2014liver\u2010related mortality (LR\u2010M), cardiovascular mortality (CV\u2010M) and extra\u2010hepatic cancer mortality (EHC\u2010M). Markov model was developed to depict the F2 and F3 fibrosis stage progression towards the complications and to evaluate the effect of Resmetirom treatment on the natural history of MASLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We estimated the 5\u2010year probability of Resmetirom\u2010treated and untreated MASLD patients with baseline F2 fibrosis of developing CC (5.16% vs. 6.82%, respectively), DC (0.25% vs. 0.3%, respectively), HCC (0.25% vs. 0.32%, respectively) and mortality (0.15% vs. 0.16% for LR\u2010M; 1.02% vs. 1.1% for CV\u2010M; 1.07% vs. 1.2% for EHC\u2010M, respectively). Similarly, we estimated the five\u2010year probability of Resmetirom\u2010treated and untreated MASLD patients with baseline F3 fibrosis of developing CC (17.12% vs. 21.34%, respectively), DC(1.1% vs. 1.47%, respectively), HCC (1.21% vs. 1.73%, respectively) and mortality (0.59% vs. 0.91% for LR\u2010M, 1.92% vs. 2.14% for CV\u2010M and 1.04% vs. 1.14% for EHC\u2010M, respectively). Life Years Gained (LYG) of Resmetirom\u2010treated patients were 0.45 and 0.63 in MASLD patients with F2 and F3 fibrosis, respectively, and the model was sensitive to changes in Resmetirom efficacy and transition probabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Resmetirom decreases the 5\u2010year and lifetime Markov\u2010model estimated risk of CC, DC, HCC and liver\u2010related mortality in patients with MASLD and F2 or F3 fibrosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70056","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T08:13:10Z","timestamp":1741680790000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A Markov Model Unveiling the Impact of Resmetirom on the Natural History of\n                    <scp>MASLD<\/scp>\n                    Patients: A Sistematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"45","author":[{"given":"Grazia","family":"Pennisi","sequence":"first","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Di Maria","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Enea","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"Department of Economic, Business, and Statistical Sciences University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Celsa","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Antonucci","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neurosciences, and Advanced Diagnostics (BIND) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacinta","family":"Ciancimino","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Ciccioli","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Infantino","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"La Mantia","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Tulone","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Di Marco","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calogero","family":"Camm\u00e0","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0822-9673","authenticated-orcid":false,"given":"Salvatore","family":"Petta","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE) University of Palermo  Palermo 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