Tesamorelin
A long-acting GHRH analog FDA-approved as Egrifta for HIV-associated visceral fat accumulation.
In plain English
Tesamorelin is a stabilized GHRH analog FDA-approved as Egrifta to reduce excess abdominal fat (lipodystrophy) in adults living with HIV. In its pivotal trials, it produced approximately 15–18% reductions in visceral adipose tissue over 26 weeks. Tesamorelin has also been studied off-label and in academic trials for cognitive endpoints in mild cognitive impairment, for fatty liver, and in age-related GH decline. It is one of the few GHRH peptides with a clearly registered drug approval.
What it is
Tesamorelin is a synthetic analog of GHRH (1-44) modified with a trans-3-hexenoic acid group on the N-terminus to resist enzymatic degradation.
Mechanism (summary)
Tesamorelin binds the GHRH receptor on pituitary somatotrophs, stimulating release of endogenous growth hormone in a pulsatile pattern. The downstream rise in IGF-1 drives metabolic effects including lipolysis from visceral fat.
Why people research it
- HIV-associated lipodystrophy (FDA-approved indication)
- Cognitive function in mild cognitive impairment
- Nonalcoholic fatty liver disease (NAFLD/MASH)
- Age-related GH decline
Human evidence
Two Phase 3 trials in HIV-associated lipodystrophy demonstrated ~15–18% reductions in visceral adipose tissue over 26 weeks vs. placebo. Smaller academic trials in MCI showed improvements in executive function. Trials in NAFLD show reductions in liver fat.
Animal / lab evidence
Animal data confirm GHRH pharmacology with appropriate selectivity vs. ghrelin-receptor agonists.
Key studies
Each summary explains the design, what was found, and what it doesn't prove.
Adults with HIV-related belly-fat accumulation lost a meaningful amount of internal fat and liver fat on tesamorelin.
Older adults with cognitive concerns on tesamorelin scored better on tests of planning and memory than the placebo group.
History
Developed by Theratechnologies. Approved by FDA as Egrifta in 2010 for HIV-associated lipodystrophy; reformulation Egrifta SV approved later.
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