Muscle & Body Composition

Myostatin inhibitor investigated for muscle hypertrophy, muscular dystrophy, and body composition.

Urolithin A is generated by gut bacteria metabolizing ellagitannins (pomegranate, berries). Direct supplementation induces mitophagy and improves muscle endurance in RCTs.

Circulating follistatin isoform (315 aa). Same myostatin/activin neutralization as FS-344 but shorter half-life due to loss of heparin-binding C-terminus.

Fully human mAb against activin type-II receptors. Failed sarcopenia and sIBM endpoints; now developed by Lilly for obesity in combination with tirzepatide (BELIEVE trial).

Soluble ActRIIB-Fc fusion decoy receptor. DMD Phase 2 halted in 2013 due to epistaxis and telangiectasia from vascular off-target effects.

Locally acting follistatin-Fc fusion for intramuscular hypertrophy. FSHD and CMT Phase 2 trials failed functional endpoints; discontinued.

PEGylated 24-aa IGF-1Ec E-peptide that activates muscle satellite cells via a non-IGF-1R pathway. Grey-market use with no registered trials.

Proapoptotic peptidomimetic targeting prohibitin on adipose vasculature. Induced obesity regression in primates but nephrotoxicity limits translation.

Truncated IGF-1 analog missing the first three N-terminal residues, giving much weaker IGFBP binding and a short but locally intense IGF-1R activation at the injection site.

Oral ghrelin-receptor agonist approved in Japan (2021) for cancer cachexia. Phase III ROMANA-1 and ROMANA-2 met weight gain endpoints but failed functional-improvement endpoints in the US/EU.