Limited · human
This IRB-approved pilot study investigated the safety of intravenous (IV) administration of BPC-157 (Body Protection Compound 157) in humans. Two participants — a 58-year-old Asian male and a 68-year-old Caucasian female, both with prior IV BPC-157 exposure — received escalating doses over two consecutive days at a private clinic in Florida. Baseline and follow-up fasting blood work and vital signs were collected across three days. The researchers measured biomarkers related to heart, liver, kidney, and thyroid function, as well as blood glucose. Both participants reportedly tolerated the infusions without any adverse side effects, and no clinically meaningful changes in the monitored biomarkers were observed. The authors conclude that IV BPC-157 appeared safe and well-tolerated in these two individuals and call for larger studies to confirm these findings. Key limitations are substantial: the study included only two participants with prior BPC-157 exposure, lacked a control group, had no blinding, involved a very short observation window (three days), and was conducted at a single private clinic. These factors severely restrict the generalizability of the findings and preclude any broad conclusions about safety or efficacy.
Alternative therapies in health and medicine · Sep 2025Source ↗ Review
This review paper examines the challenge of preserving muscle mass during weight loss induced by GLP-1–based pharmacotherapies, including GLP-1 receptor agonists (e.g., semaglutide), dual GLP-1/GIP agonists (e.g., tirzepatide), and triple GLP-1/GIP/glucagon agonists (e.g., retatrutide). The authors note that while these agents can produce clinically meaningful weight loss (5–10% or more of body weight), a portion of that loss comes from lean mass, including skeletal muscle, which may contribute to long-term weight regain and increase the risk of sarcopenia. The paper discusses the biology of myokines—over 600 signaling proteins released during muscle contraction identified in human myocyte research—as potentially important targets for protecting or expanding muscle mass. The authors explore emerging anti-obesity agents and their potential combinations with incretin-based therapies to preferentially reduce fat mass while sparing or building muscle. The paper calls for further research to clarify the functional consequences of lean mass changes during weight loss and maintenance. As a narrative review, it synthesizes existing literature without conducting original trials, and no new clinical data are presented. Generalizability is limited by the review format and the evolving evidence base for newer agents.
World journal of diabetes · Sep 2025DOI ↗ Strong · human
This systematic review and meta-analysis pooled data from 25 randomized controlled trials (RCTs) involving approximately 2,600 patients to evaluate the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) — including liraglutide, exenatide, dulaglutide, semaglutide, tirzepatide, efinopegdutide, survodutide, and retatrutide — on metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH). Across a median treatment period of 24 weeks, the authors reported that GLP-1RAs were associated with a statistically significant mean reduction in liver fat content of 5.21%, with retatrutide showing the largest effect. Histological analyses suggested significant improvements in steatosis, hepatocellular ballooning, and lobular inflammation, though improvements in fibrosis did not reach statistical significance. Liver enzymes (ALT, AST, γ-GT) and liver stiffness also improved significantly, with semaglutide showing the most pronounced effect on stiffness. No liver-related adverse drug effects were identified. Limitations include heterogeneity across trials, variable treatment durations, and the relatively short median follow-up, which may be insufficient to capture fibrosis outcomes. The evidence base is derived entirely from RCTs in human populations.
The Journal of clinical endocrinology and metabolism · Sep 2025DOI ↗ Moderate · human
This systematic review and meta-analysis examined the risk of pancreatitis and pancreatic cancer associated with GLP-1 receptor agonists (GLP-1 RAs), including dulaglutide, exenatide, liraglutide, semaglutide, beinaglutide, retatrutide, and tirzepatide. Following PRISMA guidelines, the authors searched PubMed, Embase, and the Cochrane Library, ultimately including 62 randomised controlled trials encompassing 66,232 patients with a mean age of 58.3 years and a mean follow-up of approximately 43.5 weeks. The pooled analysis found a statistically significant increase in pancreatitis risk overall (RR: 1.44, 95% CI 1.09–1.89); however, this significance disappeared when results were stratified by background medication use, suggesting that concomitant medications may be a confounding factor. For pancreatic cancer, no significant overall association was identified (RR: 1.30, 95% CI 0.86–1.97), though a significant signal emerged in the subgroup taking background medications (RR: 1.85, 95% CI 1.05–3.26). The authors note this subgroup finding may be an artifact, as many excluded trials had zero events in both arms. Key limitations include variable follow-up durations, heterogeneous patient populations, and the influence of concomitant therapies, which complicate causal attribution to GLP-1 RAs alone.
Endocrinology, diabetes & metabolism · Sep 2025DOI ↗ Moderate · human
This systematic review and meta-analysis pooled data from 33 randomized controlled trials (n = 12,028 adults with overweight or obesity) to evaluate whether combining lifestyle modifications with GLP-1 receptor agonists (GLP-1RAs) produces greater improvements in body weight and cardiometabolic markers than lifestyle modification plus placebo. Searches covered PubMed, Embase, and the Cochrane Library through May 2025, and the protocol was pre-registered on PROSPERO. The study found that the combination therapy was associated with a statistically significant mean weight reduction of 7.13 kg, along with improvements in waist circumference, fat mass, systolic blood pressure, fasting blood glucose, glycated hemoglobin, total cholesterol, triglycerides, and LDL cholesterol. HDL cholesterol did not show a significant change. Subgroup analyses suggested that longer treatment duration, use of semaglutide or tirzepatide, weekly dosing, and trials conducted in North America were associated with larger weight loss effects. No included trials were rated high risk of bias. GRADE certainty ranged from low to high across outcomes, with heterogeneity and potential publication bias limiting confidence in several findings. The authors conclude that results should be interpreted cautiously given this variability in evidence certainty.
EClinicalMedicine · Aug 2025DOI ↗ Limited · human
This study investigated the detection of ibutamoren (MK-677), a growth hormone secretagogue, in human hair samples to aid forensic interpretation of anti-doping hair test results. Two scenarios were examined: (1) a single 10 mg oral dose administered to a male volunteer, with hair collected 4 weeks later; and (2) hair collected from an individual who had consumed 60 capsules of 10 mg ibutamoren over 90 days, also sampled 4 weeks after discontinuation. Researchers developed a liquid/liquid extraction method using bicalutamide-D4 as an internal standard, with a validated linear range of 0.5–250 pg/mg and a limit of detection of 0.1 pg/mg. The study found that a single 10 mg dose produced a positive hair result at 1.3 pg/mg in the 0–1 cm segment, while the prolonged-use scenario yielded 224 pg/mg in the 0–4 cm segment. The authors conclude that these findings establish, for the first time, ibutamoren's incorporation into human hair and provide reference concentration ranges to support interpretation of hair test results in anti-doping proceedings. Key limitations include the very small sample size (essentially two subjects) and the non-controlled nature of the second case.
Clinica chimica acta; international journal of clinical chemistry · Aug 2025DOI ↗ Review
This review examines the evolving pharmacological landscape for obesity management, with a focus on gut-brain axis hormones and their therapeutic potential. The authors describe how nutrient-stimulated gastroenteropancreatic hormones — including GLP-1, GIP, glucagon, and amylin — have become central targets in obesity drug development. The review covers both marketed agents and those in ongoing clinical trials. GLP-1 receptor agonists (e.g., weekly injectable or daily oral semaglutide) are reported to achieve roughly 15–17% weight loss with a favorable safety profile. The dual GLP-1/GIP agonist tirzepatide is described as achieving up to approximately 22.5% weight loss at higher doses. Combination therapies under investigation — such as cagrilintide plus semaglutide (Cagrisema), GLP-1/glucagon co-agonists, and the triple agonist retatrutide (GLP-1/GIP/glucagon) — are noted as potentially reaching weight loss comparable to bariatric surgery. The review also discusses cardiometabolic benefits and challenges around long-term treatment adherence for both patients and clinicians. As a narrative review, it synthesizes existing trial data rather than generating new primary evidence, and conclusions depend on the quality of the underlying studies cited.
Medicina clinica · Aug 2025DOI ↗ Limited · human
This Phase 1 randomized, double-blind, placebo-controlled trial examined the safety and efficacy of mazdutide — a dual glucagon-like peptide-1 (GLP-1) and glucagon receptor agonist — at doses up to 16 mg in adults with overweight or obesity but without diabetes. Thirty-two participants received once-weekly subcutaneous injections of mazdutide (n=24, split across two dose-escalation cohorts) or placebo (n=8) for 20 weeks. The study found that both mazdutide cohorts experienced substantially greater mean percent reductions in body weight from baseline (approximately -20% and -21%, respectively) compared to the placebo group (approximately -0.1%), with statistically significant differences. The authors also reported improvements in metabolic markers and concluded that the 16 mg dose was well tolerated. Key limitations include the small sample size (particularly the placebo group of only 8 participants), the short 20-week duration, the Phase 1 design which is primarily safety-focused, and the absence of participants with diabetes, limiting generalizability. These findings suggest a dose-response relationship at higher doses than previously studied, but larger and longer trials are needed to confirm these results.
Diabetes, obesity & metabolism · Aug 2025DOI ↗ Preclinical
This study investigated whether thymosin beta 4 (Tβ4), encoded by the gene TMSB4X, plays a role in Alzheimer's disease (AD) pathology and could serve as a potential intervention target. Researchers generated cerebral organoids ("mini-brains") from induced pluripotent stem cells (iPSCs) carrying familial AD (fAD)-associated mutations in the amyloid precursor protein (APP) gene. Using these organoids, they characterized dynamic changes in cellular states and found that mature neuron formation was markedly reduced in fAD organoids compared to healthy controls, alongside increased cellular senescence and beta-amyloid (Aβ) production. Notably, TMSB4X/Tβ4 expression was significantly decreased both in fAD organoid neurons and in excitatory neurons from post-mortem AD patient brain data. Treatment with Tβ4 protein appeared to rescue neurodevelopmental deficits and reduce Aβ formation in the fAD organoids. Corroborating findings were also reported in 5xFAD transgenic mice. The study concludes that Tβ4 may act as a neuroprotective factor capable of mitigating altered neurogenesis and AD pathology. Key limitations include the use of organoid and animal models rather than human clinical data, and the inherent complexity of translating organoid findings to human disease.
Stem cell reports · Aug 2025DOI ↗ Animal only
This study developed a biodegradable buccal suction patch designed to improve the systemic delivery of peptide therapeutics by bypassing gastrointestinal degradation. Researchers replaced previously used non-degradable silicone materials with thermally crosslinked, synthesized copolyesters, fabricated via a scalable mold-casting process. Mechanical testing across multiple polymer formulations and patch shapes identified the best-performing biodegradable candidate, and degradation was confirmed in both aqueous media and simulated waste environments. An ex vivo model using porcine buccal tissue demonstrated that the biodegradable patch, when combined with a chemical permeation enhancer, improved permeation of a poorly permeable dye compared to controls. In an in vivo study conducted in beagle dogs, the patch substantially improved the bioavailability of semaglutide (4.11 kDa) relative to a commercially available oral tablet over a 10-minute application window. Additionally, the patch achieved a relative bioavailability of approximately 26% for bremelanotide (1.03 kDa) compared to subcutaneous injection. Limitations include the use of an animal model (beagle dogs) rather than human subjects, a small experimental scale, and the need for further clinical translation studies. The work highlights a potential sustainable alternative to silicone-based buccal delivery devices.
Journal of Controlled Release · Aug 2025
Review
This editorial provides a narrative overview of the rapidly escalating global obesity crisis and the evolving landscape of pharmacological treatments, with a focus on GLP-1 receptor agonists such as oral semaglutide. Drawing on the World Obesity Atlas 2025, the authors highlight that the number of adults living with obesity is projected to more than double—from 524 million in 2010 to 1.13 billion by 2030. The editorial notes that the global market for weight-loss medications has been revised upward to $150 billion by 2035, reflecting explosive growth in demand. The authors discuss the FDA's acceptance of a new drug application for oral semaglutide, potentially the first oral agent approved for long-term weight management. Key concerns raised include the limited long-term and real-world safety and efficacy data for GLP-1 receptor agonists, challenges with treatment adherence, and the proliferation of unregulated compounded ("copycat") versions of these drugs that lack quality and safety evaluation. As an editorial, this piece synthesizes publicly available data and regulatory updates rather than presenting original research, and it does not conduct systematic literature searches or meta-analyses. Its conclusions are opinion-based and should be interpreted accordingly.
Medical science monitor : international medical journal of experimental and clinical research · Aug 2025DOI ↗ Review
This evidence review examines the evolving landscape of incretin-based pharmacotherapy, focusing on GLP-1 receptor agonists (GLP-1RAs) and newer multi-receptor co-agonists for cardiometabolic disease management. The paper surveys established GLP-1RAs — including liraglutide, dulaglutide, albiglutide, exenatide, and semaglutide — noting their reported benefits on glycated hemoglobin, body weight, lipid profiles, liver fat, and cardiovascular outcomes (reduction in major adverse cardiovascular events, or MACE). It also covers emerging agents: dual GIP/GLP-1 agonist tirzepatide (approved for diabetes and obesity), dual GLP-1/glucagon co-agonists (notable for synergistic weight loss), and triple GLP-1/GIP/glucagon receptor agonists such as retatrutide and efocipegtrutide, described as achieving the highest pharmacotherapy-associated weight loss observed to date. Additional novel classes reviewed include GLP-1/amylin agonists (CagriSema, Amycretin), non-semaglutide oral GLP-1 agents, and peptide YY/GLP-1 dual agonists. As a narrative review, the paper does not present original trial data, and its conclusions are based on synthesized existing literature, which may introduce selection bias. The authors anticipate that metabolic benefits will translate into cardiometabolic outcomes, though direct evidence for many newer agents remains limited.
World journal of cardiology · Aug 2025DOI ↗ Limited · human
This systematic review examined the existing literature on BPC-157 (Body Protection Compound-157), a naturally occurring gastric pentadecapeptide, specifically through the lens of orthopedic sports medicine. Researchers searched PubMed, Cochrane, and Embase for English-language studies published from database inception through June 2024. Of 544 identified articles, 36 met inclusion criteria — 35 preclinical studies and only 1 clinical study. Preclinical findings suggested BPC-157 may enhance growth hormone receptor expression, promote angiogenesis, stimulate cell growth pathways, and reduce inflammatory cytokines, with improved functional, structural, and biomechanical outcomes reported across muscle, tendon, ligament, and bone injury models. The sole clinical study was a retrospective case series in which 7 of 12 patients reported musculoskeletal pain relief lasting more than 6 months following intraarticular injection for chronic knee pain. The compound was found to be hepatically metabolized with a half-life under 30 minutes and renally cleared. Preclinical safety data showed no adverse effects across multiple organ systems; no clinical safety data were identified. The authors note that BPC-157 lacks FDA approval and is banned in professional sports, and caution about risks from unregulated manufacturing. The review is limited almost entirely to preclinical evidence, leaving significant gaps in human safety and efficacy data.
HSS journal : the musculoskeletal journal of Hospital for Special Surgery · Jul 2025DOI ↗ Review
This review examines the rationale and emerging clinical evidence for triple receptor agonist therapies targeting GLP-1, GIP, and glucagon receptors as next-generation treatments for obesity and type 2 diabetes (T2D). The authors focus primarily on retatrutide, the most clinically advanced triple agonist, which has completed Phase 2 trials. In people with obesity, retatrutide achieved up to 24.2% mean weight loss over 48 weeks; in people with T2D, it produced 16.9% mean weight loss over 36 weeks, alongside a 2.2% reduction in HbA1c and 82% of participants reaching HbA1c ≤ 6.5%. The review also highlights improvements in blood pressure, lipid profiles, waist circumference, and liver fat (82% reduction in hepatic steatosis). Gastrointestinal side effects were the most commonly reported adverse events, with no major safety signals identified in Phase 2. The authors also briefly discuss other unimolecular triple agonists and combination regimens in development. Key limitations include that this is a narrative review of Phase 2 data; Phase 3 confirmatory trials are still ongoing. Conclusions about long-term efficacy, safety, and cardiovascular/renal outcomes remain premature pending those results.
Current cardiovascular risk reports · Jul 2025DOI ↗ Preclinical
This study developed a novel injectable soft tissue filler by loading the GHK-Cu tripeptide (glycyl-L-histidyl-L-lysine copper complex) onto hydroxyapatite microspheres (HAPs), which were then combined with carboxymethyl cellulose, glycerol, and water to form a gel formulation called GHK-Cu@CMHA. The researchers report this is the first combination of HAPs and GHK-Cu designed to address implant-induced inflammation. The formulation demonstrated sustained GHK-Cu release over 7 days in laboratory testing, along with good flowability and injectability. Using a lipopolysaccharide (LPS)-induced inflammation model tested both in cell culture (in vitro) and in animals (in vivo), the study found that GHK-Cu@CMHA reduced levels of inflammatory cytokines and reactive oxygen species (ROS), while increasing superoxide dismutase (SOD) activity, suggesting antioxidant effects. Histological staining (H&E and Masson) indicated collagen deposition at treatment sites. Key limitations include the absence of human data, reliance on an LPS-induced inflammation model that may not fully replicate clinical filler complications, and no long-term safety or efficacy follow-up. These findings are preliminary and require further clinical validation before any conclusions about human benefit can be drawn.
Colloids and surfaces. B, Biointerfaces · Jul 2025DOI ↗ Animal only
This study investigated whether dietary supplementation with GHRP-6, a synthetic ghrelin analog peptide, could modulate endocrine and immune responses in gilthead seabream (Sparus aurata), a commercially important aquaculture species. Fish were fed diets containing GHRP-6 for 97 days and then challenged with Incomplete Freund's Adjuvant (IFA), an immune stimulant, via intraperitoneal injection. Samples were collected 72 hours post-injection. The study found that GHRP-6-fed fish maintained more stable plasma levels of lactate, triglycerides, and cortisol following IFA challenge compared to control fish, suggesting reduced metabolic stress. Circulating immunoglobulin levels were significantly elevated in the GHRP-6/IFA group, indicating enhanced humoral immunity. Transcriptomic analysis showed the anterior intestine was the most responsive tissue, with upregulation of immune-related genes including il10, il15, il34, and mx1. Spleen tissue showed increased expression of il8, il10, and ighm, suggesting a balanced inflammatory response. No histological damage was observed in the intestine or spleen. Limitations include the exclusive use of a single fish species, no mammalian or human data, a single GHRP-6 dietary concentration tested, and the authors themselves characterize results as "preliminary."
Review
This review article, published as part of a special issue on GLP-1 receptor agonists, examines the emerging class of glucagon receptor (GCGR)-based multi-agonist drugs as pharmacological treatments for obesity. The authors discuss several investigational agents — mazdutide, pemvidutide, survodutide, and retatrutide — all of which are in advanced stages of clinical development. According to the review, early-phase trial data for these agents suggest they can produce significant weight loss, potentially exceeding that seen with currently available therapies. The article also highlights their potential to address obesity-related comorbidities such as type 2 diabetes and cardiovascular disease, and notes that some agents are being evaluated in cardiovascular outcomes trials. The authors position GCGR-based multi-agonists as potentially important additions to future obesity treatment guidelines, particularly for patients who have not responded adequately to existing medications or lifestyle interventions. Key limitations and considerations noted include cost, access, and the need for long-term safety data as these drugs progress toward regulatory approval. As a narrative review, this article synthesizes existing trial data but does not generate new primary evidence.
Drugs in context · Jul 2025DOI ↗ In vitroPreprint
This study investigated whether Tβ4-17, a small bioactive peptide derived from thymosin β4 and identified via iTRAQ technology, could enhance the sensitivity of cisplatin (DDP)-resistant ovarian cancer cells to chemotherapy. Using in vitro models of DDP-resistant ovarian cancer cell lines, the researchers examined the effects of Tβ4-17 alone and in combination with DDP on cell proliferation, migration, and apoptosis. Multiple assays were employed, including CCK8 viability assays, EDU fluorescence proliferation assays, cell scratch (wound healing) assays, qRT-PCR, and Western blot. The study found that Tβ4-17 combined with DDP significantly inhibited proliferation and migration of resistant cells and promoted apoptosis compared to either agent alone. Mechanistically, the researchers reported that NF-κB p65 was highly expressed in DDP-resistant cells, and that Tβ4-17 down-regulated NF-κB p65 protein expression. Use of NF-κB inhibitors and activators further supported this proposed pathway. Key limitations include the exclusive use of cell-line models with no animal or human data, the preprint status of the work, and the absence of in vivo validation. Findings are preliminary and require further study.
Unknown journal · Jul 2025DOI ↗ Animal only
This preclinical study investigated whether three GLP-1-based receptor agonists — semaglutide (GLP-1 receptor agonist), tirzepatide (dual GLP-1/GIP receptor agonist), and retatrutide (triple GIP/GLP-1/glucagon receptor agonist) — could alter the interoceptive (subjective-like) effects of alcohol in rats. Using an operant drug discrimination paradigm in both male and female rats, researchers trained animals to distinguish alcohol from vehicle, then tested whether these compounds disrupted that learned discrimination. The study found that acute administration of all three agents attenuated alcohol's discriminative stimulus effects, suggesting modulation of how alcohol "feels" internally. Repeated semaglutide treatment maintained this effect over a 15-day period, and the effect reversed within three days of cessation. The authors suggest these findings may help explain clinically observed reductions in alcohol craving and drinking in humans receiving GLP-1 receptor agonists. Limitations include the exclusive use of animal models, meaning direct translation to human subjective alcohol experience remains uncertain, and the study does not assess long-term outcomes or dependence-related endpoints.
Psychopharmacology · Jul 2025DOI ↗ Strong · human
This Bayesian network meta-analysis (NMA) synthesized evidence from 19 randomized controlled trials (RCTs) enrolling 29,506 adults with overweight or obesity (BMI ≥ 25 kg/m²) to compare the weight-loss efficacy and safety of GLP-1 receptor agonists (liraglutide, semaglutide), dual agonists (tirzepatide, survodutide), and the triple agonist retatrutide against placebo over at least 36 weeks. The study found that retatrutide and dual agonists achieved equivalent mean weight loss (approximately −11.0 kg), both outperforming GLP-1 receptor agonists (approximately −9.0 kg). Retatrutide showed the highest odds of achieving ≥15% weight loss (OR 54.6), followed by dual agonists (OR 16.4) and GLP-1 receptor agonists (OR 9.0). However, retatrutide was also associated with the highest adverse event risk. Meta-regression analyses indicated that type 2 diabetes mellitus attenuated weight loss across all drug classes, while female-dominant and higher-BMI cohorts showed enhanced outcomes. Limitations include indirect comparisons inherent to NMA methodology, heterogeneity across trials in baseline characteristics, and the fact that retatrutide data remain from earlier-phase trials. The authors recommend individualized treatment selection based on patient-specific factors.
Obesity (Silver Spring, Md.) · Jul 2025DOI ↗