Injectable Peptides in Sports Medicine: A Structured Narrative Review of Evidence, Safety, and Antidoping Implications.
This structured narrative review synthesized contemporary evidence (January 2020–August 2025) on injectable peptides used in orthopaedics and sports medicine, drawing from PubMed/MEDLINE, Embase, and Web of Science. The authors identified five functional peptide classes: GLP-1 receptor agonists (e.g., semaglutide), collagen-derived injectables, regenerative peptides (e.g., BPC-157, thymosin derivatives), growth hormone secretagogues (e.g., CJC-1295, ipamorelin, tesamorelin), and related compounds. The review found that GLP-1 receptor agonists were the only class supported by reproducible randomized evidence for musculoskeletal benefit—specifically symptomatic improvement in knee osteoarthritis—attributing this primarily to weight loss and putative anti-inflammatory effects rather than proven structural cartilage modification. Collagen-derived preparations showed only preliminary signals from small, single-center prospective studies. All remaining classes were deemed investigational, carrying unresolved safety profiles, significant product quality concerns, and widespread antidoping restrictions. Risk of bias was appraised for included human trials. The authors concluded that clinical use of injectable peptides should be restricted to approved agents for established indications or rigorously designed research protocols, and that clinicians should counsel athletes about uncertain efficacy, safety risks, and antidoping consequences. The study was assigned Level V evidence and a predominantly Grade C strength of recommendation.
Why this grade: This is a structured narrative review (Level V) synthesizing heterogeneous human and translational studies; it does not generate original trial data and its conclusions are limited by the underlying evidence base it summarizes.
Background Injectable peptides are increasingly promoted for musculoskeletal recovery, tissue repair, and performance enhancements; however, clinical adoption has outpaced high-quality evidence and regulatory consensus. Purpose To summarize contemporary human and translational evidence (January 1, 2020-August 31, 2025) for injectable peptides relevant to orthopaedics and sports medicine, and to clarify safety, product quality, regulatory, antidoping implications, and clinical outcomes. Study design Structured narrative review. Methods PubMed/MEDLINE, Embase, and Web of Science were searched (January 1, 2020-August 31, 2025). Eligible studies included randomized controlled trials, prospective human studies, and translational investigations directly applicable to musculoskeletal care; noninjectable formulations and nonmusculoskeletal indications were excluded. Results were synthesized qualitatively; risk of bias for human trials was appraised using standard tools. Results Five functional peptide classes were identified. Glucagon-like peptide-1 receptor agonists (e.g., semaglutide) are the only class supported by reproducible randomized evidence of symptomatic improvement in knee osteoarthritis, with benefits primarily mediated by clinically meaningful weight loss and putative anti-inflammatory effects, whereas structural cartilage modification remains unproven. Collagen-derived injectable preparations show preliminary postoperative symptom/early recovery benefits in small, single-center prospective human studies. Regenerative peptides (e.g., body protection compound-157 and thymosin derivatives) and growth hormone axis secretagogues (e.g., CJC-1295, ipamorelin, and tesamorelin) remain investigational, with uncertain safety profiles, product quality concerns, and widespread antidoping restrictions. Conclusions Injectable peptides for sports medicine remain largely experimental. Clinical use should be confined to approved metabolic agents for indicated conditions and to rigorously designed research protocols. Clinicians caring for athletes must counsel patients regarding uncertain efficacy, product quality, safety risks, and antidoping implications. Level of evidence Level V. See Instructions for Authors for a complete description of levels of evidence. Strength of recommendation taxonomy Predominantly C.
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