Tesamorelin
FDA-approved
Also known as: Egrifta WR, Egrifta SV
Tesamorelin is a lab-made version of growth-hormone-releasing hormone (GHRH), a natural hormone from the brain, given by injection under the skin. It prompts the pituitary gland to release more of the body's own growth hormone. Its evidence comes mainly from large trials in adults with HIV, where it reduced deep belly fat.
Approved for the reduction of excess abdominal fat in HIV-infected adults with lipodystrophy (as Egrifta WR and Egrifta SV).
How it works
- It is a full copy of human GHRH, all 44 amino acids, with a short six-carbon chain (a hexenoyl group) attached at the front end.
- It binds the GHRH receptor on the pituitary cells that make growth hormone.
- This makes the pituitary make and release more of the body's own growth hormone, in natural pulses.
- Growth hormone then raises IGF-1, another growth factor.
Evidence
Belly fat in adults with HIV and lipodystrophy
Two placebo-controlled trials each enrolled about 400 adults with HIV and excess belly fat. After six months, deep belly fat (visceral fat) on CT scans fell 15% in one trial, against a 5% rise on placebo. In the other, it fell 11%, against 1% on placebo. IGF-1 levels rose.
Liver fat in people with HIV
In a randomized trial in people with HIV and fatty liver disease, tesamorelin lowered liver fat by 37% from starting levels, compared with placebo. An earlier, smaller trial also found less liver fat.
Caveats
- Common side effects include joint pain, injection-site reactions, swelling in the legs, muscle pain and pain in the arms or legs.
- It can raise blood sugar. In the main trials, 5% of people on tesamorelin reached an HbA1c of 6.5% or higher (the diabetes range), against 1% on placebo.
- It raises IGF-1, and the effects of high IGF-1 over the long term are unknown. It is not used in people with active cancer.
- It is not used in pregnancy. In rats, it caused fluid on the brain (hydrocephalus) in offspring.
- It needs a working pituitary gland. It is not used after pituitary surgery or other pituitary damage, such as from radiation to the head.
- About half of people develop antibodies to it within six months. These did not appear to weaken its effect on belly fat or IGF-1.
- The drop in belly fat lasted only while people kept taking it.
- It is not approved for weight loss; its label describes a weight-neutral effect.
- All of the large trials were in people with HIV. Outside HIV, a few small randomized trials have been published.
- In 60 adults with belly obesity and low growth hormone release, a year of treatment reduced visceral fat compared with placebo. In 152 older adults, with or without mild memory problems, it improved scores on some thinking tests over 20 weeks. In 53 adults with type 2 diabetes, it did not change blood sugar control over 12 weeks. Each result comes from a single trial.
References
This page is for education only. It is not medical advice. Decisions about any treatment belong with a physician who knows your history.