Tesamorelin

Tesamorelin, sold under the brand name Egrifta, is a synthetic analog of human growth hormone-releasing hormone (GHRH), also called growth hormone-releasing factor ^[1][2]. It is a stabilized peptide based on the natural GHRH sequence, modified to resist enzymatic degradation and prolong its activity, and it works by stimulating the pituitary gland to synthesize and release the body's own growth hormone in a physiological, pulsatile manner ^[2].

The compound was developed by Theratechnologies and approved by the U.S. Food and Drug Administration in November 2010 for the reduction of excess abdominal fat in patients with HIV-associated lipodystrophy, a condition in which antiretroviral therapy can drive accumulation of visceral fat along with metabolic and body-image complications ^[1][3]. This makes tesamorelin the first and, for many years, the only agent indicated specifically for that use ^[2].

Its efficacy was established in two large phase 3 randomized, placebo-controlled trials and their extension phases, which showed significant reductions in visceral adipose tissue and waist circumference over roughly 26 to 52 weeks; a systematic review and later meta-analyses of randomized trials confirmed reductions in visceral fat and increases in lean body mass across studies ^[1][3][7]. Beyond its approved indication, tesamorelin has been studied for nonalcoholic fatty liver disease (NAFLD), where it reduced liver fat and slowed fibrosis progression in people with HIV ^[5][6]. It is supplied as a peptide for reconstitution and given by subcutaneous injection ^[2]. Benefits generally reverse if treatment is stopped, as visceral fat tends to reaccumulate ^[2].

Tesamorelin is a growth-hormone-releasing hormone analogue (approved for HIV-associated lipodystrophy) that raises growth hormone and IGF-1; common effects include injection-site reactions, joint pain, muscle aches, fluid retention and swelling, and tingling. It can raise blood glucose and reduce insulin sensitivity, and hypersensitivity reactions can occur. It is contraindicated in pregnancy and active malignancy, since increasing IGF-1 could theoretically promote tumor growth, and use in healthy adults for performance is off-label with unestablished long-term safety.

Tesamorelin is a growth hormone-releasing hormone (GHRH) analog indicated for HIV-associated lipodystrophy. It is primarily studied in HIV-infected patients and may potentiate metabolic effects of antiretroviral agents; responders showing visceral adipose tissue reduction of 8% or greater demonstrated significantly greater improvements in triglyceride levels (26-week reduction of 0.6 mmol/L versus 0.1 mmol/L in nonresponders) and preservation of glucose homeostasis, suggesting a synergistic metabolic benefit when layered onto standard HIV care. ^[10]

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Tesamorelin is a stabilized synthetic analogue of human growth hormone-releasing hormone (GHRH 1-44), created by adding a trans-3-hexenoyl group to the peptide's N-terminus to slow degradation; during development it carried the code TH9507. It was developed by the Canadian company Theratechnologies of Montreal. In November 2010 the U.S. Food and Drug Administration approved it under the brand name Egrifta for the reduction of excess visceral abdominal fat in people with HIV-associated lipodystrophy, making it the first therapy specifically indicated for that condition. The approval rested on two 26-week randomized, placebo-controlled phase 3 trials, with extension data confirming that the visceral fat reduction was maintained on continued treatment and reaccumulated after discontinuation.

Tesamorelin holds a distinctive place as the first and, for years, only drug approved specifically to shrink deep visceral abdominal fat, and it is respected for doing so by restoring the body's own pulsatile growth hormone release rather than supplying a flat external dose. Clinicians and researchers value its selective action on visceral fat with little effect on subcutaneous fat, along with well-documented gains in lean mass and reductions in liver fat that have extended interest into fatty liver disease.

Its generally favorable tolerability, with glucose and CD4 counts largely unaffected in trials, further supports its standing. Realistically, benefits depend on continued use and it can cause injection-site reactions and growth-hormone-related symptoms such as joint pain and fluid retention. On balance it is regarded as an effective, mechanistically elegant tool for a difficult metabolic problem.