Safety and Efficacy of Approved and Unapproved Peptide Therapies for Musculoskeletal Injuries and Athletic Performance.

Narrative review

“This narrative review focuses on the utilization of peptides in sports medicine, and alternative treatments that may be considered.”

Approved and unapproved peptides marketed direct to patients

“Our objective is to present the pharmacological mechanisms, safety profiles, and regulatory status of prominent approved and unapproved peptides marketed direct to patients, including AOD-9604 (anti-obesity drug 9604), BPC-157 (body protection compound 157), CJC-1295, FS-344 (follistatin-344), GHK-Cu (glycyl-L-histidyl-L-lysine copper), ipamorelin, MOTS-C (mitochondrial ORF of the 12S rRNA type-c), sermorelin, SS-31 (elamipretide), tesamorelin (Egrifta), Tβ4 (thymosin beta-4), and TB-500 (thymosin beta-4 fragment).”

Many unapproved peptides show favorable outcomes in animal models but lack rigorous human safety data.

“Many unapproved peptides demonstrate favorable tissue repair and metabolic outcomes in animal models, but rigorous human safety data are scarce, and there is potential for serious harm to patients.”

A gray market of unapproved compounds operates largely outside regulatory oversight.

“While numerous peptide drugs have undergone a rigorous approval process that evaluates both safety and efficacy, a parallel "gray market" of unapproved compounds has emerged, operating largely outside of regulatory oversight.”

Social media amplifies the placebo effect as a mediator of peptide efficacy.

“We also discuss the placebo effect as a mediator of peptide efficacy, and how social media amplifies this effect.”

Rigorous human safety data are scarce for many unapproved peptides.

“Many unapproved peptides demonstrate favorable tissue repair and metabolic outcomes in animal models, but rigorous human safety data are scarce, and there is potential for serious harm to patients.”