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MetabolicApproved drug

Tesamorelin

Published research and evidence base

Tesamorelin (TH9507) is a synthetic analogue of human growth hormone-releasing hormone (GHRH) that stimulates endogenous, pulsatile growth hormone secretion via the GHRH receptor. It was evaluated in large multicentre phase 3 trials in people with HIV and excess abdominal fat, where visceral adipose tissue was the primary endpoint, and was subsequently approved for HIV-associated lipodystrophy. Later investigator-initiated trials extended the work to hepatic fat in NAFLD/MASLD, to neurocognitive endpoints in mild cognitive impairment and in HIV, and to lean mass and physical function. Recent literature is dominated by meta-analyses of the HIV lipodystrophy trials, MASLD reviews, and preclinical GHRH-agonist neurobiology.

Studies cited
15
Published 2023+
11
Newest paper
2026
Last reviewed
Aug 2026

Recurring themes in the literature

  • HIV-associated lipodystrophy and visceral adipose tissue reduction
  • Hepatic fat fraction, NAFLD/MASLD in people with HIV
  • GHRH receptor signalling and endogenous GH pulsatility
  • Cognition, brain connectivity and mild cognitive impairment
  • Lean body mass and physical function preservation
  • Safety signals: glucose homeostasis, arthralgia, IGF-1 elevation

Compound identifiers

CAS
218949-48-5
PubChem
16137828
Chemical identity

What Tesamorelin is, chemically.

Molecular formula
C221H366N72O67S
Molecular weight
5136 g/mol
CAS number
218949-48-5
PubChem CID
16137828
Also written as

TH 9507

These figures come from the PubChem record for this compound and describe the free base. Lyophilised peptide is normally supplied as an acetate or trifluoroacetate salt and carries residual water, so the mass of powder in a vial is not the same quantity as the molecular weight above would suggest. Chromatographic purity on a certificate of analysis does not resolve that difference either — how to read a certificate of analysis explains why.

The evidence

15 published studies.

Ordered by strength of study design, then by recency. Every entry links to its source record so the finding can be checked against the paper rather than taken on our word.

  1. 01Systematic review2026

    Efficacy and Safety of Tesamorelin in People Living With HIV (PLWH) With Lipodystrophy: A Systematic Review and Meta-Analysis

    Ditta AM, et al. · Journal of the International Association of Providers of AIDS Care · systematic review and meta-analysis of 4 randomised controlled trials, 909 participants with HIV-associated lipodystrophy

    Pooled analysis reported reductions in visceral adipose tissue and waist circumference and an increase in lean body mass with tesamorelin 2 mg relative to placebo. The authors also recorded higher discontinuation rates and growth hormone-related adverse effects in the treatment arms.

  2. 02Systematic review2026

    Body composition, hepatic fat, metabolic, and safety outcomes of Tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials

    Badran AS, et al. · Obesity Research & Clinical Practice · meta-analysis of 5 randomised controlled trials in HIV-associated lipodystrophy

    Tesamorelin was associated with reductions in visceral adipose tissue (mean difference -27.71 cm2), trunk fat and hepatic fat, and with an increase in lean body mass (mean difference 1.42 kg). Reported adverse events included arthralgia, myalgia and paraesthesia.

  3. 03Human clinical2026

    The effect of growth hormone-releasing hormone on cognition and brain connectivity in adults with cognition ranging from normal to mild cognitive impairment

    Stewart CE, et al. · eNeurologicalSci · randomised placebo-controlled study, n=22 adults spanning normal cognition to mild cognitive impairment, 1 mg tesamorelin, 10 weeks

    Low-dose GHRH treatment was not directly associated with significant changes in the study's cognitive measures over 10 weeks. Machine-learning analysis of imaging data identified candidate differences in connectivity within cognition-related brain regions.

  4. 04Human clinical2026

    Tesamorelin as an Adjunct to Exercise for Improving Physical Function in HIV (TRIUMPH): a clinical trial protocol

    Erlandson KM, et al. · BMJ Open · randomised controlled trial protocol, planned n=100 sedentary adults aged 50-80 with HIV, 24 weeks treatment plus 24-week exercise extension (NCT06554717)

    The protocol described a trial testing tesamorelin combined with exercise, with endpoints covering physical function, muscle quality, quality of life and metabolic markers. No outcome data were reported, as the paper described study design only.

  5. 05Human clinical2025

    Effects of Tesamorelin on Neurocognitive Impairment in Persons With HIV and Abdominal Obesity

    Ellis RJ, et al. · The Journal of Infectious Diseases · phase 2 multicentre randomised trial, n=73 persons with HIV and abdominal obesity, 6 months

    Within-group cognitive change in the tesamorelin arm approached but did not reach significance (P=.060), and the between-group difference versus standard care was not significant (P=.673). Greater reduction in waist circumference was observed in the tesamorelin arm.

  6. 06Human clinical2024

    Efficacy and safety of tesamorelin in people with HIV on integrase inhibitors

    Russo SC, et al. · AIDS · randomised placebo-controlled trial, 31 completers (15 tesamorelin, 16 placebo) with HIV on integrase strand transfer inhibitors, 12 months

    Tesamorelin was associated with declines in visceral fat, hepatic fat and the trunk-to-appendicular fat ratio relative to placebo in participants receiving integrase inhibitor regimens. Adverse event frequency was similar between groups.

  7. 07Human clinical2019

    Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial

    Stanley TL, et al. · The Lancet HIV · randomised, double-blind, placebo-controlled multicentre trial, n=61 people with HIV and NAFLD, 12 months

    Hepatic fat fraction fell more in the tesamorelin group than in the placebo group, with an absolute effect size of -4.1% (p=0.018). At 12 months, 35% of tesamorelin recipients versus 4% of placebo recipients had a hepatic fat fraction below 5%.

  8. 08Human clinical2014

    Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial

    Stanley TL, et al. · JAMA · randomised placebo-controlled trial, n=48 (28 tesamorelin, 22 placebo) with HIV and abdominal fat accumulation, 6 months

    Visceral adipose tissue decreased by 34 cm2 with tesamorelin versus an increase of 8 cm2 with placebo (p=0.005). Liver fat, measured as lipid-to-water percentage, showed a net reduction of 2.9%.

  9. 09Human clinical2012

    Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trial

    Baker LD, et al. · Archives of Neurology · randomised double-blind placebo-controlled trial, 137 completers (66 with mild cognitive impairment), tesamorelin, 20 weeks

    Intent-to-treat analysis indicated a favourable effect of GHRH administration on a composite cognitive measure (P=.03), with the strongest signal in executive function (P=.005). Effects were observed in both the mild cognitive impairment and healthy older adult groups.

  10. 10Human clinical2007

    Metabolic effects of a growth hormone-releasing factor in patients with HIV

    Falutz J, et al. · The New England Journal of Medicine · multicentre randomised placebo-controlled trial, n=412 patients with HIV and abdominal fat accumulation, 26 weeks

    Visceral adipose tissue decreased by 15.2% in the tesamorelin group and increased by 5.0% in the placebo group (p<0.001). Triglycerides fell by 50 mg/dL with tesamorelin versus a rise of 9 mg/dL with placebo (p<0.001).

  11. 11Animal in vivo2026

    Growth hormone-releasing hormone attenuates amyloid deposition and neuroinflammation in Alzheimer's disease models

    Pedrolli F, et al. · Cell Death & Disease · rat hippocampal neural stem cells and human neuroblastoma cells in vitro; 5xFAD transgenic mice treated with the GHRH agonist MR-409

    GHRH(1-44)NH2 promoted neural stem cell survival and differentiation under amyloid-beta exposure and engaged cAMP/PKA/CREB, ERK1/2 and PI3K/Akt signalling. In 5xFAD mice, MR-409 reduced amyloid-beta deposition, tau phosphorylation, gliosis and proinflammatory cytokine expression without altering systemic GH or IGF-1.

  12. 12Review2026

    Pharmacologic Treatments for the Preservation of Lean Body Mass During Weight Loss

    Arora G, et al. · Journal of Clinical Medicine · narrative review of agents investigated for muscle preservation during weight loss

    The review placed tesamorelin among GHRH-directed agents examined for attenuating lean mass loss, alongside bimagrumab and enobosarm. It summarised the available trial evidence and noted that data specific to lean mass preservation during pharmacological weight loss remained limited.

  13. 13Review2025

    Metabolic dysfunction-associated steatotic liver disease in people with HIV

    Gattu AK, et al. · Current Opinion in HIV and AIDS · narrative review of MASLD epidemiology, diagnosis and therapeutics in people with HIV

    The review summarised the higher burden of steatotic liver disease in people with HIV and the diagnostic approaches used. It described dedicated studies of GLP-1 receptor agonists and the GHRH analogue tesamorelin as the main HIV-specific therapeutic evidence to date.

  14. 14Review2025

    Growth hormone-releasing hormone receptor (GHRH-R) and its signaling

    Halmos G, et al. · Reviews in Endocrine and Metabolic Disorders · mechanistic review of GHRH receptor structure, splice variants and downstream signalling

    The review described pituitary and extrapituitary GHRH receptor expression, splice variant biology and the cAMP-dependent signalling engaged by GHRH agonists. It outlined therapeutic contexts spanning oncology, endocrinology, obesity and diabetes.

  15. 15Review2025

    GHRH in diabetes and metabolism

    Steenblock C, et al. · Reviews in Endocrine and Metabolic Disorders · review of GHRH and GHRH analogue effects on metabolic regulation and pancreatic islet biology

    The review reported that GHRH and its analogues enhanced survival of insulin-producing pancreatic beta cells in vitro and in animal models. It also summarised GHRH-axis involvement in adiposity and glucose metabolism.

Limitations

What this evidence does not establish.

Controlled evidence outside HIV-associated visceral adiposity and hepatic steatosis remains limited: cognitive trials have been small and inconsistent, the largest recent HIV neurocognitive trial found no significant between-group difference, and no histology-based endpoints in MASLD or long-term cardiovascular or oncological outcome data have been established. Effects on physical function and lean mass preservation in non-HIV populations are still under investigation, with the TRIUMPH protocol published but no results reported.

Common questions about the research.

What is tesamorelin?

Tesamorelin is a synthetic analogue of growth-hormone-releasing hormone (GHRH 1-44) with a stabilising hexenoyl modification at its N-terminus. It is studied in research on GHRH-receptor signalling, growth hormone pulsatility, and the IGF-1 axis.

How does tesamorelin differ from CJC-1295 and ipamorelin?

All three appear in growth-hormone-axis research, but through different mechanisms. Tesamorelin and CJC-1295 are GHRH analogues acting at the GHRH receptor, while ipamorelin is a ghrelin-mimetic acting at the GH secretagogue receptor (GHS-R1a). Tesamorelin is distinguished by its large clinical literature and its minimally modified full-length GHRH sequence.

What did the trials in HIV-associated lipodystrophy report?

The 2007 multicentre randomised placebo-controlled trial in 412 patients with HIV and abdominal fat accumulation reported a 15.2 percent decrease in visceral adipose tissue over 26 weeks against a 5.0 percent increase with placebo, and a fall in triglycerides of 50 mg/dL versus a rise of 9 mg/dL with placebo. A 2026 meta-analysis of five randomised controlled trials reported a pooled visceral adipose tissue mean difference of -27.71 cm2 and an increase in lean body mass of 1.42 kg. Reported adverse events across those trials included arthralgia and myalgia.

Available from our catalog

For research purposes only. Not for human consumption, diagnosis, treatment, or prevention of any condition. Nothing on this page is medical advice, and no study summarised here should be read as a recommendation.