Tesamorelin

n/c: not counted here; see the cited review.

Two randomised placebo-controlled trials (412 and 404 participants) found that tesamorelin reduced CT-measured visceral fat over 26 weeks (about 15% and 11% versus small changes on placebo), with improvements in some lipid measures and raised IGF-1. In the extension phase, visceral fat returned toward baseline after switching to placebo. Neither trial measured cardiovascular events; the US label states long-term cardiovascular safety is not established, and the EMA's committee questioned whether the fat reduction was clinically meaningful.

• [1] Visceral adipose tissue fell 15.2% with tesamorelin versus a 5.0% rise with placebo over 26 weeks in 412 adults with HIV
• [2] Visceral fat fell 10.9% versus 0.6% on placebo at 6 months; gains were lost after switching to placebo
• [3] 26-week re-randomised extension of the first Phase 3 trial reporting longer-term safety and visceral fat effects in adults with HIV

Registered-study counts: ClinicalTrials.gov intervention search “tesamorelin”, fetched 2026-10-10. Registered studies include trials of other uses; the gap between registered and reported is itself a finding.

No randomised controlled trial in humans has been published for this use.

Two small randomised placebo-controlled trials in people with HIV (50 and 61 participants) found reductions in liver fat; the larger trial's primary endpoint was a 4.1 percentage-point absolute reduction in hepatic fat fraction over 12 months. Neither was powered for liver-related clinical outcomes, and the authors called for further studies of long-term histological effects. Not an approved indication.

• [4] Greater reduction in hepatic fat fraction than placebo over 12 months in 61 adults with HIV and NAFLD
• [5] Reduced visceral fat and modestly reduced liver fat over 6 months versus placebo in 50 adults with HIV

Registered-study counts: ClinicalTrials.gov intervention search “tesamorelin AND fatty liver”, fetched 2026-10-10. Registered studies include trials of other uses; the gap between registered and reported is itself a finding.

No randomised controlled trial in humans has been published for this use.

One randomised placebo-controlled trial of 60 abdominally obese adults selected for reduced growth hormone secretion found lower visceral fat, triglycerides, C-reactive protein and carotid intima-media thickness after 12 months, with no change in subcutaneous fat. No trial has tested it in obesity without that selection, and none measured clinical outcomes. The US label states it is not indicated for weight loss and has a weight-neutral effect.

• [6] Reduced visceral adipose tissue versus placebo over 12 months in 60 abdominally obese adults with reduced GH secretion

Registered-study counts: ClinicalTrials.gov intervention search “tesamorelin AND obesity”, fetched 2026-10-10. Registered studies include trials of other uses; the gap between registered and reported is itself a finding.

No randomised controlled trial in humans has been published for this use.

One randomised placebo-controlled trial of 152 adults aged 55 to 87 (66 with mild cognitive impairment) reported a favourable effect on a cognitive composite after 20 weeks, driven mainly by executive function. Adverse events were reported by 68% on tesamorelin versus 36% on placebo. The result has not been replicated in a larger or longer trial, and no dementia or functional outcomes were assessed.

• [7] Favourable effect on a cognitive composite versus placebo over 20 weeks in older adults with and without mild cognitive impairment

Registered-study counts: ClinicalTrials.gov intervention search “tesamorelin AND cognition”, fetched 2026-10-10. Registered studies include trials of other uses; the gap between registered and reported is itself a finding.