Tesamorelin

Specifically targets visceral adipose tissue (VAT) reduction via anterior pituitary GH secretion. Preserves pulsatile GH physiology. Does not directly affect peripheral tissues — works through natural GH axis.

HIV-associated lipodystrophy (FDA-approved). Off-label VAT reduction in non-HIV populations (lacks Phase III evidence).

Active malignancy, hypersensitivity to GHRH analogs or mannitol, pregnancy, disruption of hypothalamic-pituitary axis, hypopituitarism.

FDA-approved for HIV-associated lipodystrophy. Phase III data shows significant VAT and hepatic fat reduction.

• 1.Falutz J et al., NEJM 2007 — significant VAT reduction (average -18%) without peripheral fat loss. Led to FDA approval. n=412, Phase III RCT
• 2.Stanley TL et al., Lancet HIV 2019 — hepatic fat fraction reduced 37% relative to baseline. Decreased liver fibrosis markers. n=61, RCT

FDA-approved ONLY for HIV-associated lipodystrophy. Off-label general VAT reduction lacks Phase III evidence. Effects completely reverse upon discontinuation.