Teriparatide
Approved drugPTH(1-34) · Forteo
The first bone-anabolic osteoporosis drug. Intermittent PTH1 receptor activation stimulates osteoblasts, cutting vertebral fracture risk in a landmark 2001 randomised trial.
SVSEIQLMHNLGKHLNSMERVEWLRKKLQDVHNF
FDA approved in 2002 and EMA approved for osteoporosis at high fracture risk. Prescription only.
Primary sources
Calcitonin (salmon)
Approved drugsCT · Miacalcin · Fortical
Inhibits osteoclast-driven bone resorption and lowers serum calcium. Widely used for Paget's disease and osteoporosis before bisphosphonates, with a long trial record from the 1980s and 1990s.
CSNLSTCVLGKLSQELHKLQTYPRTNTGSGTP-NH2
FDA and EMA approved, but long-term use is restricted after a 2013 European safety review flagged a possible malignancy signal.
Primary sources
ACE-031
Human trials (limited)Ramatercept · ActRIIB-Fc
A soluble receptor trap developed to release the brake myostatin places on muscle growth. It raised lean mass in boys with Duchenne muscular dystrophy but was discontinued on safety grounds.
Fusion protein: activin receptor IIB ectodomain plus human IgG1 Fc
Never approved; the paediatric Duchenne programme was halted early for bleeding-related safety signals. Myostatin inhibitors are prohibited in sport (WADA S4.5).
Primary sources
PEG-MGF
Animal / in-vitro onlyMechano growth factor · IGF-1Ec C-terminal peptide
A muscle-repair peptide derived from a mechanically induced IGF-1 splice variant. Published results conflict on whether it does anything at all, and no human trials exist.
YQPPSTNKNTKSQRRKGSTFEEHK (E-domain peptide; PEGylation is a synthetic modification)
Not approved and never clinically trialled. Prohibited in sport under WADA S2 (IGF-1 and analogues). Basic bioactivity is contested.
Primary sources
Osteogenic growth peptide
Animal / in-vitro onlyOGP · histone H4 C-terminal peptide · OGP(10-14)
OGP stimulates osteoblast proliferation and improves fracture callus structure and mineral density in rodent models, with a multi-decade literature from a small number of groups. Human data are limited to serum correlations; no interventional bone-healing trial has been completed.
ALKRQGRTLYGFGG
Not approved by FDA or EMA.
Primary sources