Metabolism and fat — exenatide, AICAR, CBL-514 and others
Exenatide has 93 phase 3 trials and zero active registrations. Oxyntomodulin, zero in phase 3. CBL-514 has 7 articles and 16 registered studies, all from the same company
Experimental material. Read before using anything from here.
Nothing on this page is a medical recommendation, prescription or treatment plan. It is an organized translation of protocols circulating in research communities and, where it exists, of what published trials tested. The two are marked differently — and they are not equivalent.
Most of the compounds here have no FDA approval for human use. Several are sold labeled "research use only", which means they have not gone through purity, sterility or dosage controls for human consumption. A community-reported dose is not a validated dose: it is what someone reported having done.
Talk to a licensed health professional before considering any of these compounds. If you already use one and feel anything unexpected, seek care — do not wait for the next routine test.
Summary
Six weight and metabolism compounds that were missing from the site: exenatide, oxyntomodulin, efinopegdutide, AICAR (acadesine), CBL-514 and L-carnitine. They range from the most studied to almost nothing, and what separates them is always the same question: in whom was it tested, and for what.
Six names from outside the pen lineup
The site already has semaglutide, tirzepatide, retatrutide, survodutide, cagrilintide, mazdutide and the next-generation incretins page. Left out were exenatide, approved in the United States in 2005; oxyntomodulin, a gut hormone; efinopegdutide, from MSD; AICAR, which the store I took the list from describes as an exercise mimetic; CBL-514, an injection for localized fat; and L-carnitine.
Three method caveats. One: AICAR OR acadesine returns the entire literature of a lab tool, and the number is a ceiling. To measure that: (AICAR OR acadesine) AND AMPK returns 2,164 of the 2,891 articles. Two: the L-carnitine search returns records in which it enters as co-treatment in trials of something else; the largest phase 3 is an antiviral trial in HIV. Three: oxyntomodulin is a hormone the body produces, and some of the records measure it in the blood.
No number on this page came from the site's secondary source.
How much evidence exists, compound by compound
The numbers below were gathered by me on October 5, 2026, on PubMed and ClinicalTrials.gov. Each row's query is written out in full, next to the number, so anyone can repeat it and contradict me — and so the script that rechecks this site's counts can run all of them.
The condition column is not a claim about mechanism: it is the Condition field copied from the largest phase 3 record that the search itself returned. When there is no phase 3 record, the cell says so.
| Compound | Condition in phase 3 registrations | Query | Articles in PubMed | Studies on ClinicalTrials.gov |
|---|---|---|---|---|
| Exenatide | Type 2 Diabetes Mellitus | exenatide | 4.526 | 378 |
| Oxyntomodulin | no phase 3 registration in this search | oxyntomodulin | 476 | 10 |
| Efinopegdutide | no phase 3 registration in this search | efinopegdutide OR "MK-6024" | 9 | 7 |
| AICAR (acadesine) | Coronary Artery Bypass; Myocardial Infarction; Ventricular Dysfunction, Left; Stroke | AICAR OR acadesine | 2.891 | 5 |
| CBL-514 | Subcutaneous Fat | "CBL-514" | 7 | 16 |
| L-carnitine | Cytomegalovirus Infections; HIV Infections | levocarnitine OR "L-carnitine" | 23.815 | 312 |
What exists in phase 3, and who it belongs to
An article count measures academic attention, not outcome evidence. The table below separates what has a registered phase 3 trial — and shows the largest record the search returned, with the declared number of participants and the sponsor. A registration is not a result.
| Compound | Query | Registered phase 3 trials | The largest registration I opened |
|---|---|---|---|
| Exenatide | (exenatide) AND AREA[Phase]PHASE3 | 93 | NCT01144338 · n = 14,752 · AstraZeneca Type 2 Diabetes Mellitus |
| Oxyntomodulin | (oxyntomodulin) AND AREA[Phase]PHASE3 | 0 | — |
| Efinopegdutide | (efinopegdutide OR "MK-6024") AND AREA[Phase]PHASE3 | 0 | — |
| AICAR (acadesine) | (AICAR OR acadesine) AND AREA[Phase]PHASE3 | 1 | NCT00872001 · n = 3,080 · Merck Sharp & Dohme LLC Coronary Artery Bypass, Myocardial Infarction, Ventricular Dysfunction, Left, Stroke |
| CBL-514 | ("CBL-514") AND AREA[Phase]PHASE3 | 3 | NCT07140939 · n = 320 · Caliway Biopharmaceuticals Co., Ltd. Subcutaneous Fat |
| L-carnitine | (levocarnitine OR "L-carnitine") AND AREA[Phase]PHASE3 | 53 | NCT00001082 · n = 505 · National Institute of Allergy and Infectious Diseases (NIAID) Cytomegalovirus Infections, HIV Infections |
Where the numbers don't add up
- Exenatide has 93 phase 3 trials and no active registration. The largest is EXSCEL, a cardiovascular outcome trial, with 14,752 participants. In the United States, the search returns BYETTA as discontinued and a synthetic generic approved in 2024. It is the one with the most phase 3 trials on this page — and it has no product registered in Brazil.
- Oxyntomodulin does not have a single phase 3 trial, across 476 articles. The largest record is phase 2, from OPKO Health, Inc., with 420 participants in type 2 diabetes; the rest is phase 1 or physiology — the hormone measured after bariatric surgery, after exercise, after a meal.
- Efinopegdutide is, so far, in phase 2: 4 phase 2 records, all from MSD and all in fatty liver, and none in phase 3.
- AICAR's only phase 3 trial was terminated. Under the pharmaceutical name acadesine, it was tested in 3,080 coronary artery bypass surgery patients, to reduce cardiovascular and cerebrovascular events. Record NCT00872001 is listed as terminated. None of the 5 records is about performance or exercise.
- CBL-514 has more registrations than articles: 7 articles and 16 studies, all from the same company, Caliway. Of the 3 in phase 3, none has completed status — not yet recruiting, recruiting. It is development happening now, and still without a phase 3 result.
- L-carnitine has a label, for something else. In the United States, levocarnitine is approved for primary systemic carnitine deficiency. In the Brazilian database of registered medicines, the search finds no active registration with the active ingredient.
Approval in the United States
For those that have a drug name in the United States, I queried Drugs@FDA through the public openFDA API, on the same day. The search is written in the table; the date is that of the earliest approved original submission the search returned.
| Compound | openFDA search | Applications returned | Brands | Earliest original approval | Market status |
|---|---|---|---|---|---|
| Exenatide | openfda.generic_name:"EXENATIDE" | 2 | BYETTA, EXENATIDE SYNTHETIC | 28/04/2005 | Discontinued, Prescription |
| L-carnitine | openfda.generic_name:"LEVOCARNITINE" | 12 | CARNITOR, CARNITOR SF, LEVOCARNITINE, LEVOCARNITINE SF | 27/12/1985 | Discontinued, Prescription |
In Brazil
I searched every active ingredient in the open data on registered medicines in Brazil, downloaded on October 5, 2026 — 43,596 rows, counting only Active status, in the active ingredient and in the product name, ignoring accents and case. The therapeutic class is the one the dataset itself declares.
CBL-514 is left out of the table: as a development code, with no published INN, it has no active ingredient to look up.
| Active ingredient | Search pattern | Active registrations | Declared therapeutic class | Products |
|---|---|---|---|---|
| Exenatide | EXENAT | 0 | — | — |
| Oxyntomodulin | OXINTOMOD | 0 | — | — |
| Efinopegdutide | EFINOPEG | 0 | — | — |
| AICAR (acadesine) | ACADESIN | 0 | — | — |
| L-carnitine | CARNITINA | 0 | — | — |
References
- Public ClinicalTrials.gov API, version 2 — the source for all the study and phase 3 counts on this page.
- PubMed E-utilities (esearch) — the basis for all article counts on this page.
- Record NCT01144338 on ClinicalTrials.gov.
- Record NCT00872001 on ClinicalTrials.gov.
- Record NCT07140939 on ClinicalTrials.gov.
- Levocarnitine oral solution label on DailyMed — indication in primary systemic carnitine deficiency.
- openFDA API, drugsfda endpoint — the applications and approval dates on this page.