Muscle, bone, HPG axis and immune system

Summary

Four groups this site only skimmed. Muscle and bone: apitegromab (the anti-myostatin cousin of bimagrumab from the antibodies page), romosozumab, abaloparatide, palopegteriparatide, vosoritide. Melanocortin: setmelanotide and afamelanotide — the cousins with a package insert of MT-2 and PT-141. HPG axis: gonadorelin, hCG, enclomiphene, carbetocin — the contrast to research kisspeptin. Immune: efgartigimod, tezepelumab, low-dose IL-2, and immunofan, alongside TA-1. What the table shows is the difference between having and not having a package insert. 6 of the 14 lines searched have active registration. The ones that don't include exactly the ones the community discusses the most: setmelanotide, afamelanotide, enclomiphene, and apitegromab.

Four blocks, one single question

The question is always the same on this site: what the trial tested, and what the bottle promises. In these fifteen lines, the answer is almost always that the trial tested a rare disease and the bottle promises body recomposition.

The cleanest case is afamelanotide: the phase 3 records the search returns are for erythropoietic protoporphyria, sponsored by Clinuvel — a rare skin disease with photosensitivity. Nothing to do with tanning, which is why melanotan I circulates. Setmelanotide's is the same: the records are for obesity from a defined genetic deficiency, sponsored by Rhythm, and one of them has fifteen participants.

Carbetocin is another example of the same type: the two largest phase 3 records I opened are for hyperphagia in Prader-Willi syndrome, sponsored by ACADIA — not for bonding, anxiety, or libido, which is how the oxytocin analog is usually sold.

Three search-breadth caveats are in the notice above and apply to gonadorelin and enclomiphene. The third is immunofan: I searched using the Latin spelling the literature uses, and the number is small enough that any spelling variation would change the order of magnitude.

No number on this page came from the site's secondary source.

How much evidence exists, compound by compound

The numbers below were compiled by me on September 12, 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's the Condition field copied from the phase 3 records that the search itself returned. When there is no phase 3 record, the cell says so.

What exists in phase 3, and who it belongs to

Article count measures academic attention, not outcome evidence. The table below separates what has a registered phase 3 trial — and shows the largest registration the search returned in each row, with the declared number of participants and the sponsor.

A registration is not a result. A recruiting phase 3 trial is declared intent with money behind it, and nothing more than that.

Where the numbers don't add up

• Afamelanotide has 6 phase 3 trials, all the ones I opened in erythropoietic protoporphyria. It's proof that a serious melanocortin clinical program exists — for a rare photosensitivity disease, not for pigmenting healthy skin.
• Apitegromab is the anti-myostatin with a trial, and it's not for weight loss. 14 articles, 7 studies, 2 phase 3, sponsored by Scholar Rock. It's the same target that bimagrumab pursues by another route.
• Bone is where the Brazilian registration is. Romosozumab (EVENITY) and vosoritide (VOXZOGO) have active registration; abaloparatide and palopegteriparatide, 0.
• The immune side has two package inserts and two nothings. Efgartigimod (VYVGART) and tezepelumab (TEZSPIRE) have active registration. Low-dose IL-2 is a strategy, not a product — 57 registered studies, and the largest phase 3 trial I opened is for melanoma. Immunofan has 51 articles and 0 studies.
• 8 of the 14 searches come up empty. Among them, setmelanotide, afamelanotide, enclomiphene, and apitegromab — the four that show up in forums as if they were purchasable.

In Brazil

I searched every active ingredient in the open data on registered medicines, downloaded on September 12, 2026 — 43,508 rows, counting only Active status. The therapeutic class column is the one the dataset itself declares.

Two searches were split apart on purpose. Chorionic gonadotropin is entered separately from the hCG in the evidence table because that's how the database names the active ingredient. And clomiphene is entered alongside enclomiphene because the two names coexist on the topic — and the result shows that what's registered here is clomiphene, not enclomiphene.

References

1. Public ClinicalTrials.gov API, version 2 — the source for all the study and phase 3 counts on this page.
2. PubMed E-utilities (esearch) — the basis for all article counts on this page.
3. Registration NCT00979745 on ClinicalTrials.gov — afamelanotide in erythropoietic protoporphyria, sponsored by Clinuvel.
4. Registration NCT05093634 on ClinicalTrials.gov — EMANATE, setmelanotide in obesity from a genetic variant, sponsored by Rhythm Pharmaceuticals.
5. Registration NCT06173531 on ClinicalTrials.gov — carbetocin nasal spray for hyperphagia in Prader-Willi syndrome, sponsored by ACADIA.
6. Registration NCT05156320 on ClinicalTrials.gov — apitegromab, sponsored by Scholar Rock.

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