Prevention

5.3.3 Peptide based therapies

Peptide therapies represent a burgeoning field within medicine, highlighting the significance of peptides as therapeutic agents in various health conditions. These short chains of amino acids exhibit diverse functions and have been explored for applications in regenerative medicine, oncology, and chronic diseases such as diabetes and cardiovascular disorders. The versatility of peptides is evident in their ability to serve as signaling molecules, influencing biochemical pathways that promote healing and tissue regeneration.

The following two tables list commonly used peptides alongside their action and indication, split by those that are FDA-approved and used off-label for longevity, and non-FDA approved peptides.

Some FDA-Approved Peptides With Frequent Off-Label use

Non-FDA Approved, Injectable Peptides

Figure a. FDA approved Peptides; Figure b. Non-FDA approved Peptides Source: Topol, 2025.

*Evidence of efficacy and safety from randomized trials in people; WADA-World Anti-Doping Agency, HGH-human growth hormone, IGF-1-insulin-like growth factor-1

GLP-1 Peptides

Glucagon-like peptide-1 (GLP-1) peptide therapies function by mimicking the endogenous incretin hormone GLP-1, which enhances glucose-dependent insulin secretion, suppresses glucagon release, slows gastric emptying and increases satiety. These mechanisms collectively improve glycaemic control and facilitate weight loss in individuals with type 2 diabetes (T2D) and obesity. As of 2024, over 15 million prescriptions for GLP-1 agonists have been issued annually in the United States alone, with a similar trend observed across Europe, reflecting their growing acceptance as first-line agents for metabolic disease management (Nauck et al., 2021).

There is substantial health impact of GLP-1 receptor agonists across a range of conditions. They have demonstrated a mean weight reduction of 8–15% in obese individuals and improvement in glycaemic control, with HbA1c reductions of 1–1.5% in T2D populations (Frías et al., 2021; Davies et al., 2022). Furthermore, large-scale trials have shown a 12–14% reduction in major adverse cardiovascular events, including myocardial infarction and stroke (Husain et al., 2019). Further, emerging evidence supports potential benefits in cancer risk reduction, mental health stabilisation, and attenuation of Alzheimer’s disease progression, though more robust data are required (Drucker, 2016; Ueda et al., 2024). Early studies also suggest a role in reducing cravings and withdrawal in substance use disorders, highlighting the broad therapeutic potential of this class (Ueda et al., 2024).

However, the success of these therapies is hampered by the lack of sustained use, with an average of 12 months before coming off the drug. Future developments in this drug class look to tackle this setback. These include dual agonists such as tirzepatide, which target both GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptors, with greater weight loss and metabolic control (Frías et al., 2021; Coşkun et al., 2018) and triple agonists, such as retatrutide—combining GLP-1, GIP, and glucagon receptor modulation—promising even greater cardiometabolic benefits with fewer gastrointestinal side effects (Katsi et al., 2025).

The use of GLP-1 peptides for longevity has gained traction, with the use of subtherapeutic dosing regimens to harness metabolic and anti-inflammatory benefits with the rationale that these pathways are involved in ageing. There are as yet no robust clinical trials supporting microdosing for longevity purposes.

Due to this high level of impact, projections underscore the substantial economic and societal potential of widespread GLP-1 therapy adoption, with 12% of Americans already currently taking these drugs. A large-scale economic analysis projected that offering GLP-1 receptor agonists to adults with T2D in the UK would result in direct healthcare savings of over £2–3 billion annually, primarily due to reductions in hospitalisations, CVD events, and diabetes-related complications. Additionally, these savings are complemented by an estimated gain of 0.12–0.23 quality-adjusted life years (QALYs) per patient over a decade, and a potential reduction in lost workdays equivalent to tens of thousands of full-time working years across the population.

These innovative agents are expected to transform the landscape of metabolic and age-related disease management for both health and cost burden of chronic disease and more.

BPC-157

Body Protection Compound-157 (BPC-157), a peptide derived from human gastric juice, is under active investigation for its therapeutic potential in regenerative medicine and health optimisation. Early animal studies have demonstrated that BPC-157 can accelerate wound healing and tissue regeneration as well as anti-inflammatory effects, reducing markers of inflammation (Vasireddi et al., 2025). These properties are particularly relevant for ageing populations, where diminished regenerative capacity and chronic inflammation contribute to physical decline. However, robust data in humans are lacking to confirm its safety and efficacy.

Other Peptides

Other peptide therapies, including ipamorelin, sermorelin, tesamorelin, and thymosin alpha-1, are increasingly used for their potential benefits in muscle growth, metabolic enhancement, immune modulation, and longevity. Ipamorelin, a growth hormone-releasing peptide, stimulates endogenous growth hormone via ghrelin receptors, and while it may improve lean muscle mass and recovery, robust clinical evidence for significant fat loss is lacking (Peptides Institute, 2024). Tesamorelin, used for HIV-comorbidities, is also used off-label for reducing abdominal fat, improving muscle mass and cognitive improvement. Thymosin alpha-1 (Zadaxin) is approved for hepatitis B and C and adjunctive cancer therapy, with off-label use for immune health. Other peptides used for longevity without FDA approval include CJC-1295, AOD 9604, Epitalon, GHK-Cu, TB-500, Cerebrolysin, Dihexa, Melanotan II, kisspeptin and KPV.

Unlike the robust data for GLP-1 and GIP agonists, evidence for anti-ageing effects and safety of other peptides remains limited and primarily anecdotal (Frías et al., 2021; Davies et al., 2022; Husain et al., 2019; Shi et al., 2021).

Safety Profile of Peptide

Unlike the class of GLP-1 drugs, which have been extensively characterized from large randomized trials with placebo controls, and deemed to be relatively safe, the safety profiles of other peptides remain uncharacterised, with a theoretical potential for hormonal imbalance, to accelerate dormant tumour growth, disrupt the immune response and increase the risk of cancer.