Meta-analysis of RCTs · PMID 41545261

Body composition, hepatic fat, metabolic, and safety outcomes of Tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials — VialBase Research

5 RCTs included; tesamorelin vs placebo in HIV adults

Last updated · 2026 · Badran AS, Helal A, Shata KS, Ayesh H · Obesity Research & Clinical Practice
Key findings
  • 5 RCTs included; tesamorelin vs placebo in HIV adults
  • Significant reduction in visceral adipose tissue (MD=-27.71 cm2, P<0.001)
  • Trunk fat reduced (MD=-1.18 kg), hepatic fat reduced (MD=-4.28%)
  • Lean body mass increased (MD=+1.42 kg, P<0.001)
  • No significant change in subcutaneous fat, BMI, or CD4+ counts
  • Adverse events: arthralgia, myalgia, paresthesia, injection site reactions

PMID 41545261 — Tesamorelin HIV Lipodystrophy Meta-Analysis

Compound: Tesamorelin Citation: Badran AS et al. Obes Res Clin Pract. 2026;20(1):2-12. doi:10.1016/j.orcp.2026.01.002

Summary

Systematic review and meta-analysis of 5 randomized controlled trials evaluating tesamorelin versus placebo in adults with HIV-associated lipodystrophy. Searched PubMed, Embase, Scopus, Web of Science, and CENTRAL through July 2025. Risk of bias assessed with RoB 2.0; certainty of evidence with GRADE.

Key Results

OutcomeMean Difference95% CIP value
Visceral adipose tissue-27.71 cm2[-38.37, -17.06]<0.001
Trunk fat-1.18 kg[-1.40, -0.96]<0.001
Limb fat-0.22 kg[-0.35, -0.08]0.001
Hepatic fat %-4.28%[-6.31, -2.24]<0.001
Waist circumference-1.61 cm[-2.28, -0.95]<0.001
Lean body mass+1.42 kg[1.13, 1.71]<0.001
Subcutaneous fatNSNS
BMINSNS

Safety

  • No serious adverse events
  • Common: arthralgia, myalgia, paresthesia, injection site erythema
  • No significant change in CD4+ T-cell counts
  • No perturbation of glucose metabolism

Clinical Significance

Strongest evidence base for tesamorelin’s primary indication. Demonstrates selective visceral fat reduction with concurrent lean mass gain — a unique and clinically valuable body composition effect.

PubMed

See Also