Peptide Supplements and Their Therapeutic Applications in Sports Medicine
Kushagra Tewari, Timothy P. Liu, Christina Im, Christopher Hamad, Frank Petrigliano, Edward C. Cheung, Thomas J. KremenBackground:
The peptide supplement market has experienced rapid growth due to marketing claims of enhanced performance and accelerated recovery from musculoskeletal injury. These peptides are increasingly popular with patients and athletes and are often perceived as low risk, despite the absence of efficacy or safety data for many emerging peptides.
Purpose:
To summarize existing peer-reviewed data on 6 emerging peptides (BPC-157, thymosin beta-4 or TB-500, CJC-1295, MK-677, ipamorelin, and GHK-Cu [copper peptide]) for musculoskeletal recovery and enhancement in animal and human models.
Study Design:
Scoping review.
Methods:
Three independent reviewers searched the PubMed database using permutations of peptide search terms (BPC-157, TB-500, CJC-1295, MK-677 [ibutamoren], ipamorelin, and GHK-Cu) combined with musculoskeletal tissue search terms (bone, fracture, muscle, tendon, ligament, meniscus, and cartilage) following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Papers were independently screened by 2 reviewers, with a third serving as a tiebreaker. Papers examining these peptides for musculoskeletal treatment, tissue recovery, or performance in animal or human models were included.
Results:
Overall, 67% of identified publications utilized preclinical animal models. In animal models, most commonly rats, each compound demonstrated unique mechanisms with promising but variable effects on tendon, muscle, bone, and ligament healing. Human clinical studies were limited to a handful of investigations, most lacking robust controls or rigorous study designs. Human data were heterogeneous and revealed modest improvements at best for metabolic bone health and degenerative knee pain. Some peptides such as MK-677 were associated with significant risks including congestive heart failure, and significant heterogeneity existed in dosing and route of administration.
Conclusion:
Despite promising findings in animal studies, the claimed benefits of emerging peptide supplements for musculoskeletal recovery and performance remain unsubstantiated by current human trials. Documented risks include cardiovascular complications and metabolic dysfunction such as insulin resistance. Because of the lack of robust efficacy and safety data, peptide supplements should not currently be recommended as a replacement or adjunct for existing orthopaedic standard of care.