State of the Art: Oral GH Secretagogues and Their Clinical Future | Research

The takeaway

Comprehensive review of orally active GH secretagogues including their pharmacology, clinical trial results, and therapeutic potential across GH deficiency, aging, and catabolic states.

Effective oral GH stimulation
Multiple oral compounds demonstrated consistent GH and IGF-1 elevation in clinical trials across diverse patient populations

What the researchers found

Oral GH secretagogues effectively increase GH and IGF-1 through a specific receptor, with clinical potential spanning GH deficiency, aging, and catabolic states, though their optimal therapeutic role remained to be defined.

Why it matters

This review represented the most complete clinical assessment of oral GH secretagogues available at the time, helping define where these agents fit in endocrine therapeutics and identifying which clinical applications showed the most promise.

How the study worked

Comprehensive review of published preclinical and clinical data on oral GH secretagogues.

What this study cannot tell us

1998 review — clinical trial database was still developing. Long-term outcome data not available. The therapeutic niche for oral GH secretagogues versus GH replacement was not yet resolved.

How to read the evidence

Comprehensive clinical review in Annals of Medicine. Synthesizes substantial preclinical and clinical evidence but reflects early-stage clinical development.

When this study was published

Published in 1998, this review captures the peak of pharmaceutical interest in oral GH secretagogues. Many compounds discussed did not ultimately reach market, though MK-677 remains widely studied.

The bigger picture

The development of oral GH secretagogues represented a potential paradigm shift in treating GH-related disorders. Instead of daily GH injections, patients could potentially take a pill that stimulates natural GH production. This review captured the field's optimism while noting that optimal clinical applications were still being defined.

Questions still open

Will oral GH secretagogues replace GH injections for any indications?
What are the long-term metabolic effects of chronic GH secretagogue use?
Can oral GH secretagogues improve outcomes in critically ill catabolic patients?

Common questions

What makes a GH secretagogue 'orally active'?

Most peptide-based GH releasers are destroyed by digestion and must be injected. Orally active secretagogues are non-peptide molecules that survive digestion and absorb through the gut, allowing them to be taken as pills.

Did oral GH secretagogues ever become approved medications?

Despite promising clinical trial results, most oral GH secretagogues from this era did not achieve regulatory approval for GH-related indications. However, MK-677 continues to be studied in clinical trials for various conditions.

Read the original research

Orally active growth hormone secretagogues: state of the art and clinical perspectives.

Annals of medicine, 30(2), 159-68

View on PubMed ↗

Citation

Ghigo, E; Arvat, E; Camanni, F. (1998). Orally active growth hormone secretagogues: state of the art and clinical perspectives.. Annals of medicine, 30(2), 159-68.