Ratings change. Here's the receipt.

Editorial update: registry expanded from 42 to 56 curated compounds, adding major approved peptide medicines across oral, nasal, injectable and implant routes, plus a source-completeness layer on every profile.

This is a registry coverage change, not a new clinical discovery. Fourteen established medicines — from desmopressin and oxytocin to linaclotide and icatibant — were added so that approved peptide therapy across routes can be compared against research-market claims. Each profile now also shows whether its references are fully curated, partially curated or still pending, and outstanding placeholders (e.g. vasopressin, calcitonin) are marked openly rather than filled with weak links.

Editorial update: major taxonomy expansion from 15 to 42 curated compounds, adding approved peptide medicines and high-interest research compounds.

This is a registry coverage change, not a new clinical discovery. New categories (metabolic, gastrointestinal, bone-calcium, melanocortin, immune, antiviral, pain-neuro) and a new route (intrathecal) were added so that approved medicines — from bremelanotide to ziconotide — can be catalogued alongside the research compounds they are constantly confused with.

Editorial update: profiles created or revised using FDA 2026 Pharmacy Compounding Advisory Committee material.

This reflects curation of existing regulatory documents, not new clinical findings. FDA 2026 PCAC review material established, for example, that no clinical studies or human exposure data were identified for KPV via any route — a fact that sets the ceiling for every marketed claim about it.

Baseline entry: registry position set to preclinical-only for musculoskeletal healing claims.

Reviewed the available literature landscape. Preclinical breadth is large; controlled human evidence for tendon and injury claims remains absent, so confidence stays very low.

Baseline entry: split rating into approved narrow indication versus general anti-ageing claims.

A rare-disease accelerated approval justifies a higher regulatory status but not higher confidence in longevity or performance claims. The registry now separates the two explicitly.

Baseline entry: efficacy confidence for weight loss set high; safety confidence held low pending Phase 3 completion.

Randomised human trial data support large weight reduction. Long-term safety and a regulatory decision are still outstanding, so the two axes are rated separately.

Baseline entry: classified as promising-but-unproven rather than emerging therapy.

Human data are observational. Without a published trial of exogenous administration, therapeutic claims cannot rise above Level 2.

Baseline entry: topical and systemic evidence separated into distinct positions.

Small topical cosmetic studies support modest skin-appearance effects. Injectable systemic use has no controlled human evidence and is rated independently.

Baseline entry: discontinued clinical development recorded in the profile.

Trials in postoperative ileus did not meet endpoints and development stopped. Physique claims have never been trialled.

Baseline entry: added as combination-therapy candidate with moderate confidence.

Additive weight reduction in combination trials is supported. Standalone long-term evidence remains limited.

Baseline entry: lifespan-extension claims recorded as unsupported.

Supporting literature is historical, narrow and largely unreplicated. Mechanistic telomerase findings do not establish human outcomes.

United States

FDA granted accelerated approval to Forzinity (elamipretide) for Barth syndrome in patients weighing at least 30 kg, on a surrogate endpoint with a confirmatory trial required. Does not cover anti-ageing or performance use.

United States

FDA approved Wegovy to reduce the risk of cardiovascular death, heart attack and stroke in adults with established cardiovascular disease and overweight or obesity.

United States

FDA granted accelerated approval to Wegovy for adults with noncirrhotic MASH with moderate-to-advanced liver fibrosis (F2-F3).

United States

FDA approved Zepbound as the first medication for obstructive sleep apnoea in adults with obesity.

China

NMPA approved mazdutide for chronic weight management. A regional approval; not approved in the US, UK or EU.

China

NMPA approved mazdutide for glycaemic control in adults with type 2 diabetes, its second Chinese indication.

United States

Approved for excess visceral abdominal fat in HIV-associated lipodystrophy only.

United States

Placed on the FDA 503A Category 2 list of bulk substances raising significant safety risks for compounding; not an approved medicine in any major region.

Global

Investigational only; advanced Phase 3 programme in obesity and metabolic disease.