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Tesamorelin for Cognition in HIV-associated Neurocognitive Disorder — VialBase Research

Trial Summary

Phase 2 trial evaluating tesamorelin (a synthetic GHRH analogue) for cognitive improvement in HIV-positive adults with mild cognitive impairment. Tesamorelin is FDA-approved for HIV-associated lipodystrophy (reducing visceral fat) but has shown cognitive benefits in pilot studies, likely mediated through IGF-1-dependent neurotrophic effects and improvements in brain insulin signaling.

Design

  • Type: Randomized, double-blind, placebo-controlled
  • Population: HIV-positive adults on stable ART with mild cognitive impairment (HAND)
  • Arms: Tesamorelin 2 mg SC daily vs. placebo
  • Duration: 6-12 months
  • Key measures: Neuropsychological test battery (memory, executive function, processing speed), brain MRI (hippocampal volume, white matter integrity), IGF-1 levels, visceral fat, metabolic parameters

Key Outcomes

  • Study completed; results showed tesamorelin improved cognitive function vs. placebo
  • Specific improvements in executive function and processing speed domains
  • IGF-1 levels increased significantly with tesamorelin
  • Improvements in body composition (reduced visceral adiposity)
  • Brain MRI showed preservation of hippocampal and cortical volumes
  • Results published in academic journals supporting GHRH-IGF-1 axis as a therapeutic target for neurodegeneration

Significance for Peptide Research

This trial provides proof-of-concept that GHRH agonist peptides can improve cognitive function, likely through IGF-1-mediated neurotrophic effects. The results are relevant beyond HIV, potentially informing GHRH-based approaches to age-related cognitive decline and early neurodegeneration. Tesamorelin’s dual benefit (metabolic + cognitive) makes it a compelling multi-target peptide therapeutic. The cognitive findings connect to the broader growth hormone axis and brain health evidence base.

See Also