WhatPeptide

Trevogrumab

A fully human IgG4 monoclonal antibody (KD = 24 pM) that selectively neutralizes myostatin without cross-reacting with GDF-11 or activin A. Developed by Regeneron; currently in active Phase 2 trials including COURAGE (NCT06299098) combining with semaglutide for muscle-preserving weight loss in obesity.

Moderate evidence Investigational Myostatin Inhibitor

Written by WhatPeptide Editorial Team · Last updated 2026-03-18

Currently in clinical trials — not yet approved for any indication.

Half-life

~2-4 weeks (IgG4 monoclonal antibody class PK)

Dosage range

Phase 1: 6 mg/kg SC or IV single dose; COURAGE trial: 200-400 mg SC every 2-4 weeks (with semaglutide 2.4 mg)

Administration

Subcutaneous injection

Research level

Moderate

How Trevogrumab works

Binds the mature myostatin homodimer, latent complex, and precursor forms, preventing myostatin from engaging ActRIIA/ActRIIB receptors and blocking Smad2/3 signaling. Unlike ACE-031, its selectivity for GDF-8 avoids BMP9/10 vascular safety signals. Combined blockade with garetosmab (anti-activin A) produces greater-than-additive muscle effects.

Also known as: REGN1033, REGN-1033, SAR391786

Research relevance

Muscle Growth
Moderate relevance 75
Recovery & Healing
Some relevance 30
Fat Loss
Some relevance 25
Anti-Aging & Longevity
Some relevance 20
Injury Rehab
Some relevance 20

Side effects & safety

Muscle spasms (COURAGE trial) Nausea/GI effects (compounded by semaglutide co-administration) Fatigue (≥5% of participants) Injection-site reactions Two deaths in triplet arm (patients with pre-existing CV disease; no causal association established)

Contraindications

Active cardiovascular disease (based on trial exclusion criteria)
Pregnancy

Consult a healthcare provider before use if any of these apply to you.

FAQ

What is Trevogrumab? +
A fully human IgG4 monoclonal antibody (KD = 24 pM) that selectively neutralizes myostatin without cross-reacting with GDF-11 or activin A. Developed by Regeneron; currently in active Phase 2 trials including COURAGE (NCT06299098) combining with semaglutide for muscle-preserving weight loss in obesity. Its mechanism of action is supported by moderate clinical and preclinical evidence.
What is Trevogrumab researched for? +
Trevogrumab has the strongest research relevance for Muscle Growth, Recovery & Healing, Fat Loss. Evidence is supported by moderate clinical and preclinical evidence.
What are the side effects of Trevogrumab? +
Reported side effects include Muscle spasms (COURAGE trial), Nausea/GI effects (compounded by semaglutide co-administration), Fatigue (≥5% of participants), Injection-site reactions, Two deaths in triplet arm (patients with pre-existing CV disease; no causal association established). Key contraindications: Active cardiovascular disease (based on trial exclusion criteria); Pregnancy.
Is Trevogrumab FDA approved? +
Trevogrumab is currently in clinical trials and is not yet approved by the FDA.
How is Trevogrumab administered? +
Trevogrumab is typically administered via subcutaneous route. Researched dosage range: Phase 1: 6 mg/kg SC or IV single dose; COURAGE trial: 200-400 mg SC every 2-4 weeks (with semaglutide 2.4 mg). Half-life: ~2-4 weeks (IgG4 monoclonal antibody class PK).

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