Compound monographs
The Institute publishes a monograph for each of the 51 compounds in its assessment set. Each is one document in eight numbered parts with a per-indication evidence extract for every indication assessed.
A monograph states what is known about a compound, how confident the Institute is in each claim, and what has not been established. It is not a product description and contains no recommendation.
Every monograph is versioned and dated, carries a next-review date, and records the assessment cycle in which its current version was ratified. Where a monograph extrapolates or illustrates rather than reports, it says so at the point where it does it.
Monographs
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NNMT methylates nicotinamide, diverting it from NAD+ salvage and generating 1-methylnicotinamide. Inhibiting NNMT is proposed to raise cellular NAD+ and to reduce adipocyte lipogenesis. In diet-induced obese mice, 5-amino-1MQ…
Very low07 Dec 2025 -
A single peptide engineered to activate both the amylin and GLP-1 receptor systems, combining two complementary satiation mechanisms without the pharmaceutical complexity of a fixed-ratio co-formulation.
Low11 Aug 2024 -
The proposed mechanism is stimulation of lipolysis and inhibition of lipogenesis in adipose tissue without the growth-hormone-receptor-mediated effects on IGF-1, glucose tolerance or tissue growth. The Institute notes that no…
Very low17 Sep 2025 -
The proposed mechanism is angiogenic and cytoprotective action through VEGF receptor 2 transactivation and nitric-oxide-pathway modulation, described extensively in rodent models of gastrointestinal, tendon, muscle, nerve and…
Very low11 May 2024 -
Amylin is co-secreted with insulin and acts at the area postrema to promote meal-related satiation, and separately reduces gastric emptying and glucagon secretion. Cagrilintide reproduces this signalling with a pharmacokinetic…
Moderate06 Feb 2025 -
The combination pairs two complementary satiation mechanisms: GLP-1 receptor agonism acting on hypothalamic and hindbrain appetite circuits, and amylin receptor agonism acting principally at the area postrema to promote meal…
Moderate24 Feb 2025 -
Both variants are GHRH receptor agonists that increase pulsatile growth-hormone secretion and, downstream, IGF-1. The DAC variant achieves sustained exposure by covalently bonding to albumin in vivo, producing a continuous rather…
Low14 Jul 2024 -
Small-molecule GLP-1 receptor agonism with a short half-life requiring twice-daily administration. The Institute includes this monograph specifically because a discontinued programme is evidence, and because the reasons for…
Low20 Jul 2026 -
DSIP was isolated on the hypothesis that it mediated sleep induction. Subsequent work has not established a receptor, a consistent pharmacological effect, or a physiological role, and the somnogenic activity that gave the peptide…
Very low24 May 2026 -
Receptor pharmacology is that of the selective GLP-1 class, delivered from a large fusion protein. Because the molecule is above the renal filtration threshold, clearance is not renal, and the pharmacokinetics are governed by…
High23 Sep 2025 -
Selective GLP-1 receptor agonism with a reported bias towards Gαs-coupled cyclic-AMP signalling. Whether signalling bias translates into a clinically distinguishable profile in humans is unresolved, and the Institute regards this…
Low27 Jun 2025 -
Epithalon is supplied on the premise that it activates telomerase and thereby extends replicative lifespan, on the basis of cell-culture reports of telomerase induction in human somatic cells. The Institute notes that telomerase…
Very low26 Jan 2025 -
Exenatide is a naturally DPP-4-resistant GLP-1 receptor agonist. The immediate-release presentation gives short, high peaks that produce a pronounced effect on gastric emptying and postprandial glucose but a modest effect on…
High17 Apr 2026 -
GHK is a naturally occurring tripeptide present in plasma at concentrations that decline with age. Complexed with copper it acts as a physiological copper carrier and, in cultured human fibroblasts, alters expression of a broad…
Low08 Jan 2026 -
Ghrelin receptor agonism producing growth-hormone release. Its approved use is a single-dose provocative diagnostic test, for which the acute pharmacodynamic effect is the entire basis of the indication and questions of chronic…
Low17 Apr 2024 -
Ghrelin receptor agonism with pronounced growth-hormone release, marked appetite stimulation, and concomitant elevation of cortisol and prolactin. Its historical importance is substantial — it was the pharmacological tool that…
Very low21 Sep 2025 -
CEI-MN-046Mitochondrial and metabolic cofactorsUnapproved, research supply3 assessed outcomesversion 1.3
Glutathione is the dominant intracellular low-molecular-weight thiol and the cofactor of the glutathione peroxidase and S-transferase systems. Administered glutathione is largely degraded extracellularly by gamma-glutamyl…
Low06 May 2026 -
Gonadorelin stimulates pituitary release of luteinising hormone and follicle-stimulating hormone. Its pharmacology is dominated by a pattern dependence that is unusual and clinically decisive: pulsatile administration stimulates…
Moderate18 Jan 2024 -
Hexarelin is a potent ghrelin receptor agonist producing marked growth-hormone release. Unlike ipamorelin it also stimulates adrenocorticotropin, cortisol and prolactin, which the Institute regards as a material disadvantage…
Very low10 Mar 2024 -
IGF-1 receptor agonism with greatly reduced binding-protein sequestration. The consequence is a sustained, unbuffered IGF-1 receptor signal. Because the IGF-binding proteins normally constrain free IGF-1 to a small fraction of…
Very low18 Jun 2024
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