Trevogrumab (REGN1033)
Trevogrumab (REGN1033) is a fully human anti-myostatin monoclonal antibody from Regeneron, evaluated for sarcopenia and later combined with an anti-activin antibody and GLP-1 agonists to preserve lean mass during weight loss. It selectively neutralises myostatin and has been explored as a muscle-sparing adjunct.
01 Overview
Trevogrumab binds myostatin with high selectivity, sparing closely related ligands such as GDF-11. Early work targeted age-related sarcopenia, where myostatin blockade increases muscle mass.
More recent interest centres on combining trevogrumab with the anti-activin A antibody garetosmab and with GLP-1-based weight-loss drugs, aiming to blunt the loss of lean mass that accompanies large reductions in body weight. This positions myostatin inhibition as a potential companion to incretin therapy rather than a standalone muscle drug.
02 Mechanism
A fully human IgG4 monoclonal antibody that selectively binds mature myostatin, preventing ActRIIB activation while largely sparing GDF-11 and activin.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Trial dosing | 100–600 mg | SubQ | Investigational fixed dosing, often monthly; not marketed. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Preservation of lean massInvestigated for maintaining muscle mass during GLP-1-driven weight loss, alone and with anti-activin antibody. | Under study | Clinical | |
| Increased muscle mass in sarcopeniaEarly sarcopenia studies showed increases in muscle volume. | Modest | Clinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Injection-site reactionsLocal reactions at subcutaneous sites. | Mild | Common | Clinical | |
| ImmunogenicityAnti-drug antibodies can develop against the therapeutic antibody. | Mild | Uncommon | Clinical |