Skip to content

Study · Randomized controlled trial · n = 18 · 2019

22 results

Glepaglutide, a novel long-acting glucagon-like peptide-2 analogue, for patients with short bowel syndrome: a randomised phase 2 trial.

Naimi RM, Hvistendahl M, Enevoldsen LH, Madsen JL, Fuglsang S, Poulsen SS, Kissow H, Pedersen J, Nerup N, Ambrus R, Achiam MP, Svendsen LB and 8 more

Show all authors

Holst JJ, Hartmann B, Hansen SH, Dragsted LO, Steensberg A, Mouritzen U, Hansen MB, Jeppesen PB

The lancet. Gastroenterology & hepatology15 Mar 2019Cited by 60 (Europe PMC)

Summary

The text of this summary is not shown here, because the article license does not allow reuse. Read it at the source (opens in a new tab)

Text rights: Publisher copyright. Results still quote short attributed sentences.

Results from this study22

22 results from studies that gave the peptide. 22 results from people.

  1. 01HumanRandomized controlled trialEfficacy outcome

    In adults with short bowel syndrome, glepaglutide reduced adjusted mean faecal output by 592 g/day from baseline (p=0·002).

    In plain wordsIn adults with short bowel syndrome, glepaglutide reduced faecal output from baseline.

    Outcome
    DecreaseFaecal wet weight output
    Study

    n: not reported in source

    Comparator
    Baseline
    Analysis
    Primary
    Outcome group
    Intestinal growth and absorption · Gastrointestinal
    Studied dose
    1 mg daily · subcutaneous · 3 weeksAs given in this study (human).

    Measurements

    Change in faecal wet weight output
    −592 g/day
    1 mg glepaglutide, adjusted mean change from baseline

    Source sentences

    Summary
    Treatment with 1 mg and 10 mg glepaglutide changed the adjusted mean faecal output by -592 g/day (95% CI -913 to -272; p=0·002) and -833 g/day (-1152 to -515; p=0·0002) from baseline, respectively.
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  2. 02HumanRandomized controlled trialEfficacy outcome

    In adults with short bowel syndrome, glepaglutide reduced adjusted mean faecal output by 833 g/day from baseline (p=0·0002).

    In plain wordsIn adults with short bowel syndrome, glepaglutide reduced faecal output from baseline.

    Outcome
    DecreaseFaecal wet weight output
    Study

    n: not reported in source

    Comparator
    Baseline
    Analysis
    Primary
    Outcome group
    Intestinal growth and absorption · Gastrointestinal
    Studied dose
    10 mg daily · subcutaneous · 3 weeksAs given in this study (human).

    Measurements

    Change in faecal wet weight output
    −833 g/day
    10 mg glepaglutide, adjusted mean change from baseline

    Source sentences

    Summary
    Treatment with 1 mg and 10 mg glepaglutide changed the adjusted mean faecal output by -592 g/day (95% CI -913 to -272; p=0·002) and -833 g/day (-1152 to -515; p=0·0002) from baseline, respectively.
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  3. 03HumanRandomized controlled trialEfficacy outcome

    In adults with short bowel syndrome, faecal output did not change from baseline with 0·1 mg glepaglutide.

    In plain wordsIn adults with short bowel syndrome, faecal output did not change from baseline with 0·1 mg glepaglutide.

    Outcome
    No significant changeFaecal wet weight output
    Study

    n: not reported in source

    Comparator
    Baseline
    Analysis
    Primary
    Outcome group
    Intestinal growth and absorption · Gastrointestinal
    Studied dose
    0·1 mg daily · subcutaneous · 3 weeksAs given in this study (human).

    Source sentences

    Summary
    No changes were observed with 0·1 mg glepaglutide.
    2 context sentences
    Summary · context
    Treatment with 1 mg and 10 mg glepaglutide changed the adjusted mean faecal output by -592 g/day (95% CI -913 to -272; p=0·002) and -833 g/day (-1152 to -515; p=0·0002) from baseline, respectively.
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  4. 04HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, treatment-related stoma complications occurred in 13 patients (72%) receiving glepaglutide.

    In plain wordsIn adults with short bowel syndrome, treatment-related stoma complications occurred in 72% of patients receiving glepaglutide.

    Outcome
    Not applicableStoma complications
    Study

    n = 18

    Outcome group
    Adverse events · Gastrointestinal
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Measurements

    Patients with treatment-related stoma complications
    13 patients
    all randomized patients (n=18)
    Proportion with treatment-related stoma complications
    72%
    all randomized patients (n=18)

    Source sentences

    Summary
    Of the 18 patients who were randomly assigned to treatment, common treatment-related adverse events were stoma complications (13 [72%] patients),
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  5. 05HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, treatment-related injection site reactions occurred in 11 patients (61%) receiving glepaglutide.

    In plain wordsIn adults with short bowel syndrome, treatment-related injection site reactions occurred in 61% of patients receiving glepaglutide.

    Outcome
    Not applicableInjection site reactions
    Study

    n = 18

    Outcome group
    Adverse events · Skin and wound
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Measurements

    Patients with treatment-related injection site reactions
    11 patients
    all randomized patients (n=18)
    Proportion with treatment-related injection site reactions
    61%
    all randomized patients (n=18)

    Source sentences

    Summary
    Of the 18 patients who were randomly assigned to treatment, common treatment-related adverse events were stoma complications (13 [72%] patients), injection site reactions (11 [61%]),
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  6. 06HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, treatment-related peripheral oedema occurred in ten patients (56%) receiving glepaglutide.

    In plain wordsIn adults with short bowel syndrome, treatment-related peripheral oedema occurred in 56% of patients receiving glepaglutide.

    Outcome
    Not applicablePeripheral oedema
    Study

    n = 18

    Outcome group
    Adverse events · Whole body
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Measurements

    Patients with treatment-related peripheral oedema
    10 patients
    all randomized patients (n=18)
    Proportion with treatment-related peripheral oedema
    56%
    all randomized patients (n=18)

    Source sentences

    Summary
    Of the 18 patients who were randomly assigned to treatment, common treatment-related adverse events were stoma complications (13 [72%] patients), injection site reactions (11 [61%]), peripheral oedema (ten [56%]),
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  7. 07HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, treatment-related nausea occurred in eight patients (44%) receiving glepaglutide.

    In plain wordsIn adults with short bowel syndrome, treatment-related nausea occurred in 44% of patients receiving glepaglutide.

    Outcome
    Not applicableNausea
    Study

    n = 18

    Outcome group
    Gastrointestinal adverse events · Gastrointestinal
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Measurements

    Patients with treatment-related nausea
    8 patients
    treatment-related, adults with short bowel syndrome (n=18)
    Proportion of patients with treatment-related nausea
    44%
    treatment-related, adults with short bowel syndrome (n=18)

    Source sentences

    Summary
    nausea and abdominal pain (eight [44%] each),
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  8. 08HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, treatment-related abdominal pain occurred in eight patients (44%) receiving glepaglutide.

    In plain wordsIn adults with short bowel syndrome, treatment-related abdominal pain occurred in 44% of patients receiving glepaglutide.

    Outcome
    Not applicableAbdominal pain
    Study

    n = 18

    Outcome group
    Gastrointestinal adverse events · Gastrointestinal
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Measurements

    Patients with treatment-related abdominal pain
    8 patients
    treatment-related, adults with short bowel syndrome (n=18)
    Proportion of patients with treatment-related abdominal pain
    44%
    treatment-related, adults with short bowel syndrome (n=18)

    Source sentences

    Summary
    nausea and abdominal pain (eight [44%] each),
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  9. 09HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, treatment-related polyuria occurred in six patients (33%) receiving glepaglutide.

    In plain wordsIn adults with short bowel syndrome, treatment-related polyuria occurred in 33% of patients receiving glepaglutide.

    Outcome
    Not applicablePolyuria
    Study

    n = 18

    Outcome group
    Adverse events · Kidney and urinary
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Measurements

    Patients with treatment-related polyuria
    6 patients
    treatment-related, adults with short bowel syndrome (n=18)
    Proportion of patients with treatment-related polyuria
    33%
    treatment-related, adults with short bowel syndrome (n=18)

    Source sentences

    Summary
    polyuria and fatigue (six [33%] each),
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  10. 10HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, treatment-related fatigue occurred in six patients (33%) receiving glepaglutide.

    In plain wordsIn adults with short bowel syndrome, treatment-related fatigue occurred in 33% of patients receiving glepaglutide.

    Outcome
    Not applicableFatigue
    Study

    n = 18

    Outcome group
    Adverse events · Whole body
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Measurements

    Patients with treatment-related fatigue
    6 patients
    treatment-related, adults with short bowel syndrome (n=18)
    Proportion of patients with treatment-related fatigue
    33%
    treatment-related, adults with short bowel syndrome (n=18)

    Source sentences

    Summary
    polyuria and fatigue (six [33%] each),
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  11. 11HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, treatment-related abdominal distention occurred in five patients (28%) receiving glepaglutide.

    In plain wordsIn adults with short bowel syndrome, treatment-related abdominal distention occurred in 28% of patients receiving glepaglutide.

    Outcome
    Not applicableAbdominal distention
    Study

    n = 18

    Outcome group
    Gastrointestinal adverse events · Gastrointestinal
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Measurements

    Patients with treatment-related abdominal distention
    5 patients
    treatment-related, adults with short bowel syndrome (n=18)
    Proportion of patients with treatment-related abdominal distention
    28%
    treatment-related, adults with short bowel syndrome (n=18)

    Source sentences

    Summary
    abdominal distention, vomiting, and dizziness (five [28%] each);
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  12. 12HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, treatment-related vomiting occurred in five patients (28%) receiving glepaglutide.

    In plain wordsIn adults with short bowel syndrome, treatment-related vomiting occurred in 28% of patients receiving glepaglutide.

    Outcome
    Not applicableVomiting
    Study

    n = 18

    Outcome group
    Gastrointestinal adverse events · Gastrointestinal
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Measurements

    Patients with treatment-related vomiting
    5 patients
    treatment-related, adults with short bowel syndrome (n=18)
    Proportion of patients with treatment-related vomiting
    28%
    treatment-related, adults with short bowel syndrome (n=18)

    Source sentences

    Summary
    abdominal distention, vomiting, and dizziness (five [28%] each);
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  13. 13HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, treatment-related dizziness occurred in five patients (28%) receiving glepaglutide.

    In plain wordsIn adults with short bowel syndrome, treatment-related dizziness occurred in 28% of patients receiving glepaglutide.

    Outcome
    Not applicableDizziness
    Study

    n = 18

    Outcome group
    Adverse events · Nervous system and cognition
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Measurements

    Patients with treatment-related dizziness
    5 patients
    treatment-related, adults with short bowel syndrome (n=18)
    Proportion of patients with treatment-related dizziness
    28%
    treatment-related, adults with short bowel syndrome (n=18)

    Source sentences

    Summary
    abdominal distention, vomiting, and dizziness (five [28%] each);
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  14. 14HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, treatment-related cough occurred in four patients (22%) receiving glepaglutide.

    In plain wordsIn adults with short bowel syndrome, treatment-related cough occurred in 22% of patients receiving glepaglutide.

    Outcome
    Not applicableCough
    Study

    n = 18

    Outcome group
    Adverse events · Respiratory
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Measurements

    Patients with treatment-related cough
    4 patients
    treatment-related, adults with short bowel syndrome (n=18)
    Proportion of patients with treatment-related cough
    22%
    treatment-related, adults with short bowel syndrome (n=18)

    Source sentences

    Summary
    cough and decreased appetite (four [22%] each).
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  15. 15HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, treatment-related decreased appetite occurred in four patients (22%) receiving glepaglutide.

    In plain wordsIn adults with short bowel syndrome, treatment-related decreased appetite occurred in 22% of patients receiving glepaglutide.

    Outcome
    Not applicableDecreased appetite
    Study

    n = 18

    Outcome group
    Appetite and food intake · Metabolic and weight
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Measurements

    Patients with treatment-related decreased appetite
    4 patients
    treatment-related, adults with short bowel syndrome (n=18)
    Proportion of patients with treatment-related decreased appetite
    22%
    treatment-related, adults with short bowel syndrome (n=18)

    Source sentences

    Summary
    cough and decreased appetite (four [22%] each).
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  16. 16HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome receiving glepaglutide, no patients died during the trial.

    In plain wordsIn adults with short bowel syndrome receiving glepaglutide, no patients died during the trial.

    Outcome
    Not applicableDeaths
    Study

    n = 18

    Outcome group
    Mortality · Whole body
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Source sentences

    Summary
    No patients died during the trial.
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  17. 17HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, related or possibly related serious adverse events occurred in two patients receiving 0·1 mg glepaglutide.

    In plain wordsIn adults with short bowel syndrome, two patients receiving 0·1 mg glepaglutide experienced related or possibly related serious adverse events.

    Outcome
    Not applicableRelated or possibly related serious adverse events
    Study

    n: not reported in source

    Outcome group
    Adverse events · Whole body
    Studied dose
    0·1 mg daily · subcutaneous · 3 weeksAs given in this study (human).

    Measurements

    Patients with related or possibly related serious adverse events
    2 patients
    glepaglutide 0·1 mg dose group

    Source sentences

    Summary
    Related or possibly related serious adverse events were reported in two patients in the 0·1 mg dose group and two patients in the 10 mg dose group.
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  18. 18HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome, related or possibly related serious adverse events occurred in two patients receiving 10 mg glepaglutide.

    In plain wordsIn adults with short bowel syndrome, two patients receiving 10 mg glepaglutide experienced related or possibly related serious adverse events.

    Outcome
    Not applicableRelated or possibly related serious adverse events
    Study

    n: not reported in source

    Outcome group
    Adverse events · Whole body
    Studied dose
    10 mg daily · subcutaneous · 3 weeksAs given in this study (human).

    Measurements

    Patients with related or possibly related serious adverse events
    2 patients
    glepaglutide 10 mg dose group

    Source sentences

    Summary
    Related or possibly related serious adverse events were reported in two patients in the 0·1 mg dose group and two patients in the 10 mg dose group.
    1 context sentence
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  19. 19HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome receiving glepaglutide, related or possibly related serious adverse events included abdominal pain.

    In plain wordsIn adults with short bowel syndrome receiving glepaglutide, related or possibly related serious adverse events included abdominal pain.

    Outcome
    Not applicableSerious abdominal pain
    Study

    n: not reported in source

    Outcome group
    Gastrointestinal adverse events · Gastrointestinal
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Source sentences

    Summary
    These events included abdominal pain, stoma obstruction, catheter-related sepsis, and infection of unknown origin.
    2 context sentences
    Summary · context
    Related or possibly related serious adverse events were reported in two patients in the 0·1 mg dose group and two patients in the 10 mg dose group.
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  20. 20HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome receiving glepaglutide, related or possibly related serious adverse events included stoma obstruction.

    In plain wordsIn adults with short bowel syndrome receiving glepaglutide, related or possibly related serious adverse events included stoma obstruction.

    Outcome
    Not applicableSerious stoma obstruction
    Study

    n: not reported in source

    Outcome group
    Gastrointestinal adverse events · Gastrointestinal
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Source sentences

    Summary
    These events included abdominal pain, stoma obstruction, catheter-related sepsis, and infection of unknown origin.
    2 context sentences
    Summary · context
    Related or possibly related serious adverse events were reported in two patients in the 0·1 mg dose group and two patients in the 10 mg dose group.
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  21. 21HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome receiving glepaglutide, related or possibly related serious adverse events included catheter-related sepsis.

    In plain wordsIn adults with short bowel syndrome receiving glepaglutide, related or possibly related serious adverse events included catheter-related sepsis.

    Outcome
    Not applicableSerious catheter-related sepsis
    Study

    n: not reported in source

    Outcome group
    Adverse events · Infection
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Source sentences

    Summary
    These events included abdominal pain, stoma obstruction, catheter-related sepsis, and infection of unknown origin.
    2 context sentences
    Summary · context
    Related or possibly related serious adverse events were reported in two patients in the 0·1 mg dose group and two patients in the 10 mg dose group.
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.
  22. 22HumanRandomized controlled trialSafety outcome

    In adults with short bowel syndrome receiving glepaglutide, related or possibly related serious adverse events included infection of unknown origin.

    In plain wordsIn adults with short bowel syndrome receiving glepaglutide, related or possibly related serious adverse events included infection of unknown origin.

    Outcome
    Not applicableSerious infection of unknown origin
    Study

    n: not reported in source

    Outcome group
    Adverse events · Infection
    Studied dose
    Dose not stated · subcutaneousAs given in this study (human).

    Source sentences

    Summary
    These events included abdominal pain, stoma obstruction, catheter-related sepsis, and infection of unknown origin.
    2 context sentences
    Summary · context
    Related or possibly related serious adverse events were reported in two patients in the 0·1 mg dose group and two patients in the 10 mg dose group.
    Summary · context
    Patients received daily subcutaneous injections of the first assigned dose of glepaglutide for 3 weeks, followed by a washout period of 4-8 weeks, and then the second dose of glepaglutide for 3 weeks.

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Registered trials1

Trials this study reports on, or that list this study as a reference. Registry data from ClinicalTrials.gov.

1 trial · 1 completed · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 2NCT02690025

A Phase 2 Trial Testing ZP1848 in Patients With SBS

Zealand Pharman = 18Feb 2016 to May 2017

Short Bowel Syndrome

Trial pageClinicalTrials.govUpdated 21 Jun 2017

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

  1. Version 2Current

    27 Oct 2026, 18:20 UTC

    Study results updated

  2. Version 1

    27 Oct 2026, 16:32 UTC

    First added · source update from Europe PMC

Subjects

Terms as the source lists them.

PepBank is a research reference. Talk to a doctor before you use any peptide.