Emerging Muscle Growth-Promoting Agents: Mechanisms of Action, Therapeutic Potential, Misuse in Sport, and Associated Health Complications – A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.65.74151Keywords
skeletal muscle hypertrophy, selective androgen receptor modulators (SARMs), myostatin inhibitors, growth hormone secretagogues, ghrelin receptor agonists, follistatin-based therapy, adverse effectsAbstract
The development of novel muscle growth-promoting agents has significantly expanded the possibilities of pharmacological intervention in skeletal muscle disorders. Selective androgen receptor modulators (SARMs), myostatin and activin pathway inhibitors, growth hormone secretagogues, and follistatin-based therapies represent promising approaches for treating conditions associated with muscle loss, including sarcopenia, cachexia, and neuromuscular diseases. However, their increasing misuse for performance enhancement has raised important concerns regarding safety, regulation, and anti-doping control. This narrative review summarizes current knowledge regarding the mechanisms of action, therapeutic potential, adverse effects, and misuse of emerging anabolic agents. Although these compounds can promote increases in lean body mass, evidence demonstrating consistent improvements in muscle strength and physical performance remains limited. Furthermore, potential risks involving endocrine dysfunction, metabolic disturbances, cardiovascular complications, hepatotoxicity, and long-term safety remain insufficiently characterized. Continued research is required to determine their clinical value while preventing inappropriate use in sport.
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