| What is actually introduced | An analogue of the releasing hormone — not growth hormone itself | Recombinant human growth hormone itself | Two molecules: a GHRH analogue plus a ghrelin receptor agonist |
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| Site of action | The GHRH receptor in the anterior pituitary | Directly at peripheral GH receptors — the pituitary is bypassed | Two different pituitary receptors at once |
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| Pulsatile release | Preserved — the pituitary secretes its own hormone in pulses | Abolished — steady levels rather than physiological pulses | Preserved, with amplified pulse amplitude |
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| Negative feedback control | Remains intact — somatostatin and IGF-I still regulate output | Bypassed | Remains intact |
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| Regulatory status | FDA approval (2010) for one specific indication in patients with HIV | Approved medicine for growth hormone deficiency and other indications | No approval — research molecules |
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| Maturity of the evidence | Completed Phase III trials, 806 participants in the pooled analysis | Decades of clinical use and data | Limited published human data |
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| WADA status | Prohibited substance (S2) | Prohibited substance (S2) | Prohibited substances (S2) |
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