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While not first-line therapies, both drug classes show promise as adjuncts in high-risk populations

JAMA Cardiology 2026, 11: 156-164

Pigmentation effects accumulate over days to weeks of repeated administration, because melanogenesis is a slow process dependent on melanocyte turnover (4-6 weeks for a complete epidermal cycle)

This antioxidant activity is believed to be mediated through the Nrf2 signaling pathway, which enhances the expression of protective proteins such as heme oxygenase-1 (HO-1), glutathione (GSH), and paraoxonase-1 (PON1)

Oral precursors like NMN and NR are common

The tesamorelin evidence base is stronger than most peptides because of its FDA approval pathway