Clinical Trials Pipeline & In-Development

Relamorelin

also known as: RM-131, BIM-28131

Motus Therapeutics' (formerly Rhythm, then Allergan) ghrelin agonist pentapeptide — Phase 2b results in diabetic gastroparesis were positive, Phase 3 development paused following Allergan's divestiture; status ambiguous as of 2026.

A synthetic pentapeptide ghrelin receptor (GHS-R1a) agonist with accentuated prokinetic activity, developed primarily for diabetic gastroparesis. Phase 2b trials in diabetic gastroparesis showed meaningful reductions in core symptoms (vomiting, nausea, abdominal pain, bloating, early satiety) and improvements in gastric emptying. Development was licensed from Ipsen to Rhythm Pharmaceuticals (which later spun out the metabolic program as Motus Therapeutics), then acquired by Allergan. Following Allergan's 2020 acquisition by AbbVie, Phase 3 development appeared to stall; status ambiguous as of 2026.

Mechanism of action

Agonism at the ghrelin receptor (GHS-R1a), with an in-vivo profile biased toward gastrointestinal prokinetic effects (accelerated gastric emptying via vagal afferent signaling and enteric neural pathways) rather than toward pituitary GH release. Clinical effects in gastroparesis appear mediated principally through this motility action.

Primary uses

Diabetic gastroparesis (investigational)
Chronic idiopathic constipation (investigational)

Typical dosing

10–100 mcg twice daily twice daily (Phase 2 protocol) (subcutaneous)

Investigational dosing only.

Regulatory status

Not approved. Phase 2b completed in diabetic gastroparesis (positive outcome 2017). Development program transferred Ipsen → Rhythm → Motus → Allergan → AbbVie; Phase 3 plans announced 2018 but program status since the 2020 AbbVie acquisition has not been publicly clarified.

References

[pubmed] Camilleri M, et al. "Efficacy and Safety of Relamorelin in Diabetics With Symptoms of Gastroparesis: A Randomized, Placebo-Controlled Study." Gastroenterology, 2017;153:1240-1250.
[manufacturer] Allergan. 2018 investor communications regarding relamorelin gastroparesis Phase 3 plans.

Related peptides

Anamorelin

Ono Pharmaceutical's oral ghrelin receptor agonist (Adlumiz) — approved in Japan in 2021 for cancer cachexia in non-small-cell lung, gastric, pancreatic, and colorectal cancers; FDA issued a Complete Response Letter in 2020 and anamorelin remains unapproved in the US.

MK-677

An orally active non-peptide ghrelin receptor agonist — included here by convention because it is universally marketed alongside peptide GH secretagogues. FDA warns of heart failure risk.

GHRP-2

A second-generation GHRP approved as a diagnostic agent in Japan, with more pronounced GH-releasing potency than GHRP-6 but a meaningful prolactin and cortisol rise at higher doses.

Disclaimer

This entry is for educational purposes only and does not constitute medical advice. Dosing information reflects published regulatory or research data and is not a recommendation. Many compounds described here are not approved for human use in the United States. Consult a licensed medical professional before considering any peptide therapy.