Independent · non-commercial · publishes on a quarterly cycle|Current cycle 2026 Q3
Compound Evidence InstituteEvidence synthesis · established 2023Graded assessments of compounds, trials, methods and supply
Document set current to 30 July 2026
Compound monograph · evidence extract

Melanotan-II in obesity and overweight in adults — evidence extract

The Institute's graded assessment of Melanotan-II for obesity and overweight in adults, with the contributing trials and the domain-by-domain certainty reasoning.

Document identifier
CEI-MN-049/EV-OBESITY
Series
Evidence extract
Version
3.3
Published
02 Sep 2023
Last reviewed
02 Dec 2024
Next review
02 Dec 2026
Identifier
10.71829/cei.mono.49
Certainty
Very low
Cycle
2023 Q3

§1Evidence extract: Obesity and overweight in adults

§1.1Question and anchor outcome

Population
Excess adiposity sufficient to impair health, operationalised in the pivotal incretin programmes as a body-mass index of 30 kg/m² or above, or 27 kg/m² or above with at least one weight-related comorbidity.
Intervention
Melanotan-II, subcutaneous in unregulated use
Comparator
As used in each contributing trial; reported per trial rather than pooled across comparator types
Anchor outcome
Percentage change in body weight from baseline

Additional outcomes the Institute extracts for this indication: Proportion achieving ≥5 %, ≥10 %, ≥15 % and ≥20 % weight reduction; Change in waist circumference; Change in systolic blood pressure; Change in high-sensitivity C-reactive protein.

§1.2Contributing trials

No trial has been identified for Melanotan-II in obesity and overweight in adults. The rating below reflects that absence.

§1.3Certainty assessment

Certainty assessment by domainDowngrading decision recorded for each certainty domain.Certainty domainNo concernSeriousVery seriousEffect on ratingRisk of biasdowngrade one levelInconsistencydowngrade one levelIndirectnessno downgradeImprecisiondowngrade one levelPublication biasno downgradeTotal downgrading: 3 levelsVery low certainty
Figure 2. Domain-by-domain certainty assessment for Melanotan-II in obesity and overweight in adults. The starting rating for a body of randomised evidence is high; each serious concern reduces it by one level and each very serious concern by two.

Table 2. Reasoning recorded against each certainty domain.

DomainRatingReasoning
Risk of biasSeriousThe primary endpoint is patient-reported in a setting where blinding cannot be maintained.
InconsistencySeriousEstimates vary in magnitude across contributing trials beyond what chance would produce.
IndirectnessNo concernNo serious concern identified in this domain.
ImprecisionSeriousThe confidence interval spans values that would support different decisions.
Publication biasNo concernNo serious concern identified in this domain.
Overall rating: Very low certainty. The Institute has very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate. In this series a very low rating most often reflects an absence of controlled human evidence rather than conflicting evidence.

§1.4What this extract does not establish

References cited on this page

References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.

  1. Clayton AH, Althof SE, Kingsberg S, DeRogatis LR, Kroll R, Goldstein I, Kaminetsky J, Spana C, Lucas J, Jordan R, Portman DJ. Bremelanotide for female sexual dysfunctions in premenopausal women: a randomized, placebo-controlled dose-finding trial. Women’s Health 2016;12(3):325–337. doi:10.2217/whe-2016-0018 · PMID 27638896
  2. Carvalho M, Dinis-Oliveira RJ. Analytical and forensic aspects of counterfeit peptide hormones. Drug Testing and Analysis 2023;15(1):5–19. doi:10.1002/dta.3379
  3. Medicines and Healthcare products Regulatory Agency. Falsified Ozempic (semaglutide) pens: patient safety alert. MHRA Safety Alert 2023;Alert reference NatPSA/2023/012/MHRA. identifier not held by the Institute

Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.

Nothing published by the Institute is medical advice, a diagnosis, a prescription, a treatment recommendation or a purchasing recommendation. Compounds supplied for research use are not approved for human or veterinary use in any jurisdiction, and a favourable analytical assessment of a supplier is not a statement that any product is safe or effective. The Institute publishes certainty ratings and never recommendations. No telephone number, messaging handle or ordering channel appears anywhere on this site.