{
  "title": "Peptide Pain Evidence Index",
  "publisher": "Peptide Pain Management",
  "canonical_url": "https://peptidepain.com/evidence-index/",
  "last_reviewed": "2026-08-11",
  "scope": "Human evidence and United States regulatory status for peptide-related approaches marketed or studied for pain.",
  "limitations": "This dataset is an editorial evidence map, not a treatment recommendation, systematic review, or complete registry of peptide studies.",
  "records": [
    {
      "intervention": "Ziconotide",
      "condition": "Severe chronic pain",
      "human_evidence": "Controlled trials and FDA-reviewed use",
      "evidence_grade": "established",
      "us_regulatory_status": "FDA-approved for selected patients requiring intrathecal therapy",
      "central_limitation": "Specialist intrathecal treatment with serious neuropsychiatric risks",
      "primary_source": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/021060s012lbl.pdf"
    },
    {
      "intervention": "Semaglutide",
      "condition": "Knee osteoarthritis in adults with obesity",
      "human_evidence": "68-week randomized placebo-controlled trial; 407 participants",
      "evidence_grade": "strong_for_studied_population",
      "us_regulatory_status": "FDA-approved for other indications; not specifically approved for arthritis pain",
      "central_limitation": "Does not establish cartilage repair or benefit outside the studied population",
      "primary_source": "https://pubmed.ncbi.nlm.nih.gov/39476339/"
    },
    {
      "intervention": "Collagen peptides",
      "condition": "Knee osteoarthritis",
      "human_evidence": "Multiple randomized trials and meta-analyses",
      "evidence_grade": "moderate_heterogeneous",
      "us_regulatory_status": "Dietary supplement; not an FDA-approved pain drug",
      "central_limitation": "Products and trials vary; several studies have meaningful risk of bias",
      "primary_source": "https://pubmed.ncbi.nlm.nih.gov/39212129/"
    },
    {
      "intervention": "Cibinetide / ARA-290",
      "condition": "Small-fiber neuropathy",
      "human_evidence": "Small early randomized trials",
      "evidence_grade": "early_limited",
      "us_regulatory_status": "Investigational; not FDA-approved",
      "central_limitation": "Narrow populations; small and short studies; pain benefit not established",
      "primary_source": "https://pubmed.ncbi.nlm.nih.gov/28475703/"
    },
    {
      "intervention": "BPC-157",
      "condition": "Pain and injury-recovery claims",
      "human_evidence": "Very limited human evidence; one registered randomized injury trial without posted results",
      "evidence_grade": "insufficient",
      "us_regulatory_status": "Not FDA-approved",
      "central_limitation": "Animal research and uncontrolled reports cannot establish human benefit or safety",
      "primary_source": "https://www.fda.gov/media/193343/download"
    },
    {
      "intervention": "TB-500",
      "condition": "Healing and tissue-repair claims",
      "human_evidence": "FDA found no human administration studies in the medical literature",
      "evidence_grade": "no_established_human_evidence",
      "us_regulatory_status": "Not FDA-approved",
      "central_limitation": "Human effectiveness and safety are unknown; TB-500 is not full thymosin beta-4",
      "primary_source": "https://www.fda.gov/media/193349/download"
    }
  ]
}