---
title: "Apitegromab | PepTracker Pro"
description: "Apitegromab (SRK-015) is an investigational, fully human IgG4 monoclonal antibody developed by Scholar Rock that inhibits myostatin - the muscle-produced growth factor that limits skeletal-muscle mass - through a novel, muscle-selective mechanism. Rather than neutralizing mature, active myostatin (the approach of earlier failed inhibitors), apitegromab binds only the inactive precursor forms of the protein - promyostatin and latent myostatin - stored locally in muscle, and blocks their proteolytic conversion into the active ligand. Because it spares the closely related growth factors activin A, BMP9/10, and TGF-beta1, it aims to avoid the off-target effects (such as bleeding and vascular changes) that sank broad ActRII-pathway drugs. Apitegromab is the first muscle-targeted therapy to succeed in a pivotal Phase 3 trial in spinal muscular atrophy (SMA): in the 156-patient SAPPHIRE study of nonambulatory Type 2/3 patients aged 2-12 already on an SMN-directed therapy (nusinersen or risdiplam), adding apitegromab (10 or 20 mg/kg IV every 4 weeks) improved motor function by a pooled 1.8 points on the Hammersmith Functional Motor Scale Expanded (HFMSE) versus placebo at 12 months (p=0.019). Scholar Rock's initial Biologics License Application received an FDA Complete Response Letter in September 2025 tied solely to a third-party (Catalent Indiana) fill-finish manufacturing inspection - not to the drug's efficacy or safety - and the company resubmitted the BLA on March 31, 2026, with a PDUFA target action date of September 30, 2026. In parallel, apitegromab produced positive Phase 2 obesity data (EMBRAZE): added to tirzepatide over 24 weeks it preserved about 55% more lean mass (roughly 1.9 kg / 4.2 lb) than tirzepatide alone, positioning myostatin inhibition as a potential lean-mass-sparing partner for GLP-1-based weight loss."
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            "text": "Apitegromab is a research peptide studied in preclinical models. Apitegromab (SRK-015) is an investigational, fully human IgG4 monoclonal antibody developed by Scholar Rock that inhibits myostatin - the muscle-produced growth factor that limits skeletal-muscle mass - through a novel, muscle-selective mechanism. Rather than neutralizing mature, active myostatin (the approach of earlier failed inhibitors), apitegromab binds only the inactive precursor forms of the protein - promyostatin and latent myostatin - stored locally in muscle, and blocks their proteolytic conversion into the active ligand. Because it spares the closely related growth factors activin A, BMP9/10, and TGF-beta1, it aims to avoid the off-target effects (such as bleeding and vascular changes) that sank broad ActRII-pathway drugs. Apitegromab is the first muscle-targeted therapy to succeed in a pivotal Phase 3 trial in spinal muscular atrophy (SMA): in the 156-patient SAPPHIRE study of nonambulatory Type 2/3 patients aged 2-12 already on an SMN-directed therapy (nusinersen or risdiplam), adding apitegromab (10 or 20 mg/kg IV every 4 weeks) improved motor function by a pooled 1.8 points on the Hammersmith Functional Motor Scale Expanded (HFMSE) versus placebo at 12 months (p=0.019). Scholar Rock's initial Biologics License Application received an FDA Complete Response Letter in September 2025 tied solely to a third-party (Catalent Indiana) fill-finish manufacturing inspection - not to the drug's efficacy or safety - and the company resubmitted the BLA on March 31, 2026, with a PDUFA target action date of September 30, 2026. In parallel, apitegromab produced positive Phase 2 obesity data (EMBRAZE): added to tirzepatide over 24 weeks it preserved about 55% more lean mass (roughly 1.9 kg / 4.2 lb) than tirzepatide alone, positioning myostatin inhibition as a potential lean-mass-sparing partner for GLP-1-based weight loss."
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          "acceptedAnswer": {
            "@type": "Answer",
            "text": "Apitegromab is a research peptide studied in preclinical models. Apitegromab (SRK-015) is an investigational, fully human IgG4 monoclonal antibody developed by Scholar Rock that inhibits myostatin - the muscle-produced growth factor that limits skeletal-muscle mass - through a novel, muscle-selective mechanism. Rather than neutralizing mature, active myostatin (the approach of earlier failed inhibitors), apitegromab binds only the inactive precursor forms of the protein - promyostatin and latent myostatin - stored locally in muscle, and blocks their proteolytic conversion into the active ligand. Because it spares the closely related growth factors activin A, BMP9/10, and TGF-beta1, it aims to avoid the off-target effects (such as bleeding and vascular changes) that sank broad ActRII-pathway drugs. Apitegromab is the first muscle-targeted therapy to succeed in a pivotal Phase 3 trial in spinal muscular atrophy (SMA): in the 156-patient SAPPHIRE study of nonambulatory Type 2/3 patients aged 2-12 already on an SMN-directed therapy (nusinersen or risdiplam), adding apitegromab (10 or 20 mg/kg IV every 4 weeks) improved motor function by a pooled 1.8 points on the Hammersmith Functional Motor Scale Expanded (HFMSE) versus placebo at 12 months (p=0.019). Scholar Rock's initial Biologics License Application received an FDA Complete Response Letter in September 2025 tied solely to a third-party (Catalent Indiana) fill-finish manufacturing inspection - not to the drug's efficacy or safety - and the company resubmitted the BLA on March 31, 2026, with a PDUFA target action date of September 30, 2026. In parallel, apitegromab produced positive Phase 2 obesity data (EMBRAZE): added to tirzepatide over 24 weeks it preserved about 55% more lean mass (roughly 1.9 kg / 4.2 lb) than tirzepatide alone, positioning myostatin inhibition as a potential lean-mass-sparing partner for GLP-1-based weight loss."
          }
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    }
  ]
---

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# Apitegromab

Low Evidence 

Apitegromab (SRK-015) is an investigational, fully human IgG4 monoclonal antibody developed by Scholar Rock that inhibits myostatin - the muscle-produced growth factor that limits skeletal-muscle mass - through a novel, muscle-selective mechanism. Rather than neutralizing mature, active myostatin (the approach of earlier failed inhibitors), apitegromab binds only the inactive precursor forms of the protein - promyostatin and latent myostatin - stored locally in muscle, and blocks their proteolytic conversion into the active ligand. Because it spares the closely related growth factors activin A, BMP9/10, and TGF-beta1, it aims to avoid the off-target effects (such as bleeding and vascular changes) that sank broad ActRII-pathway drugs. Apitegromab is the first muscle-targeted therapy to succeed in a pivotal Phase 3 trial in spinal muscular atrophy (SMA): in the 156-patient SAPPHIRE study of nonambulatory Type 2/3 patients aged 2-12 already on an SMN-directed therapy (nusinersen or risdiplam), adding apitegromab (10 or 20 mg/kg IV every 4 weeks) improved motor function by a pooled 1.8 points on the Hammersmith Functional Motor Scale Expanded (HFMSE) versus placebo at 12 months (p=0.019). Scholar Rock's initial Biologics License Application received an FDA Complete Response Letter in September 2025 tied solely to a third-party (Catalent Indiana) fill-finish manufacturing inspection - not to the drug's efficacy or safety - and the company resubmitted the BLA on March 31, 2026, with a PDUFA target action date of September 30, 2026. In parallel, apitegromab produced positive Phase 2 obesity data (EMBRAZE): added to tirzepatide over 24 weeks it preserved about 55% more lean mass (roughly 1.9 kg / 4.2 lb) than tirzepatide alone, positioning myostatin inhibition as a potential lean-mass-sparing partner for GLP-1-based weight loss.

Aliases Apitegromab +4 more 

Evidence Low Evidence 

Last Updated  2026-07-17 

Reading Time  6 min 

## Table of Contents

1.  [What It Is](#what-it-is)
2.  [Regulatory Status](#regulatory-status)
3.  [Why Researchers Study It](#why-researchers-study)
4.  [Proposed Mechanisms](#proposed-mechanisms)
5.  [Evidence Snapshot](#evidence-snapshot)
6.  [Commonly Discussed Benefits](#benefits)
7.  [Safety & Cautions](#safety)
8.  [Comparisons](#comparisons)
9.  [Calculator Tools](#calculator)
10.  [Citations](#citations)

## What It Is

Apitegromab (development code SRK-015) is an investigational biologic - a fully human IgG4 monoclonal antibody - from Scholar Rock that targets myostatin (also called GDF-8), the body's built-in brake on skeletal-muscle growth. Myostatin is made and stored in muscle as inactive precursors (promyostatin and latent myostatin) that are later cleaved into the active hormone; active myostatin then signals through the ActRII receptors to restrain muscle size. Earlier myostatin-pathway drugs tried to block the active ligand or its receptor broadly, which also hit related TGF-beta-family proteins (activin A, BMP9/10) and produced dose-limiting side effects and clinical failures. Apitegromab takes a more selective route: it binds the pro- and latent forms of myostatin inside muscle and prevents their activation, so it dials down myostatin signaling without disturbing the neighboring growth factors. This 'muscle-directed' selectivity is the molecule's core differentiator from broad inhibitors such as the ActRII-blocking antibody bimagrumab and the myostatin/activin decoy-receptor taldefgrobep alfa. Its lead indication is spinal muscular atrophy, a genetic motor-neuron disease in which the existing SMN-restoring drugs (nusinersen/Spinraza, risdiplam/Evrysdi, and the gene therapy onasemnogene abeparvovec/Zolgensma) preserve motor neurons but leave residual muscle weakness; apitegromab is designed to strengthen the muscle itself on top of that background therapy. After the positive Phase 2 TOPAZ study, the Phase 3 SAPPHIRE trial made apitegromab the first muscle-targeted candidate to hit its primary motor-function endpoint in SMA. A separate franchise is emerging in obesity: because GLP-1 and GLP-1/GIP weight-loss drugs strip away a substantial fraction of lean muscle along with fat, apitegromab is being studied to protect muscle during that weight loss, with positive Phase 2 EMBRAZE data alongside tirzepatide. Scholar Rock is also running the Phase 2 OPAL study in infants and toddlers under two with SMA, advancing apitegromab into facioscapulohumeral muscular dystrophy (FSHD), and developing a subcutaneous follow-on (SRK-439) for obesity.

Also known as:  Apitegromab, SRK-015, Scholar Rock myostatin inhibitor, anti-promyostatin antibody, pro/latent myostatin inhibitor 

## Regulatory Status

## Why Researchers Study It

Apitegromab is the first myostatin/muscle-directed therapy to succeed in a pivotal Phase 3 trial in a neuromuscular disease, validating the long-pursued idea that inhibiting myostatin can meaningfully improve muscle function in patients - here, on top of SMN-restoring SMA drugs that fix the nerve but not the muscle. Its precursor-selective mechanism is studied as a template for hitting myostatin hard while avoiding the off-target liabilities that doomed earlier inhibitors. The molecule has also become a focal point of the obesity field: as GLP-1-class drugs drive dramatic weight loss but sacrifice lean muscle, apitegromab's positive EMBRAZE data make it a leading test of whether myostatin inhibition can preserve muscle quality during pharmacologic weight loss, potentially as a combination partner for incretin therapies.

## Proposed Mechanisms

-   Precursor-selective myostatin inhibition: apitegromab binds the inactive precursor forms of myostatin - promyostatin and latent myostatin - stored in skeletal muscle, blocking their proteolytic activation into mature, signaling myostatin (GDF-8).
-   Reduced ActRII signaling: by lowering the pool of active myostatin, it decreases activation of the activin type II receptors and downstream SMAD2/3 signaling that restrains muscle growth, favoring muscle hypertrophy and function.
-   Growth-factor selectivity: it spares the closely related ligands activin A, BMP9/10, and TGF-beta1, an intended contrast to broad ActRII-pathway inhibitors and a strategy to avoid off-target bleeding and vascular effects.
-   Complementary to SMN-directed therapy in SMA: acting on muscle rather than the motor neuron, it is designed to add motor-function benefit on top of nusinersen, risdiplam, or gene therapy that preserve or restore the neuron.
-   Lean-mass preservation during weight loss: sustained muscle-directed myostatin inhibition is proposed to protect skeletal muscle while GLP-1/GIP agonists (e.g., tirzepatide) drive fat and overall weight loss.

## Evidence Snapshot

Low Evidence 

Low 

Medium 

High 

Study Type

Model

Outcome

Link

RCT (human, Phase 3 - SAPPHIRE, 12 months)

156 nonambulatory Type 2/3 SMA patients aged 2-12 on background SMN therapy (nusinersen or risdiplam); apitegromab 10 or 20 mg/kg IV every 4 weeks vs placebo (1:1:1)

Met primary endpoint: pooled mean HFMSE improvement of ~1.8 points vs placebo at 12 months (p=0.019); the 10 mg/kg arm showed a ~2.2-point difference (nominal p=0.0121). First muscle-targeted therapy to succeed in a pivotal SMA trial; generally well tolerated.

[Source](https://investors.scholarrock.com/news-releases/news-release-details/scholar-rock-reports-apitegromab-meets-primary-endpoint-phase-3)

RCT (human, Phase 2 - EMBRAZE, 24 weeks, obesity)

Adults with obesity receiving tirzepatide; apitegromab 10 mg/kg added vs tirzepatide alone

Statistically significant preservation of lean mass: apitegromab preserved ~54.9% more lean mass (about 1.9 kg / 4.2 lb) than tirzepatide alone over 24 weeks, supporting myostatin inhibition as a lean-mass-sparing partner for GLP-1/GIP weight loss.

[Source](https://investors.scholarrock.com/news-releases/news-release-details/scholar-rock-reports-positive-phase-2-embraze-trial-results)

Human (Phase 2 - TOPAZ / open-label extensions and OPAL, ongoing)

Earlier Phase 2 TOPAZ study in Type 2/3 SMA (proof-of-concept for HFMSE gains) and the ongoing Phase 2 OPAL study in infants/toddlers under 2 with SMA on SMN-directed therapy or gene therapy

TOPAZ demonstrated motor-function improvements that supported SAPPHIRE; OPAL extends evaluation to the youngest SMA patients, with dosing underway. Long-term extension data continue to accrue.

[Source](https://clinicaltrials.gov/study/NCT03921528)

## Commonly Discussed Benefits

[spinal muscular atrophy (SMA) - improved motor function when added to SMN-directed therapy in nonambulatory Type 2/3 patients (investigational; Phase 3 SAPPHIRE positive)](</benefits/spinal muscular atrophy \(SMA\) - improved motor function when added to SMN-directed therapy in nonambulatory Type 2/3 patients \(investigational; Phase 3 SAPPHIRE positive\)>)[muscle strength and motor-scale (HFMSE/RHS) gains via muscle-selective myostatin inhibition](</benefits/muscle strength and motor-scale \(HFMSE/RHS\) gains via muscle-selective myostatin inhibition>)[lean-mass preservation during GLP-1/GIP (tirzepatide) weight loss (investigational; Phase 2 EMBRAZE positive)](</benefits/lean-mass preservation during GLP-1/GIP \(tirzepatide\) weight loss \(investigational; Phase 2 EMBRAZE positive\)>)[potential treatment of facioscapulohumeral muscular dystrophy (FSHD) and other muscle-wasting conditions (preclinical/early clinical)](</benefits/potential treatment of facioscapulohumeral muscular dystrophy \(FSHD\) and other muscle-wasting conditions \(preclinical/early clinical\)>)[muscle-directed selectivity that spares activin A, BMP9/10, and TGF-beta1, aiming to avoid off-target effects of broad ActRII inhibitors](</benefits/muscle-directed selectivity that spares activin A, BMP9/10, and TGF-beta1, aiming to avoid off-target effects of broad ActRII inhibitors>)

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## Safety & Cautions

-   Not approved by any regulator; the initial U.S. BLA received a Complete Response Letter in September 2025 (manufacturing/fill-finish inspection related), and approval now depends on the resubmitted BLA and a September 30, 2026 PDUFA decision.
-   Efficacy is established in SMA when added to SMN-directed therapy in nonambulatory Type 2/3 patients; benefit in other SMA populations, in obesity, or in FSHD is not yet proven by pivotal data.
-   Administered by intravenous infusion every 4 weeks (a subcutaneous follow-on, SRK-439, is separate and earlier-stage).
-   Long-term effects of sustained myostatin inhibition are unknown; earlier myostatin-pathway drugs failed or showed off-target effects in other diseases.
-   Obesity (EMBRAZE) data are Phase 2 and short-term; durability, functional/strength outcomes, and safety of long-term use with GLP-1 drugs remain to be established.

## Comparisons

See how Apitegromab compares to related peptides:

[Apitegromab vs Tirzepatide](/compare/apitegromab-vs-tirzepatide) [Apitegromab vs Semaglutide](/compare/apitegromab-vs-semaglutide) [Apitegromab vs Bimagrumab](/compare/apitegromab-vs-bimagrumab) [Apitegromab vs Taldefgrobep Alfa](/compare/apitegromab-vs-taldefgrobep) [Apitegromab vs Zilucoplan](/compare/apitegromab-vs-zilucoplan) [Apitegromab vs Trevogrumab](/compare/apitegromab-vs-trevogrumab) [Apitegromab vs Garetosmab](/compare/apitegromab-vs-garetosmab) [Apitegromab vs Sotatercept](/compare/apitegromab-vs-sotatercept)

## Calculator Tools

Use our research tools to explore dosing and reconstitution data:

[Reconstitution Calculator](/calculators)

## Citations

1.  \[1\]  Scholar Rock Reports Apitegromab Meets Primary Endpoint in Phase 3 SAPPHIRE Study in SMA - Scholar Rock (2024) [PubMed](https://investors.scholarrock.com/news-releases/news-release-details/scholar-rock-reports-apitegromab-meets-primary-endpoint-phase-3)
2.  \[2\]  FDA Issues Complete Response Letter for Apitegromab Solely Related to Observations at Catalent Indiana Fill-Finish Facility - Scholar Rock (Sept 2025) [PubMed](https://investors.scholarrock.com/news-releases/news-release-details/fda-issues-complete-response-letter-crl-apitegromab-treatment)
3.  \[3\]  Scholar Rock Resubmits BLA to FDA for Apitegromab for Children and Adults with SMA (March 31, 2026) [PubMed](https://investors.scholarrock.com/news-releases/news-release-details/scholar-rock-resubmits-biologics-license-application-bla-fda)
4.  \[4\]  Scholar Rock Reports Positive Phase 2 EMBRAZE Trial Results Demonstrating Preservation of Lean Mass with Apitegromab During Tirzepatide-Induced Weight Loss - Scholar Rock [PubMed](https://investors.scholarrock.com/news-releases/news-release-details/scholar-rock-reports-positive-phase-2-embraze-trial-results)
5.  \[5\]  Safety and Efficacy of Apitegromab in Patients With Spinal Muscular Atrophy Types 2 and 3 (TOPAZ) - Neurology [PubMed](https://www.neurology.org/doi/10.1212/WNL.0000000000209151)

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A novel myostatin-activin pathway inhibitor targeting fat reduction and lean mass gain, with Phase 2 results in obesity expected H2 2026.

[Fat Loss](/benefits/fat-loss)[muscle-preservation](/benefits/muscle-preservation)[Muscle Growth](/benefits/muscle-growth)[body-composition](/benefits/body-composition)+1 more 

[View Details](/peptides/taldefgrobep) [\+ Compare](/compare?select=taldefgrobep)[](https://app.peptrackerpro.com/?add=taldefgrobep)

### Zilucoplan

High Evidence 

A self-administered, once-daily subcutaneous macrocyclic peptide that inhibits complement component 5 (C5), FDA- and EMA-approved for anti-AChR-positive generalized myasthenia gravis.

[autoimmune disease](</benefits/autoimmune disease>)[neuromuscular function](</benefits/neuromuscular function>)

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### Trevogrumab

Medium Evidence 

Trevogrumab (REGN1033) is an investigational fully human anti-myostatin (anti-GDF8) monoclonal antibody from Regeneron being tested as a lean-mass-sparing add-on to semaglutide in the Phase 2 COURAGE obesity trial; adding it to semaglutide prevented roughly half of the ~33% of GLP-1-induced weight loss that normally comes from muscle, and the semaglutide + trevogrumab + garetosmab triplet reached 13.4% weight loss at 26 weeks with only ~7.4% of that loss from lean mass.

[muscle-preservation](/benefits/muscle-preservation)[lean-mass-retention](/benefits/lean-mass-retention)[body-composition](/benefits/body-composition)[Fat Loss](/benefits/fat-loss)+1 more 

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### Garetosmab

Medium Evidence 

Garetosmab (REGN2477) is Regeneron's investigational fully human anti-activin A monoclonal antibody. In the Phase 3 OPTIMA trial in adults with the ultra-rare bone disease fibrodysplasia ossificans progressiva (FOP), it cut new heterotopic bone lesions by ~90-94% and reduced new-lesion volume by >99% versus placebo; its BLA was accepted for FDA Priority Review with an August 2026 target action date. The same activin A blockade also makes garetosmab the muscle-preserving partner to trevogrumab and semaglutide in the Phase 2 COURAGE obesity program.

[heterotopic-ossification-reduction](/benefits/heterotopic-ossification-reduction)[rare-disease-treatment](/benefits/rare-disease-treatment)[muscle-preservation](/benefits/muscle-preservation)[body-composition](/benefits/body-composition)+1 more 

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### Sotatercept

High Evidence 

Sotatercept (Winrevair, sotatercept-csrk) is Merck's first-in-class activin signaling inhibitor - a recombinant ActRIIA-Fc fusion protein that acts as a ligand trap for activin A, activin B, GDF-8 (myostatin) and GDF-11. It is FDA-approved for adults with pulmonary arterial hypertension (PAH), where it improved 6-minute walk distance by 40.8 meters in the Phase 3 STELLAR trial and, in the Phase 3 ZENITH trial in high-risk patients, cut the composite risk of death, lung transplantation and PAH hospitalization by 76%. An expanded U.S. label reflecting ZENITH was approved on October 27, 2025.

[pulmonary-vascular-remodeling](/benefits/pulmonary-vascular-remodeling)[exercise-capacity](/benefits/exercise-capacity)[cardiovascular-support](/benefits/cardiovascular-support)[rare-disease-treatment](/benefits/rare-disease-treatment)+1 more 

[View Details](/peptides/sotatercept) [\+ Compare](/compare?select=sotatercept)[](https://app.peptrackerpro.com/?add=sotatercept)

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