Selective androgen receptor modulators (SARMs) as pharmacological treatment for muscle wasting in ongoing clinical trials

Expert Opin Investig Drugs. 2020 Aug;29(8):881-891. doi: 10.1080/13543784.2020.1777275. Epub 2020 Jun 18.


Introduction: Skeletal muscle wasting is a frequent clinical problem encountered in patients with chronic diseases. Increased levels of inflammatory markers play a role in the imbalance between muscle protein synthesis and degradation. Although testosterone has long been proposed as a treatment for patients with muscle wasting, undesirable side effects have raised concerns about prostatic hypertrophy in men as well as virilization in women. Selective androgen receptor modulators (SARMs) have demonstrated similar results like testosterone at improving lean body mass (LBM) with less side effects on androgen-dependent tissue.

Areas covered: This review outlines the ongoing clinical development in the field of SARMs and their effectiveness in improving body composition and physical function. The included articles were collected at and analyzed integrally.

Expert opinion: There is an unmet clinical need for safe and effective anabolic compounds such as SARMs. Despite the effect on LBM shown by SARMs in phase II clinical trials, results on improved physical function and muscle strength are still lacking and long-term outcomes have to be assessed in these patients. Moreover, there is a need to determine the effect of resistance exercise training and protein intake associated with SARMs in the treatment of patients with muscle wasting.

Keywords: Androgen receptor; cachexia; muscle wasting; sarcopenia; selective androgen receptor modulators; testosterone.

Publication types

  • Review

MeSH terms

  • Anabolic Agents / administration & dosage*
  • Anabolic Agents / adverse effects
  • Anabolic Agents / pharmacology
  • Animals
  • Drug Development
  • Humans
  • Muscle Strength / drug effects
  • Muscle, Skeletal / drug effects
  • Muscle, Skeletal / metabolism
  • Muscular Atrophy / drug therapy*
  • Muscular Atrophy / pathology
  • Proteins / administration & dosage
  • Receptors, Androgen / drug effects*
  • Receptors, Androgen / metabolism
  • Resistance Training / methods
  • Testosterone / administration & dosage
  • Testosterone / pharmacology


  • Anabolic Agents
  • Proteins
  • Receptors, Androgen
  • Testosterone