The clinical antiprotozoal drug halofuginone promotes weight loss by elevating GDF15 and FGF21

Sci Adv. 2025 Mar 28;11(13):eadt3142. doi: 10.1126/sciadv.adt3142. Epub 2025 Mar 26.

Abstract

Obesity is a debilitating global pandemic with a huge cost on health care due to it being a major underlying risk factor for several diseases. Therefore, there is an unmet medical need for pharmacological interventions to curb obesity. Here, we report that halofuginone, a Food and Drug Administration-approved anti-scleroderma and antiprotozoal drug, is a promising anti-obesity agent in preclinical mouse and pig models. Halofuginone suppressed food intake, increased energy expenditure, and resulted in weight loss in diet-induced obese mice while also alleviating insulin resistance and hepatic steatosis. Using molecular and pharmacological tools with transcriptomics, we identified that halofuginone increases fibroblast growth factor 21 (FGF21) and growth differentiation factor 15 (GDF15) levels via activating integrated stress response. Using Gdf15 and Fgf21 knockout mice, we show that both hormones are necessary to elicit anti-obesity changes. Together, our study reports the beneficial metabolic effects of halofuginone and underscores its utility in treating obesity and its associated metabolic complications, which merits clinical assessment.

MeSH terms

  • Animals
  • Antiprotozoal Agents* / pharmacology
  • Disease Models, Animal
  • Energy Metabolism / drug effects
  • Fibroblast Growth Factors* / genetics
  • Fibroblast Growth Factors* / metabolism
  • Growth Differentiation Factor 15* / genetics
  • Growth Differentiation Factor 15* / metabolism
  • Humans
  • Insulin Resistance
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Obesity* / drug therapy
  • Obesity* / etiology
  • Obesity* / metabolism
  • Piperidines* / pharmacology
  • Quinazolinones* / pharmacology
  • Swine
  • Weight Loss* / drug effects

Substances

  • halofuginone
  • Fibroblast Growth Factors
  • Quinazolinones
  • fibroblast growth factor 21
  • Growth Differentiation Factor 15
  • Piperidines
  • Antiprotozoal Agents
  • Gdf15 protein, mouse