Peptides Ranked by Evidence Strength: The Strongest Human Trial Record First

Every compound profile on this site, ranked by one question: how strong is the human evidence? The ranking grows as new profiles publish. Grades reflect evidence strength, never treatment advice.

By Evidence Research Team · Published 2026-10-06 · Research use only. This page describes evidence. It does not recommend any use.

What this ranking is. An evidence-strength ordering of our published compound profiles.

What it is not: a buying guide, a recommendation, or medical advice. Peptides are studied for different questions, so this compares evidence strength across those questions, not compounds as options.

How we ranked

Each compound gets a 0 to 10 score on four criteria. The overall score is the mean, and the letter grade follows the scale below. Every number is the output of this rubric applied to our verified evidence data: the conclusion rows and study rows behind each published profile.

  1. Human trial record. Controlled human trials: how many, how large, how well designed. Animal and cell studies do not count here.
  2. Certainty of key outcomes. The highest certainty grades our reviewers assigned to the compound’s main outcomes. High certainty means large, well run trials with consistent results.
  3. Safety data depth. How much is known about adverse effects from human data: large-trial safety reporting scores high, case reports and tiny pilots score low.
  4. Research depth. Total reviewed studies across all types. A deep preclinical program counts, but human studies weigh more.

Grade scale: A: 8.5 and up. B: 7.0 and up. C: 5.5 and up. D: 4.0 and up. F: below 4.0.

A grade of F does not mean a compound failed a trial. It means controlled human trials do not exist yet, so there is almost nothing to grade. Absence of evidence is not evidence of absence.

Semaglutide

Prescription GLP-1 medicine studied in large human trials for type 2 diabetes, weight management, and cardiovascular outcomes.

Evidence grade A 9.0/10
Human trial record 8 randomized human conclusions; trials enrolled up to 17,604 adults.
Certainty of key outcomes High certainty on blood sugar, weight loss, and cardiovascular outcomes.
Safety data depth Adverse-event reporting from large trials, including discontinuation rates.
Research depth 13 reviewed studies, 12 of them human.

PROS

  • 8 randomized human conclusions across blood sugar, weight, cardiovascular, and kidney outcomes
  • Largest trial (SELECT) enrolled 17,604 adults with overweight or obesity and cardiovascular disease
  • High-certainty findings: lower HbA1c, about 12.4 percentage points more weight loss than placebo at 68 weeks (STEP 1), fewer major cardiovascular events (SUSTAIN 6, SELECT)
  • Published adverse-event data from large trials, so the safety picture is quantified, not guessed

CONS

  • Evidence belongs to studied populations (type 2 diabetes, overweight or obesity). It does not generalize beyond them
  • Gastrointestinal events (nausea, vomiting, diarrhea, constipation) led to more discontinuations: 7.0% vs 3.1% in STEP 1, 16.6% vs 8.2% in SELECT
  • Boxed warning for thyroid C-cell tumors seen in rodents (not observed in humans); pancreatitis and intestinal blockage warnings from postmarketing reports
  • Brand-name confusion is common: Ozempic, Wegovy, and Rybelsus are distinct approved products, and approval does not extend to compounded or research-use versions

Why this grade

The A grade reflects a human trial record that is unusually large for a peptide medicine. STEP 1 randomized 1,961 adults with overweight or obesity and no diabetes to weekly semaglutide 2.4 mg or placebo for 68 weeks: mean weight change was -14.9% with semaglutide versus -2.4% with placebo, a treatment difference of -12.4 percentage points, and both groups received lifestyle intervention. STEP 5 extended the same comparison to 104 weeks in 304 adults and found -15.2% versus -2.6%, which shows the effect held over two years of continued treatment. These are randomized, placebo-controlled results, not observational or animal findings, which is why the human trial record criterion scores 10 out of 10.

SELECT is the largest trial behind this grade. It randomized 17,604 adults aged 45 and older with overweight or obesity, established cardiovascular disease, and no diabetes, to semaglutide 2.4 mg weekly or placebo. Over a mean follow-up of 39.8 months, the composite of cardiovascular death, nonfatal heart attack, or nonfatal stroke occurred in 6.5% of the semaglutide group versus 8.0% of the placebo group, a hazard ratio of 0.80. A prespecified analysis found the cardiovascular benefit was largely independent of the amount of weight lost. The SUSTAIN program added consistent HbA1c reductions in type 2 diabetes, while FLOW and STEP-HFpEF extended the evidence to kidney disease and heart failure. Eight human randomized conclusions sit behind this grade. The evidence still belongs to the populations that were studied, and the rodent thyroid tumor finding plus gastrointestinal adverse events keep the safety score below a perfect 10.

Verdict

The strongest human trial record on this site by a wide margin. If the question is what has actually been tested in people, semaglutide is the answer, with the standard caveat: the evidence belongs to the populations that were studied.

Read the full Semaglutide research profile

BPC-157

Experimental peptide studied in animal and cell models for tissue repair. No published human efficacy trials exist as of the literature-search date.

Evidence grade F 2.5/10
Human trial record Zero randomized human conclusions; only small uncontrolled human observations.
Certainty of key outcomes No outcome graded above very_low certainty; most are insufficient_evidence.
Safety data depth Human safety data limited to a 2-person tolerability pilot and a conference abstract.
Research depth 16 reviewed studies, an extensive animal and cell program, but almost no human data.

PROS

  • 16 reviewed studies: one of the more extensive preclinical research programs among peptides discussed online
  • Small human observations exist (uncontrolled knee-injection series, interstitial-cystitis pilot, tolerability pilot)
  • Clearly distinguished from TB-500 in the research record: different molecule, different research history

CONS

  • Zero controlled human trials. No published human efficacy trials exist as of the literature-search date
  • Best human evidence is graded very_low certainty; most outcomes are insufficient_evidence (animal data only)
  • Human pharmacokinetics are unknown: absorption, distribution, and clearance in people have not been measured
  • No approved medical product containing BPC-157 exists in any country reviewed

Why this grade

BPC-157 gets an F because the human trial record behind it is essentially empty. Zero randomized human conclusions support any outcome. The reviewed human evidence consists of small uncontrolled observations: a 2025 tolerability pilot in two healthy adults who received intravenous BPC-157, a 2021 retrospective knee-injection series with 16 contacted patients, and a 2024 interstitial-cystitis pilot in 12 women, none of them with a control group. A 2026 translational review described the published clinical evidence as fewer than 30 subjects across three uncontrolled pilot studies. None of this is a randomized trial, and none of it can establish efficacy or a safety profile in people.

The animal and cell literature is extensive: 16 reviewed studies cover rat tendon, ligament, muscle, burn, and gut-injury models plus cell cultures, with consistent reports of faster healing. Most of the research so far comes from laboratory and animal studies. That does not tell us whether it works in people. Much of that literature comes from a single research group, which limits independent confirmation. The registered Phase 1 trial, NCT02637284, was planned for 42 healthy volunteers but has no publicly posted results, so it did not create the published human foundation later researchers could build on. Until controlled human trials publish results, the F means there is almost nothing to grade. Absence of evidence is not evidence of absence: it means no one can say, from reviewed evidence, what BPC-157 does in people.

Verdict

The most studied compound here with the least human evidence. The animal research program is extensive, but with no controlled human trial, nothing about effects in people can be graded above very low certainty.

Compared with #1: Semaglutide has 8 randomized human conclusions; BPC-157 has none. The entire gap is human trial data. These compounds were also studied for different questions, so the ranking compares evidence strength, not the compounds as options.

Read the full BPC-157 research profile

Evidence behind the grades

Semaglutide's grade rests on trials you can read about in detail. Our article on what happens when semaglutide is stopped walks through the STEP 1 extension and STEP 4, the studies that show what changes after withdrawal. The semaglutide thyroid warning, explained article separates the rodent tumor finding from what the human trials did and did not show. The full semaglutide research profile lists every conclusion with its supporting studies, graded by evidence strength.

BPC-157's grade reflects the opposite situation. Our article BPC-157 human trials: the complete list inventories every published pilot, historical abstract, and registered trial, and shows why none of it can establish efficacy. The tissue repair research topic summarizes the animal and cell findings that dominate the literature, and you can compare BPC-157 with semaglutide side by side to see exactly where the human evidence diverges.

For the outcomes each compound was studied for, see the weight management research topic and the tissue repair research topic.

What this ranking cannot tell you

Our full methodology, including how certainty grades are assigned, is on the methods page. How we verify suppliers and documentation is on the verification page.

Common questions

Does a higher rank mean a peptide is better or safer?

No. Ranks measure the strength of the human evidence behind each compound, nothing more. A high rank means large, well run human trials exist. It is not a recommendation, and it says nothing about whether any use is appropriate.

Why are only two peptides ranked?

The ranking covers the compound profiles on this site, and two profiles exist so far. More profiles are in research. The list grows as they publish, and ranks can change as new evidence appears.

Can I use this ranking to decide what to take?

No. This is a research publication, not medical advice. Nothing here recommends any use of any compound. Peptides are studied for different questions, and this ranking compares evidence strength across those questions, not compounds as choices.

Keep reading