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Enobosarm is a nonsteroidal, orally bioavailable selective androgen receptor modulator (SARM) developed to provide tissue-selective anabolic effects, primarily in muscle and bone. It acts as an agonist of the androgen receptor, promoting increases in lean body mass and reductions in fat mass with minimal unwanted androgenic side effects on other tissues such as the prostate or hair follicles. Enobosarm has been studied for multiple indications including muscle wasting associated with cancer (cachexia), sarcopenia, stress urinary incontinence, triple negative breast cancer (AR-positive), and more recently for improving body composition and preserving muscle mass during weight loss therapy with GLP‑1 receptor agonists like semaglutide. Clinical trials have shown dose-dependent improvements in muscle mass and physical function as well as reductions in fat mass. The drug was originally developed by GTx but is now under development by Veru. Despite promising results for increasing lean body mass, enobosarm did not show significant improvement in muscle strength during late-stage trials for cancer cachexia; thus approval was not granted for that indication. Enobosarm has also been referred to as ostarine within bodybuilding communities due to its performance-enhancing properties; however, it remains investigational and is not approved by regulatory agencies for any indication. Side effects may include headache, fatigue, anemia, adverse lipid changes (such as decreased HDL cholesterol), changes in sex hormone concentrations (including decreased testosterone levels), elevated liver enzymes, nausea, diarrhea, back pain, and potential liver toxicity. Its safety profile appears favorable compared to traditional anabolic steroids.
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