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Metreleptin is a recombinant analog of human leptin, produced in E. coli, and differs from native human leptin by the addition of a methionine residue at its amino terminus. It is used as an adjunct to diet as replacement therapy for complications of leptin deficiency in patients with congenital or acquired generalized lipodystrophy. By binding to and activating the leptin receptor, metreleptin increases insulin sensitivity, improves lipid metabolism, reduces caloric intake, and helps normalize metabolic abnormalities such as hypertriglyceridemia and diabetes mellitus associated with lipodystrophy. It is not indicated for general obesity or HIV-related lipodystrophy[1][2][5][8].
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