Human evidence for BPC-157 in orthopaedic and regenerative medicine: a systematic review of efficacy and safety.

or mzyjp23@nottingham.ac.uk Body Protective Compound-157 (BPC-157) is a synthetic pentadecapeptide popular among athletic populations for musculoskeletal injury recovery, despite lacking regulatory approval for human use and evidence being largely limited to animal models. This PRISMA-compliant systematic review, prospectively registered with PROSPERO (CRD420261406325), aimed to evaluate the efficacy and safety of BPC-157 for orthopaedic and regenerative purposes in humans. Electronic databases (Embase, PubMed, Cochrane Library and ClinicalTrials.gov) were searched up to 1 June 2026. Eligibility included quantitative and qualitative studies investigating BPC-157 for any indication in human participants. Methodological quality and certainty of evidence was assessed using the National Institutes of Health Quality Assessment Tool for Before-After Studies With No Control Group and GRADE framework respectively. Findings were narratively synthesised in accordance with SWiM guidance. Three studies (n=30) met the inclusion criteria, consisting of a retrospective study of intra-articular BPC-157 injections for knee pain (n=16), a retrospective pilot study of intravesical BPC-157 for interstitial cystitis (n=12), and a prospective pilot study evaluating intravenous BPC-157 safety (n=2). All studies reported symptom improvement in most participants without treatment-related adverse events, but were judged to be of poor methodological quality. Overall certainty of evidence was rated very low due to serious risk of bias, indirectness and imprecision. Accordingly, BPC-157 should not be used clinically in humans outside ethically approved, regulated, high-quality clinical trials.