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Muscle growthACE-083: a locally acting follistatin-Fc ActRII ligand trapACE-083 is Acceleron's follistatin-Fc fusion protein, engineered to act only in the muscle it is injected into. In phase 2 trials in FSHD and CMT it reliably increased muscle volume but did not improve function, and development was discontinued in 2020.Muscle growthBimagrumab (BYM338): anti-ActRII monoclonal antibody — mechanism, clinical record and limits of the evidenceBimagrumab (BYM338) is a human IgG monoclonal antibody (~150 kDa, not a peptide) that blocks activin type II receptors (ActRIIA/ActRIIB), silencing myostatin, activin A and GDF-11 signalling together. A review of receptor-level blockade, the three Novartis clinical programmes, the recurring mass-without-function result, and the metabolic pivot toward body composition.