Larazotide

Larazotide acetate · AT-1001 · AT1001

Snapshot

Indications	Contraindications
Persistent celiac symptoms¹ Gluten-induced symptoms^2–4 Anti-transglutaminase IgA response² Post-COVID inflammatory syndrome^{5, 6}

Larazotide (AT-1001, larazotide acetate) is a synthetic peptide developed as a gut permeability regulator, acting as a zonulin pathway antagonist that limits tight junction opening⁷. Interest centers on reducing gluten-driven barrier disruption, so its studied uses are persistent symptoms in celiac disease despite a gluten-free diet and symptoms during gluten exposure^{1, 2}. It has also been given as adjunctive therapy in post-COVID multisystem inflammatory syndrome in children⁵.

Human research is limited to about six small trials, mostly in celiac disease and post-COVID multisystem inflammatory syndrome in children. A 2015 randomized trial in adults with persistent symptoms despite a gluten-free diet found benefit at only one of the doses tested¹. A meta-analysis found symptom improvement during gluten challenge but not on a gluten-free diet alone, with no difference in a permeability measure⁴. A 2025 randomized placebo-controlled trial in children with post-COVID inflammatory syndrome found faster symptom resolution and spike antigen clearance with adjunctive larazotide; no other trial has replicated it. Larazotide remains an investigational oral peptide, and a review notes that no medication is approved for celiac disease⁸.

Last updated October 17, 2026. Read how we make monographs.

In the full monograph

34 sources, 22 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources