On-demand peptide therapeutics for multi-year space exploration: analysis of clinical and operational relevance and...

Future crewed expeditions beyond Earth will span multiple years, requiring a transition away from Earth-dependent pharmaceutical supply chains. Medications degrade more rapidly in space due to radiation exposure and storage constraints, while transporting large quantities of temperature-controlled biologics is logistically impractical. These challenges necessitate the development of self-sufficient, in-situ medical capabilities for deep space missions. This study evaluates the operational and clinical relevance (OCR) and recombinant production feasibility (RPF) of peptide therapeutics for on-demand manufacturing during long-duration spaceflight. Building on established astropharmacy databases and literature, 26 peptide-based medications relevant to spaceflight were identified and ranked using ten predefined OCR and RPF criteria. OCR criteria included regulatory status, shelf stability, storage requirements, NASA Human Research Roadmap risk/impact score, and purification requirements. RPF criteria included amino acid chain length, prior recombinant production, functional assay availability, dosing requirements, and post-translational modification complexity. All criteria were scored from 0-2 points. Teriparatide achieved the highest overall score (17/20), followed by abaloparatide and amylin (16/20). Several therapeutics, including angiotensin II, daptomycin, GLP-1 agonists, G-CSF, GM-CSF, and salmon calcitonin, also demonstrated potential (14/20). This study identifies peptide therapeutics as promising candidates for in-situ production and provides a structured framework to guide future astropharmacy development.