Human IGF-1 made by biotechnology. Used in children with short stature due to severe primary IGF-1 deficiency, when the body does not respond to growth hormone (for example, Laron syndrome).
Regulatory status
Approved (FDA / EMA)
Family
Recombinant insulin-like growth factor 1 (IGF-1)
Scientific evidence
Moderate
Number of findings
1
Where it acts
Hormones and metabolism · Bones and muscles
Also known as
mecasermin, Increlex, rhIGF-1, recombinant IGF-1
Regulatory status
FDA (US): Approved (2005, Increlex) for growth failure due to severe primary IGF-1 deficiency or growth hormone gene deletion with neutralizing antibodies
EMA (EU): Approved (2007, Increlex, under exceptional circumstances) for growth failure in children and adolescents aged 2 to 18 years with severe primary IGF-1 deficiency
Dose
Start with 0.04–0.08 mg/kg twice a day subcutaneously, increasing up to a maximum of 0.12 mg/kg twice a day, always shortly before or after a meal (FDA/EMA label).
Safety
Hypoglycemia (the most frequent effect; never skip a meal), enlargement of tonsils and adenoids with snoring or apnea, intracranial hypertension, slipped capital femoral epiphysis, and lipohypertrophy at the injection site. It has been associated with benign and malignant tumors: contraindicated with active or suspected cancer. Only under pediatric endocrinology. It must not be used to gain muscle or for performance.
Interactions
It may potentiate the effect of insulin and other antidiabetic drugs (risk of hypoglycemia).
Effect by goal · level of evidence
Growth in children with growth hormone insensitivity
improvesModerateclinical trial (A)in people
From 2.8 to 8.0 cm/year
Mostly open-label study, without a control group, with 76 children treated for up to 12 years. Growth velocity rose from 2.8 cm/year to 8.0 cm/year in the first year and stayed above baseline for up to 8 years. Hypoglycemia in 49% and tonsillar hypertrophy in 22%.
Growth hormone acts largely through the IGF-1 made by the liver. When the growth hormone receptor does not work, IGF-1 is not produced. Mecasermin supplies that IGF-1 directly, which stimulates the growth of long bones. It also has an insulin-like effect and lowers glucose.
What the evidence says
In people
Growth in children with growth hormone insensitivity. Mostly open-label study, with no control group, with 76 children treated for up to 12 years. Growth velocity rose from 2.8 cm/year to 8.0 cm/year in the first year and stayed above baseline for up to 8 years. Hypoglycemia occurred in 49% and tonsillar hypertrophy in 22%. PubMed 17192294