Mecasermin, sold under the brand name Increlex, is medication used to treat growth failure in children due to primary insulin-like growth factor-I deficiency or lack of the gene for growth hormone.[1] It is also being look at for amyotrophic lateral sclerosis.[1] It is given by injection under the skin.[1]
Common side effects include headache, low blood sugar, vomiting, lump at the site of injection, and middle ear infection.[2] Other side effects may include enlarged tonsils, intracranial hypertension, and slipped capital femoral epiphysis.[1] It is a recombinant form of human insulin-like growth factor-1 (rhIGF-1).[1]
Mecasermin was approved for medical use in the United States in 2005 and Europe in 2007.[1][2] In the United States 400 mg costs about 54,000 USD as of 2021.[4] This amount in the United Kingdom costs the NHS about £24,000.[5]
Medical uses
It may be used in those 2 to 18 years old.[2]
Dosage
It is started at 0.04 mg/kg twice per day and may be increased up to 0.12 mg/kg twice per day.[2]
Chemistry
Mecasermin has a biological half-life of about 5.8 hours in children with severe primary IGF-1 deficiency.[3]
A related medication is mecasermin rinfabate (brand name Iplex), which is a combination of mecasermin (rhIGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), and insulin-like growth factor binding protein acid labile subunit (IGFALS) as a ternary complex.[6] The complex serves to prolong the action of mecasermin in the human body; the half-life of mecasermin when provided as this complex is 13.4 hours in individuals with severe primary IGF-1 deficiency.[6]
References
External links
| External sites: | |
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| Identifiers: | |
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| Angiopoietin |
- Agonists: Angiopoietin 1
- Angiopoietin 4
- Antagonists: Angiopoietin 2
- Angiopoietin 3
- Kinase inhibitors: Altiratinib
- CE-245677
- Rebastinib
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| CNTF | |
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| EGF (ErbB) | EGF (ErbB1/HER1) |
- Agonists: Amphiregulin
- Betacellulin
- EGF (urogastrone)
- Epigen
- Epiregulin
- Heparin-binding EGF-like growth factor (HB-EGF)
- Murodermin
- Nepidermin
- Transforming growth factor alpha (TGFα)
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| ErbB2/HER2 | |
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| ErbB3/HER3 |
- Agonists: Neuregulins (heregulins) (1, 2, 6 (neuroglycan C))
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| ErbB4/HER4 |
- Agonists: Betacellulin
- Epigen
- Heparin-binding EGF-like growth factor (HB-EGF)
- Neuregulins (heregulins) (1, 2, 3, 4, 5 (tomoregulin, TMEFF))
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| FGF | | FGFR1 |
- Agonists: Ersofermin
- FGF (1, 2 (bFGF), 3, 4, 5, 6, 8, 10 (KGF2), 20)
- Repifermin
- Selpercatinib
- Trafermin
- Velafermin
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| FGFR2 |
- Agonists: Ersofermin
- FGF (1, 2 (bFGF), 3, 4, 5, 6, 7 (KGF), 8, 9, 10 (KGF2), 17, 18, 22)
- Palifermin
- Repifermin
- Selpercatinib
- Sprifermin
- Trafermin
- Antibodies: Aprutumab
- Aprutumab ixadotin
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| FGFR3 | |
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| FGFR4 |
- Agonists: Ersofermin
- FGF (1, 2 (bFGF), 4, 6, 8, 9, 19)
- Trafermin
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| Unsorted | |
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| HGF (c-Met) |
- Agonists: Hepatocyte growth factor
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| IGF | | IGF-1 |
- Kinase inhibitors: BMS-754807
- Linsitinib
- NVP-ADW742
- NVP-AEW541
- OSl-906
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| IGF-2 |
- Agonists: Insulin-like growth factor-2 (somatomedin A)
- Antibodies: Dusigitumab
- Xentuzumab (against IGF-1 and IGF-2)
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| Others |
- Binding proteins: IGFBP (1, 2, 3, 4, 5, 6, 7)
- Cleavage products/derivatives with unknown target: Glypromate (GPE, (1-3)IGF-1)
- Trofinetide
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| LNGF (p75NTR) |
- Aptamers: Against NGF: RBM-004
- Decoy receptors: LEVI-04 (p75NTR-Fc)
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| PDGF |
- Agonists: Becaplermin
- Platelet-derived growth factor (A, B, C, D)
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| RET (GFL) | | GFRα1 |
- Agonists: Glial cell line-derived neurotrophic factor (GDNF)
- Liatermin
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| GFRα2 |
- Agonists: Neurturin (NRTN)
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| GFRα3 | |
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| GFRα4 |
- Agonists: Persephin (PSPN)
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| Unsorted |
- Kinase inhibitors: Agerafenib
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| SCF (c-Kit) | |
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| TGFβ | |
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| Trk | | TrkA |
- Negative allosteric modulators: VM-902A
- Aptamers: Against NGF: RBM-004
- Decoy receptors: ReN-1820 (TrkAd5)
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| TrkB |
- Agonists: 3,7-DHF
- 3,7,8,2'-THF
- 4'-DMA-7,8-DHF
- 7,3'-DHF
- 7,8-DHF
- 7,8,2'-THF
- 7,8,3'-THF
- Amitriptyline
- BDNF
- BNN-20
- Deoxygedunin
- Deprenyl
- Diosmetin
- DMAQ-B1
- HIOC
- LM22A-4
- N-Acetylserotonin
- NT-3
- NT-4
- Norwogonin (5,7,8-THF)
- R7
- R13
- TDP6
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| TrkC | |
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| VEGF |
- Agonists: Placental growth factor (PGF)
- Ripretinib
- Telbermin
- VEGF (A, B, C, D (FIGF))
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| Others |
- Additional growth factors: Adrenomedullin
- Colony-stimulating factors (see here instead)
- Connective tissue growth factor (CTGF)
- Ephrins (A1, A2, A3, A4, A5, B1, B2, B3)
- Erythropoietin (see here instead)
- Glucose-6-phosphate isomerase (GPI; PGI, PHI, AMF)
- Glia maturation factor (GMF)
- Hepatoma-derived growth factor (HDGF)
- Interleukins/T-cell growth factors (see here instead)
- Leukemia inhibitory factor (LIF)
- Macrophage-stimulating protein (MSP; HLP, HGFLP)
- Midkine (NEGF2)
- Migration-stimulating factor (MSF; PRG4)
- Oncomodulin
- Pituitary adenylate cyclase-activating peptide (PACAP)
- Pleiotrophin
- Renalase
- Thrombopoietin (see here instead)
- Wnt signaling proteins
- Additional growth factor receptor modulators: Cerebrolysin (neurotrophin mixture)
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- See also
- Receptor/signaling modulators
- Signaling peptide/protein receptor modulators
- Cytokine receptor modulators
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| Adiponectin | | AdipoR1 |
- Antagonists: Peptide: ADP-400
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| AdipoR2 |
- Agonists: Peptide: Adiponectin
- ADP-355
- ADP-399; Non-peptide: AdipoRon
- Deoxyschizandrin
- Parthenolide
- Syringing
- Taxifoliol
- Antagonists: Peptide: ADP-400
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| Angiotensin | |
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| Bradykinin | |
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| CGRP | |
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| Cholecystokinin | | CCKA | |
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| CCKB | |
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| Unsorted |
- Antagonists: Nastorazepide
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| CRH | | CRF1 |
- Agonists: Cortagine
- Corticorelin
- Corticotropin-releasing hormone
- Sauvagine
- Stressin I
- Urocortin
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| CRF2 |
- Agonists: Corticorelin
- Corticotropin-releasing hormone
- Sauvagine
- Urocortin
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| Cytokine | See here instead. |
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| Endothelin |
- Agonists: Endothelin 1
- Endothelin 2
- Endothelin 3
- IRL-1620
- Sarafotoxin
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| Galanin | | GAL1 |
- Agonists: Galanin
- Galanin (1-15)
- Galanin-like peptide
- Galmic
- Galnon
- NAX 810-2
- Antagonists: C7
- Dithiepine-1,1,4,4-tetroxide
- Galantide (M15)
- M32
- M35
- M40
- SCH-202596
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| GAL2 |
- Agonists: Galanin
- Galanin (1-15)
- Galanin (2-11)
- Galanin-like peptide
- Galmic
- Galnon
- J18
- NAX 810-2
- Antagonists: C7
- Galantide (M15)
- M32
- M35
- M40
- M871
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| GAL3 | |
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| Ghrelin/GHS | |
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| GH | |
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| GHRH | |
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| GLP | | GLP-1 | |
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| GLP-2 |
- Agonists: Apraglutide
- Elsiglutide
- Glepaglutide
- GLP-2
- Teduglutide
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| Others | |
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| Glucagon |
- Antagonists: Adomeglivant
- L-168,049
- LGD-6972
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| GnRH | |
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| Gonadotropin | |
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| Growth factor | See here instead. |
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| Insulin |
- Antagonists: BMS-754807
- S661
- S961
- Antibodies: Xentuzumab (against IGF-1 and IGF-2)
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| Kisspeptin |
- Agonists: Kisspeptin
- Kisspeptin-10
- Antagonists: Kisspeptin-234
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| Leptin | |
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| MCH | | MCH1 |
- Agonists: Melanin-concentrating hormone
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| MCH2 |
- Agonists: Melanin-concentrating hormone
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| Melanocortin | |
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| mTOR | |
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| Neuropeptide FF |
- Agonists: Neuropeptide AF
- Neuropeptide FF
- Neuropeptide SF (RFRP-1)
- Neuropeptide VF (RFRP-3)
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| Neuropeptide S | |
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| Neuropeptide Y | | Y1 |
- Agonists: Neuropeptide Y
- Peptide YY
- Antagonists: BIBO-3304
- BIBP-3226
- BVD-10
- GR-231118
- PD-160170
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| Y2 |
- Agonists: 2-Thiouridine 5'-triphosphate
- Neuropeptide Y
- Neuropeptide Y (13-36)
- Peptide YY
- Peptide YY (3-36)
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| Y4 |
- Agonists: GR-231118
- Neuropeptide Y
- Pancreatic polypeptide
- Peptide YY
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| Y5 |
- Agonists: BWX-46
- Neuropeptide Y
- Peptide YY
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| Neurotensin | | NTS1 |
- Agonists: Neurotensin
- Neuromedin N
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| NTS2 | |
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| Opioid | See here instead. |
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| Orexin | |
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| Oxytocin | |
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| Prolactin |
- Antagonists: Δ1–9-G129R-hPRL
- Δ1–14-G129R-hPRL
- G120K-hGH
- G129R-hPRL
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| PTH | |
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| Relaxin | |
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| Somatostatin | |
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| Tachykinin | |
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| TRH |
- Agonists: Azetirelin
- Fertirelin
- Montirelin
- Orotirelin
- Posatirelin
- Protirelin
- Rovatirelin
- Taltirelin
- TRH (TRF)
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| TSH | |
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| Vasopressin | |
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| VIP/PACAP | | VIPR1 |
- Agonists: Peptide: Bay 55-9837
- LBT-3393
- PACAP
- VIP
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| VIPR2 | |
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| PAC1 |
- Agonists: PACAP
- PACAP (1-27)
- PACAP (1-38)
- Antagonists: PACAP (6-38)
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| Unsorted | |
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| Others |
- Endogenous: Adrenomedullin
- Apelin
- Asprosin
- Bombesin
- Calcitonin
- Carnosine
- CART
- CLIP
- DSIP
- Enteroglucagon
- Formyl peptide
- GALP
- GIP
- GRP
- Integrin ligands (collagens, fibrinogen, fibronectin, laminins, ICAM-1, ICAM-2, osteopontin, VCAM-1, vitronectin)
- Kininogens
- Motilin
- Natriuretic peptides (ANP, BNP, CNP, urodilatin)
- Nesfatin-1
- Neuromedin B
- Neuromedin N
- Neuromedin S
- Neuromedin U
- Obestatin
- Osteocalcin
- Resistin
- Secretin
- Thymopoietin
- Thymosins
- Thymulin
- Urotensin-II
- VGF
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- See also
- Receptor/signaling modulators
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