Mecasermin

Mecasermin
Names
Trade namesIncrelex
Other namesFK-780; recombinant human insulin-like growth factor-1; rhIGF-1; somatomedin-1
Clinical data
Main usesGrowth failure due to primary insulin-like growth factor-I deficiency[1]
Side effectsHeadache, low blood sugar, vomiting, lump at the site of injection, middle ear infection[2]
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Pregnancy
category
  • AU: B3
  • US: C (Risk not ruled out)
    Routes of
    use    		Subcutaneous injection
    Typical dose0.04 to 0.12 mg/kg BID[2]
    External links
    AHFS/Drugs.comMonograph
    Legal
    License data
    Legal status
    • AU: S4 (Prescription only)
    • US: ℞-only
    Pharmacokinetics
    Elimination half-life5.8 hours[3]
    Chemical and physical data
    FormulaC331H512N94O101S7
    Molar mass7648.71 g·mol−1

    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

    1. 1 2 3 4 5 6 7 "Mecasermin Monograph for Professionals". Drugs.com. Archived from the original on 6 March 2021. Retrieved 14 November 2021.
    2. 1 2 3 4 5 6 "Increlex". Archived from the original on 14 November 2021. Retrieved 15 November 2021.
    3. 1 2 "INCRELEX® (mecasermin [rDNA origin] injection) Highlights of Prescribing Information" (PDF). U.S. Food and Drug Administration. Archived (PDF) from the original on 2021-04-03. Retrieved 2020-08-23.
    4. ↑ "Increlex Prices, Coupons & Patient Assistance Programs". Drugs.com. Retrieved 15 November 2021.
    5. ↑ "Mecasermin". NICE. Archived from the original on 15 November 2021. Retrieved 15 November 2021.
    6. 1 2 "IPLEXTM (mecasermin rinfabate [rDNA origin] injection) Package Insert" (PDF). U.S. Food and Drug Administration. Archived (PDF) from the original on 2020-10-30. Retrieved 2020-08-23.
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