Side by side

1. 1.Binds the IGF-1 receptor, driving cartilage and bone growth in the growth plates.
2. 2.Increases protein synthesis in muscle and other tissue.
3. 3.Promotes glucose uptake in fat and muscle, which is why it behaves partly like insulin.
4. 4.Suppresses growth hormone release by negative feedback.
5. 5.Circulates bound to IGF-binding protein 3, which modifies its availability.

• Severe primary IGF-1 deficiency and growth hormone insensitivity
• Growth failure in children with normal growth hormone
• Severe insulin resistance syndromes (investigational)
• Growth and metabolic endpoints in rare IGF-1 gene defects

• Growth velocity rising from around 2 to 3 cm per year to roughly 6 to 8 cm per year in treated children
• Hypoglycaemia is the most frequent adverse effect
• Enlargement of tonsils and adenoids
• Improved lean mass in some studies

• Hypoglycaemia, the main safety issue
• Hypertrophy of tonsils and adenoids, sometimes needing surgery
• Headache
• Injection-site reactions and lipohypertrophy
• Raised intracranial pressure with papilloedema
• Slipped capital femoral epiphysis reported in growth-disordered children

Research context only - a specialist paediatric prescription. Labelled dosing starts at 40 to 80 micrograms per kilogram subcutaneously twice daily and rises as tolerated to a maximum of 120 micrograms per kilogram twice daily, given shortly before or after a meal to reduce hypoglycaemia. Growth is assessed over 6 to 12 month intervals.

Research context only