Bone & endocrine

Mecasermin

Recombinant IGF-1, licensed for the rare children whose growth failure comes from an IGF-1 deficiency that growth hormone cannot fix.

Moderate evidenceApproved drugAdd to compare

What it is

Mecasermin is recombinant human insulin-like growth factor 1, a 70-amino-acid peptide that carries most of growth hormone's effects on growth. It is licensed (Increlex) for children with severe primary IGF-1 deficiency - growth failure with normal or high growth hormone - where growth hormone itself cannot work.

How it works

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

What it's studied for

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

Reported and studied effects

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

Research protocol notes

Research context only

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.

These figures are described so you can understand what researchers did. They are not a dose, a schedule, or a suggestion — and they are not a substitute for a doctor.

Possible side effects and contraindications

Safety profile

Possible side effects

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

Contraindications and cautions

Active or suspected malignancy - must be excluded before starting
Closed growth plates
Prior hypersensitivity
Never a substitute for growth hormone in classical growth hormone deficiency

A side-effect list is never complete, and these are not the only situations that warrant caution. Anything unexpected, or anything you are unsure about, should be discussed with a doctor before use.

Evidence assessment

Moderate evidenceSeveral human trials, some inconsistencies

Several human trials, some inconsistencies

Approval rests on small, largely single-arm growth studies in a rare deficiency; the effect on height velocity is real but the evidence base is narrow rather than large-scale randomised.

References

References link to published literature, regulator pages or literature indexes. Where a link points to a search, it collects the peer-reviewed work on that molecule rather than a single study.

Compare Mecasermin with another peptide →

Related peptides

Other entries in Bone & endocrine.

All Bone & endocrine peptides →

Bone & endocrine

Cosyntropin (tetracosactide)

The active first 24 amino acids of ACTH, licensed mainly as the standard test for adrenal function.

Strong evidenceApproved drug

Bone & endocrine

Desmopressin

A long-acting vasopressin analogue approved for central diabetes insipidus, bedwetting and mild bleeding disorders.

Strong evidenceApproved drug

Bone & endocrine

Glucagon

The pancreatic hormone that raises blood glucose, licensed as emergency treatment for severe hypoglycaemia.

Strong evidenceApproved drug