Increlex

Increlex is a prescription medication used to treat growth failure in children with severe primary IGF-1 deficiency (Primary IGFD) or with growth hormone (GH) gene deletion who have developed neutralizing antibodies to growth hormone. Increlex is not a steroid; it is a recombinant form of the human Insulin-like Growth Factor-1 (IGF-1), produced by recombinant DNA technology.

Indications

Increlex is indicated for the treatment of growth failure in pediatric patients with severe primary IGF-1 deficiency or with growth hormone gene deletion who have developed neutralizing antibodies to growth hormone.

Mechanism of Action

Increlex works by binding to the Insulin-like Growth Factor-1 Receptor (IGF-1R) on the surface of human cells. This binding activates the IGF-1R, leading to intracellular signaling that promotes cell growth and survival.

Side Effects

Common side effects of Increlex include hypoglycemia, local or systemic allergic reactions, and tonsillar hypertrophy. Serious side effects may include severe hypoglycemia, intracranial hypertension, and malignant neoplasia.

Contraindications

Increlex is contraindicated in patients with a known hypersensitivity to mecasermin or any of its components, in patients with closed epiphyses, and in patients with malignant neoplasia.

Drug Interactions

Concurrent treatment with insulin or other anti-diabetic agents may increase the risk of hypoglycemia. Other medications that may interact with Increlex include corticosteroids, estrogens, and thyroid hormones.

Dosage and Administration

Increlex should be administered subcutaneously twice daily. The dosage should be individualized for each patient based on body weight and serum IGF-1 concentrations.

Precautions

Patients should be monitored closely for signs of hypoglycemia, especially at the initiation of Increlex therapy. Increlex should be used with caution in patients with a history of malignant neoplasia.

References

• Increlex (mecasermin [rDNA origin]) Injection. Tercica, Inc. 2005.
• Rosenfeld RG, Wilson DM, Lee PD, et al. Insulin-like growth factors I and II in evaluation of growth retardation. J Pediatr. 1986;109(3):428-433.

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