Treatment of severe primary IGF-1 deficiency using rhIGF-1 preparation – first three years of Polish experience

02.03.2019

Elżbieta Petriczko, Tomasz Jackowski, Anita Horodnicka-Józwa, Beata Wikiera, Anna Noczyńska, Maria Korpal-Szczyrska, Dorota Birkholz-Walerzak, Ewa Małecka-Tendera, Barbara Kalina-Fraska, Maria Kalina, Ewa Barg, Iwona Beń-Skowronek, Leszek Szewczyk, Maciej Hilczer, Joanna Smyczyńska, Renata Stawerska, Andrzej Lewiński, Katarzyna Ziora, Artur Bossowski, Edyta Pietrewicz, Beata Pyrżak, Andrzej Kędzia, Mieczysław Szalecki, Agnieszka Kilian, Mieczysław Walczak

Abstract

Introduction: The objective of this study was to analyse the effects of the first three years of treatment with recombinant human insulinlike growth factor 1 (rhIGF-1) in patients from the Polish population.

Material and methods: Twenty-seven children (22 boys and five girls) aged 2.8 to 16.0 years old were qualified for treatment with rhIGF-1 (mecasermin) in different treatment centres, according to Polish criteria: body height below –3.0 SD and IGF-1 concentration below percentile 2.5 with normal growth hormone (GH) levels. Mecasermin initial dose was 40 μg/kg bw twice a day and was subsequently increased to an average of 100 μg/kg bw twice a day. Body height, height velocity, weight, body mass index (BMI), and adverse events were measured.

Results: Mecasermin treatment resulted in a statistically significant increase in body height (1.45 ± 1.06 SD; p < 0.01) and height velocity in comparison with pre-treatment values. The biggest change in height velocity happened during the first year and diminished during subsequent years. Body weight and BMI also increased significantly after treatment (1.16 ± 0.76 SD and 0.86 ± 0.75 SD, respectively; p < 0.01). Eight patients reported adverse events. These were mild and temporary and did not require treatment modification except in two patients.

Conclusions: Treatment with rhIGF-1 was effective and safe in Polish patients with primary IGF-1 deficiency. It had a clear beneficial effect on the height of the patients and significantly accelerated the height velocity, particularly in the first year of treatment.

Keywords: insulin-like growth factor-1 (IGF-1); growth hormone insensitivity; IGF-1 deficiency; short stature; growth-promoting therapy; mecasermin; Poland

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