Sermorelin acetate, a synthetic form of human growth-hormone-releasing factor has been approved by the FDA for treatment of idiopathic growth hormone deficiency in children with growth failure.

Mecasermin (Increlex - Tercica), which is injected subcutaneously, has been approved by the FDA for treatment of growth failure in children with severe primary insulin-like growth factor (IGF-1) deficiency. Mecasermin is recombinant human (rh) IGF-1. It has also been approved to treat children with short stature who are deficient in growth hormone (GH), but have developed neutralizing antibodies in response to GH treatment. A similar product, mecasermin rinfabate (Iplex - Insmed), that was approved by the FDA for the same indications was withdrawn from the market due to patent...

Growth hormone has been in the news recently because of accusations of criminal misconduct in some marketing and prescribing practices (G Kolata, New York Times, August 15, 1994, page 1). The high cost of the drug and its widespread use for unauthorized indications apparently were contributing factors.

Lonapegsomatropin-tcgd (Skytrofa – Ascendis), a long-acting prodrug of recombinant human growth hormone (rhGH), has been approved by the FDA for once-weekly subcutaneous (SC) treatment of growth failure due to inadequate secretion of endogenous growth hormone in children ≥1 year old who weigh ≥11.5 kg. It is the first once-weekly rhGH product to be approved in the US; other available rhGH formulations are administered more frequently.

The FDA has approved Humatrope, Lilly's brand of recombinant human growth hormone (somatropin), for long-term treatment of children with idiopathic, non-growth-hormone-deficient (NGHD) short stature who are more than 2.25 standard deviations below the mean height for their age and sex. This review describes the clinical studies, adverse effects, and includes a cost table for other brands of somatropin.

Becaplermin (be kap' ler min; Regranex - Ortho-McNeil), a 0.01% topical gel formulation of recombinant human platelet-derived growth factor (rhPDGF), was recently approved by the FDA for adjunctive treatment of diabetic ulcers of the lower extremities that extend subcutaneously or beyond and have an adequate blood supply. Endogenous platelet-derived growth factor increases proliferation of cells that repair wounds and form granulation tissue.

Correction: Cost of Genotropin: A reader has pointed out that The Medical Letter article on Growth Hormone for Normal Short Children (Medical Letter 2003, volume 45, page 89) underestimated the annual cost of Genotropin (Pfizer) because the Genotropin Pen 5 Delivery Device that is used with 5.8-mg cartridges is designed to deliver 5.0 mg of the drug. The annual cost of Genotropin in our November 10, 2003 article should have been $22,625.

A new needle-free system (cool.click) has been approved by the FDA for subcutaneous delivery of Saizen (recombinant somatotropin - Serono). Somatotropin is used for long-term treatment of children with growth failure due to inadequate secretion of endogenous growth hormone. Children with growth hormone deficiency require injections daily or several times weekly for many years.

The FDA has approved tesamorelin (Egrifta – EMD Serono), an injectable synthetic analog of growth-hormone- releasing factor (GRF), for reduction of excess abdominal fat in patients with lipodystrophy associated with HIV infection. Growth hormone (somatropin – Serostim; EMD Serono) has been available for years for treatment of HIV wasting.

The FDA has approved pegvisomant (Somavert Pfizer), a growth hormone receptor antagonist, for parenteral treatment of acromegaly in patients who are not candidates for or have had an inadequate response to surgery or other treatment. This review describes the disease of acromegaly and its standard treatment options. Also included are sections on the mechanism of action, pharmacokinetics, adverse effects, drug interactions, and the dosage and cost of pegvisomant. Results of clinical studies are discussed. The conclusion provides an overall assessment of the prospects for this new drug.