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Native IGF-1 (mecasermin) has been through the full regulatory pipeline: dose-ranging studies, controlled trials in the target population, characterized pharmacokinetics, a defined adverse-event profile, and ongoing post-marketing surveillance

Disrupted iron metabolism, particularly iron accumulation in joint tissues, contributes to oxidative damage and inflammation, suggesting a potential link to disease progression

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Protective treatment approaches aimed at restoring the NADH/NAD ratio also include increasing flux to parallel pathways such as the pentose phosphate pathway [57, 70], Krebs cycle (TCA) and oxidative phosphorylation (Fig