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These are rare at the doses used in supervised clinical care and when they occur, they're typically mild and transient

The two key modifications Arg substitution and the MFPAMPLSSLFVNG N-terminal extension dramatically reduce binding to IGF-binding proteins (IGFBPs), extending plasma half-life from ~10 minutes (native IGF-1) to 2030 hours while increasing potency at the IGF-1 receptor