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However, reduced ERK (Extracellular signal-regulated kinases) phosphorylation in GNE deficient cells after IGF-1 treatment suggests downregulation of the ERK pathway

However, this method is debated as it can cause partial reactions

In a follow up study, Gulmez et al[87] analyzed all the cases of individuals on the transplant registry and identified those that had drug overdose with resultant liver failure

Extended 15-year follow-up studies showed that treatment prevented age-related impairment of physical endurance, normalized circadian rhythm of melatonin production, and improved carbohydrate and lipid metabolism markers