Fortunately this assessment appears to be overly pessimistic.
Phase 3 of the Sprifermin trial is ongoing, and researchers envision public access to this treatment soon. [R]
I can also report that I have overcome the hurdles and obtained FGF-18, basically using the techniques you mention above. The homemade sprifermin also includes sucrose (5%), poloxamer 188 (0.1%) and phosphate-buffered saline. That's the most I've ever paid for sugar, but I didn't want to take any chances with impurities. Each dose is 2 mL with 100 µg FGF-18.
When you dig into the clinical trials you find that the more successful protocol actually consisted of a series of three injections of 100 µg each, separated by one-week intervals, and repeated every six months for two years. This makes the cost higher than suggested above, over $1,000 for each set of three injections.
The injections themselves are nearly painless, at least with the help of 10 mg of subcutaneous lidocaine at the point of entry. The tricky part is in the preparation—getting a sterile end-product with minimal waste of the expensive material. One issue is that a 0.22 µm filter can trap up to a milliliter of fluid. To get the cost down you can order a larger quantity of FGF-18, but this means dividing into aliquots and freezing the extra. Then you have to worry about stability if you don't have an expensive -80 °C freezer. I'm making do with a $300 -40 °C freezer.
In any case, my first injection was over a month ago, basically a test to see if it was doable. Except for a small amount of lost product it went smoothly. It could easily be a coincidence, but after two to three weeks there was a substantial reduction in discomfort in the joint. More recently this improvement started to reverse. There was a long delay in getting the second order of FGF-18, which is why the second injection wasn't done until this past week. I haven't decided whether to now do a new complete series of three weekly injections, or instead to count the one last month and only do two now. In either case I will do the next series in four months instead of six.
To possibly aid in cartilage growth I switched from iparmorelin (300 µg) to ibutamoren (10 mg). As reported elsewhere, I've also phased out my use of enclomiphene, which should contribute to higher IGF-1. My last measurement of this was some years back and was on the low side. I have a requisition to recheck and make sure it has not overshot and gone too high for my comfort.
I will continue to provide updates on occasion. It's probably wise to temper expectations in my case. The progression to medial bone-on-bone contact means that I would not have even qualified for the sprifermin clinical trials. Nonetheless, I am hopeful that even limited cartilage growth in the joint results in reduced discomfort and avoidance of a joint replacement.
