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Arbouche N, Blanchot A, Raul JS, Kintz P. Semaglutide and health risk: Development and validation of a LC-HRMS method for testing semaglutide in whole blood and application to real cases. J Chromatogr B Analyt Technol Biomed Life Sci 2024; 1242:124187. [PMID: 38880054 DOI: 10.1016/j.jchromb.2024.124187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/21/2024] [Accepted: 05/30/2024] [Indexed: 06/18/2024]
Abstract
The use of semaglutide, also known by its trade name Ozempic®, has been increasing worldwide in recent years due to its benefits in treating type II diabetes. Thanks to its effects on appetite regulation, in many countries it is also used to treat obesity. However, due to its promotion by social media and celebrities as a weight-loss treatment, semaglutide is misused by a non-diabetic and non-obese population and by a young public, which is the main target of these media. Following the alert by the ANSM (Agence nationale de sécurité du médicament) in France and the FDA (Food and Drug Administration) in the United States, which imposed the addition of fatal effects to the list of side effects, the misuse of semaglutide seems to be becoming a public health problem. For this reason, it seems important that a toxicology laboratory has the capacity to test for semaglutide in blood. In this study, the authors have developed and validated a method for the identification and quantification of semaglutide in whole blood using a LC-HRMS. After the addition of the internal standard (bovine insulin), the blood was subjected to protein precipitation using a mix of acetonitrile/methanol (70:30,v:v). The validation procedure demonstrated an acceptable linearity between 2 and 500 ng/mL. LOD and LOQ were 1 and 2 ng/mL, respectively. Intra and inter-day precision were below 20 % at three concentrations. The method was successfully applied to the blood samples of 3 diabetic patients under treatment of semaglutide. The samples tested positive with concentrations ranging from 31 to 70 ng/mL which fall within the limits of therapeutic blood concentrations described in the literature.
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Affiliation(s)
- N Arbouche
- Institut de médecine légale, 11 rue Humann, 67000 Strasbourg, France.
| | - A Blanchot
- Institut de médecine légale, 11 rue Humann, 67000 Strasbourg, France
| | - J S Raul
- Institut de médecine légale, 11 rue Humann, 67000 Strasbourg, France
| | - P Kintz
- Institut de médecine légale, 11 rue Humann, 67000 Strasbourg, France; X-Pertise Consulting, 42 rue principale, 67206 Mittelhausbergen, France
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2
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Yang XD, Yang YY. Clinical Pharmacokinetics of Semaglutide: A Systematic Review. Drug Des Devel Ther 2024; 18:2555-2570. [PMID: 38952487 PMCID: PMC11215664 DOI: 10.2147/dddt.s470826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/18/2024] [Indexed: 07/03/2024] Open
Abstract
Purpose The aim of this review was to provide all the pharmacokinetic data for semaglutide in humans concerning its pharmacokinetics after subcutaneously and oral applications in healthy and diseased populations, to provide recommendations for clinical use. Methodology The PubMed and Embase databases were searched to screen studies associated with the pharmacokinetics of semaglutide. The pharmacokinetic parameters included area under the curve plasma concentrations (AUC), maximal plasma concentration (Cmax), time to Cmax, half-life (t1/2), and clearance. The systematic literature search retrieved 17 articles including data on pharmacokinetic profiles after subcutaneously and oral applications of semaglutide, and at least one of the above pharmacokinetic parameter was reported in all included studies. Results Semaglutide has a predictable pharmacokinetic profile with a long t1/2 that allows for once-weekly subcutaneous administration. The AUC and Cmax of both oral and subcutaneous semaglutide increased with dose. Food and various dosing conditions including water volume and dosing schedules can affect the oral semaglutide exposure. There are limited drug-drug interactions and no dosing adjustments in patients with upper gastrointestinal disease, renal impairment or hepatic impairment. Body weight may affect semaglutide exposure, but further studies are needed to confirm this. Conclusion This review encompasses all the pharmacokinetic data for subcutaneous and oral semaglutide in both healthy and diseased participants. The existing pharmacokinetic data can assist in developing and evaluating pharmacokinetic models of semaglutide and will help clinicians predict semaglutide dosages. In addition, it can also help optimize future clinical trials.
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Affiliation(s)
- Xi-Ding Yang
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China
- Phase I Clinical Trial Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China
| | - Yong-Yu Yang
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China
- Hunan Provincial Engineering Research Central of Translational Medical and Innovative Drug, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China
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Niu H, Zhou M, Ji A, Zogona D, Wu T, Xu X. Molecular Mechanism of Pasteurized Akkermansia muciniphila in Alleviating Type 2 Diabetes Symptoms. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2024; 72:13083-13098. [PMID: 38829529 DOI: 10.1021/acs.jafc.4c01188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Type 2 diabetes (T2DM) significantly diminishes people's quality of life and imposes a substantial economic burden. This pathological progression is intimately linked with specific gut microbiota, such as Akkermansia muciniphila. Pasteurized A. muciniphila (P-AKK) has been defined as a novel food by the European Food Safety Authority and exhibited significant hypoglycemic activity. However, current research on the hypoglycemic activity of P-AKK is limited to the metabolic level, neglecting systematic exploration at the pathological level. Consequently, its material basis and mechanism of action for hypoglycemia remain unclear. Drawing upon this foundation, we utilized high-temperature killed A. muciniphila (H-K-AKK) with insignificant hypoglycemic activity as the control research object. Assessments were conducted at pathological levels to evaluate the hypoglycemic functions of both P-AKK and H-K-AKK separately. Our study unveiled for the first time that P-AKK ameliorated symptoms of T2DM by enhancing the generation of glucagon-Like Peptide 1 (GLP-1), with pasteurized A. muciniphila total proteins (PP) being a pivotal component responsible for this activity. Utilizing SDS-PAGE, proteomics, and molecular docking techniques, we deeply analyzed the material foundation of PP. We scientifically screened and identified a protein weighing 77.85 kDa, designated as P5. P5 enhanced GLP-1 synthesis and secretion by activating the G protein-coupled receptor (GPCR) signaling pathway, with free fatty acid receptor 2 (FFAR-2) being identified as the pivotal target protein for P5's physiological activity. These findings further promote the widespread application of P-AKK in the food industry, laying a solid theoretical foundation for its utilization as a beneficial food ingredient or functional component.
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Affiliation(s)
- Huifang Niu
- Key Laboratory of Environment Correlative Dietology (Ministry of Education), Hubei Key Laboratory of Fruit Vegetable Processing Quality Control (Huazhong Agricultural University), School of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, PR China
| | - Minfeng Zhou
- Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, PR China
| | - Anying Ji
- Key Laboratory of Environment Correlative Dietology (Ministry of Education), Hubei Key Laboratory of Fruit Vegetable Processing Quality Control (Huazhong Agricultural University), School of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, PR China
| | - Daniel Zogona
- Department of Food & Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada
| | - Ting Wu
- Key Laboratory of Environment Correlative Dietology (Ministry of Education), Hubei Key Laboratory of Fruit Vegetable Processing Quality Control (Huazhong Agricultural University), School of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, PR China
| | - Xiaoyun Xu
- Key Laboratory of Environment Correlative Dietology (Ministry of Education), Hubei Key Laboratory of Fruit Vegetable Processing Quality Control (Huazhong Agricultural University), School of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, PR China
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4
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Mahzari MM, Alluhayyan OB, Almutairi MH, Bayounis MA, Alrayani YH, Omair AA, Alshahrani AS. Safety and efficacy of semaglutide in post kidney transplant patients with type 2 diabetes or Post-Transplant diabetes. J Clin Transl Endocrinol 2024; 36:100343. [PMID: 38623181 PMCID: PMC11016780 DOI: 10.1016/j.jcte.2024.100343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024] Open
Abstract
Objective Type 2 diabetes mellitus (T2DM) and post-transplant diabetes mellitus (PTDM) are common in renal transplant recipients. Semaglutide has demonstrated efficacy and safety in patients with T2DM. To date, only a limited number of studies have investigated its use in renal transplant patients. This study assessed the safety and efficacy of semaglutide in post-renal transplant patients. Methods A retrospective study was conducted at king Abdulaziz Medical City-Riyadh, Saudi Arabia. The subjects of the study were adults and adolescents (>14 years) who had undergone a kidney transplant and had pre-existing T2DM or PTDM. The study subjects were given semaglutide during the study period, from January 2018 to July 2022. The data were collected over a period of 18 months. Results A total of 39 patients were included, 29 (74 %) of whom were male. A significant decrease in hemoglobin A1c (HbA1c) was observed during the follow-up period when compared to baseline (8.4 %±1.3 % at baseline vs. 7.4 %±1.0 % at 13-18 months (p < 0.001). A significant reduction in weight was also noted at follow-up as compared to baseline (99.5 kg ± 17.7 vs 90.7 kg ± 16.8 at 13-18 months (p < 0.001). No significant changes were found in renal graft function markers. Conclusion Semaglutide was found to significantly reduce HbA1c levels and weight in post renal transplant patients with diabetes. No significant changes in markers of renal graft function were observed.
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Affiliation(s)
- Moeber Mohammed Mahzari
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 22490, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Ministry of National Guard-Health Affairs, Riyadh 14611, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Omar Buraykan Alluhayyan
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Ministry of National Guard-Health Affairs, Riyadh 14611, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Mahdi Hamad Almutairi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 22490, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Mohammed Abdullah Bayounis
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 22490, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Yazeed Hasan Alrayani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 22490, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Amir A. Omair
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 22490, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Awad Saad Alshahrani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 22490, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Ministry of National Guard-Health Affairs, Riyadh 14611, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
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Urva S, Levine JA, Schneck K, Tang CC. Model-based simulation of glycaemic effect and body weight loss when switching from semaglutide or dulaglutide to once weekly tirzepatide. Curr Med Res Opin 2024; 40:567-574. [PMID: 38407177 DOI: 10.1080/03007995.2024.2322072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/19/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE To evaluate the efficacy endpoints of HbA1c and body weight loss after switching from the GLP-1 receptor agonists, semaglutide or dulaglutide, to treatment with the GIP/GLP-1 receptor agonist (RA) tirzepatide. METHODS Models were developed and validated to describe the HbA1c and weight loss time course for semaglutide (SUSTAIN 1-10), dulaglutide (AWARD-11) and tirzepatide (SURPASS 1-5, phase 3 global T2D program). The impact of switching from once weekly GLP-1 RAs to tirzepatide was described by simulating the efficacy time course. Semaglutide and dulaglutide doses were escalated in accordance with their respective labels. RESULTS Model-predicted mean decreases from baseline in HbA1c and body weight for semaglutide 0.5 mg, 1 mg, and 2 mg were 1.22 to 1.79% and 3.62 to 6.87 kg respectively, at Week 26. Model-predicted mean decreases from baseline in HbA1c and body weight for dulaglutide 1.5 mg, 3 mg and 4.5 mg were 1.53 to 1.84% and 2.55 to 3.71 kg respectively, at Week 26. After switching to tirzepatide 5, 10 and 15 mg HbA1c reductions were predicted to range between 1.95 to 2.46% and body weight reductions between 6.50 to 12.1 kg by Week 66. CONCLUSION In this model-based simulation, switching from approved maintenance doses of semaglutide or dulaglutide to tirzepatide, even at the lowest approved maintenance dose of 5 mg, showed the potential to further improve HbA1c and body weight reductions.
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Affiliation(s)
- Shweta Urva
- Global PK/PD & Pharmacometrics, Eli Lilly and Company, Indianapolis, IN, USA
| | - Joshua A Levine
- Diabetes and Obesity Global Medical Affairs, Eli Lilly and Company, Indianapolis, IN, USA
| | - Karen Schneck
- Pharmacometrics & QSP, Eli Lilly and Company, Indianapolis, IN, USA
| | - Cheng Cai Tang
- Clinical Pharmacology Modeling and Simulation (CPMS), Parexel International, Singapore
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Mariam Z, Niazi SK. Glucagon-like peptide agonists: A prospective review. Endocrinol Diabetes Metab 2024; 7:e462. [PMID: 38093651 PMCID: PMC10782143 DOI: 10.1002/edm2.462] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/03/2023] [Accepted: 11/19/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as promising therapeutic options for addressing Type-2 diabetes, obesity, and related conditions. Among these, semaglutide, tirzepatide, liraglutide etc., all notable GLP-1RA, have gained attention owing to their favourable pharmacological properties and clinical efficacy. AIMS This comprehensive review aims to provide a detailed analysis of both the currently available GLP-1RAs in the market and those undergoing clinical trials. The focus is on examining their mechanism of action, pharmacokinetics, efficacy in glycemic control and weight management, safety profile, and potential applications. MATERIALS & METHODS The review employs a systematic approach to gather information on GLP-1RAs. Relevant literature from the currently literature and ongoing clinical trials is thoroughly examined. Detailed scrutiny is applied to understand the mechanism of action, pharmacokinetic properties, and clinical outcomes of these agents. RESULTS The review presents a comprehensive overview of the GLP-1RAs, highlighting their distinct mechanisms of action, pharmacokinetic profiles, and clinical effectiveness in glycemic control and weight management. Safety profiles are also discussed, providing a holistic understanding of these therapeutic agents. DISCUSSION The findings are discussed in the context of advancements in the field of GLP-1RAs. Potential applications beyond diabetes and obesity are explored, shedding light on the broader implications of these agents in managing related conditions. CONCLUSION In conclusion, this review underscores the significance of GLP-1RAs, with a specific focus on semaglutide, in the management of type 2 diabetes, obesity, and beyond. By synthesizing information on their mechanisms, pharmacokinetics, efficacy, and safety, this review provides valuable insights into the potential benefits these agents offer, contributing to the ongoing discourse in the field.
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Derdau V, Elmore CS, Hartung T, McKillican B, Mejuch T, Rosenbaum C, Wiebe C. The Future of (Radio)-Labeled Compounds in Research and Development within the Life Science Industry. Angew Chem Int Ed Engl 2023; 62:e202306019. [PMID: 37610759 DOI: 10.1002/anie.202306019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/23/2023] [Accepted: 08/23/2023] [Indexed: 08/24/2023]
Abstract
In this review the applications of isotopically labeled compounds are discussed and put into the context of their future impact in the life sciences. Especially discussing their use in the pharma and crop science industries to follow their fate in the environment, in vivo or in complex matrices to understand the potential harm of new chemical structures and to increase the safety of human society.
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Affiliation(s)
- Volker Derdau
- Sanofi-Aventis Deutschland GmbH, Research & Development, Integrated Drug Discovery, Isotope Chemistry, Industriepark Höchst, G876, 65926, Frankfurt am Main, Germany
| | - Charles S Elmore
- Early Chemical Development, Pharmaceutical Sciences, R&D, AstraZeneca, Mölndal, Sweden
| | - Thomas Hartung
- Pharma Research and Early Development, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Bruce McKillican
- Syngenta Crop Protection, LLC, North America Product Safety (retired), USA
| | - Tom Mejuch
- BASF SE, Agricultural Solutions, Ludwigshafen, Germany
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8
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d'Aquino AI, Maikawa CL, Nguyen LT, Lu K, Hall IA, Jons CK, Kasse CM, Yan J, Prossnitz AN, Chang E, Baker SW, Hovgaard L, Steensgaard DB, Andersen HB, Simonsen L, Appel EA. Use of a biomimetic hydrogel depot technology for sustained delivery of GLP-1 receptor agonists reduces burden of diabetes management. Cell Rep Med 2023; 4:101292. [PMID: 37992687 PMCID: PMC10694761 DOI: 10.1016/j.xcrm.2023.101292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 08/02/2023] [Accepted: 10/23/2023] [Indexed: 11/24/2023]
Abstract
Glucagon-like peptide-1 (GLP-1) is an incretin hormone and neurotransmitter secreted from intestinal L cells in response to nutrients to stimulate insulin and block glucagon secretion in a glucose-dependent manner. Long-acting GLP-1 receptor agonists (GLP-1 RAs) have become central to treating type 2 diabetes (T2D); however, these therapies are burdensome, as they must be taken daily or weekly. Technological innovations that enable less frequent administrations would reduce patient burden and increase patient compliance. Herein, we leverage an injectable hydrogel depot technology to develop a GLP-1 RA drug product capable of months-long GLP-1 RA delivery. Using a rat model of T2D, we confirm that one injection of hydrogel-based therapy sustains exposure of GLP-1 RA over 42 days, corresponding to a once-every-4-months therapy in humans. Hydrogel therapy maintains management of blood glucose and weight comparable to daily injections of a leading GLP-1 RA drug. This long-acting GLP-1 RA treatment is a promising therapy for more effective T2D management.
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Affiliation(s)
- Andrea I d'Aquino
- Department of Materials Science & Engineering, Stanford University, Stanford, CA 94025, USA
| | - Caitlin L Maikawa
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA
| | - Leslee T Nguyen
- Department of Biochemistry, Stanford University, Palo Alto, CA 94305, USA
| | - Katie Lu
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Ian A Hall
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA
| | - Carolyn K Jons
- Department of Materials Science & Engineering, Stanford University, Stanford, CA 94025, USA
| | - Catherine M Kasse
- Department of Materials Science & Engineering, Stanford University, Stanford, CA 94025, USA
| | - Jerry Yan
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA
| | - Alexander N Prossnitz
- Department of Materials Science & Engineering, Stanford University, Stanford, CA 94025, USA
| | - Enmian Chang
- Department of Materials Science & Engineering, Stanford University, Stanford, CA 94025, USA
| | - Sam W Baker
- Department of Comparative Medicine, Stanford University, Palo Alto, CA 94305, USA
| | - Lars Hovgaard
- Department of Biophysics and Formulations, Global Research Technologies, Novo Nordisk Park, 2760 Maaloev, Denmark
| | - Dorte B Steensgaard
- Department of Biophysics and Formulations, Global Research Technologies, Novo Nordisk Park, 2760 Maaloev, Denmark
| | - Hanne B Andersen
- Department of Biophysics and Formulations, Global Research Technologies, Novo Nordisk Park, 2760 Maaloev, Denmark
| | - Lotte Simonsen
- Department of Obesity Research, Global Drug Discovery, Novo Nordisk Park, 2760 Maaloev, Denmark
| | - Eric A Appel
- Department of Materials Science & Engineering, Stanford University, Stanford, CA 94025, USA; Department of Bioengineering, Stanford University, Stanford, CA 94305, USA; ChEM-H Institute, Stanford University, Stanford, CA 94305, USA; Department of Pediatrics (Endocrinology), Stanford University, Stanford, CA 94305, USA; Woods Institute for the Environment, Stanford University, Stanford, CA 94305, USA.
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9
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He MM, Zhu SX, Cannon JR, Christensen JK, Duggal R, Gunduz M, Hilgendorf C, Hughes A, Kekessie I, Kullmann M, Leung D, Terjung C, Wang K, Wesche F. Metabolism and Excretion of Therapeutic Peptides: Current Industry Practices, Perspectives, and Recommendations. Drug Metab Dispos 2023; 51:1436-1450. [PMID: 37591731 DOI: 10.1124/dmd.123.001437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 08/19/2023] Open
Abstract
Therapeutic peptides (TPeps) have expanded from the initial endogenous peptides to complex modified peptides through medicinal chemistry efforts for almost a century. Different from small molecules and large proteins, the diverse submodalities of TPeps have distinct structures and carry different absorption, distribution, metabolism, and excretion (ADME) properties. There is no distinct regulatory guidance for the industry on conducting ADME studies (what, how, and when) for TPeps. Therefore, the Peptide ADME Working Group sponsored by the Translational and ADME Sciences Leadership Group of the International Consortium for Innovation and Quality in Pharmaceutical Development (IQ) was formed with the goal to develop a white paper focusing on metabolism and excretion studies to support discovery and development of TPeps. In this paper, the key learnings from an IQ industry survey and U.S. Food and Drug Administration/European Medicines Agency submission documents of TPeps approved between 2011 and 2022 are outlined in detail. In addition, a comprehensive assessment of in vitro and in vivo metabolism and excretion studies, mitigation strategies for TPep metabolism, analytical tools to conduct studies, regulatory status, and Metabolites in Safety Testing considerations are provided. Finally, an industry recommendation on conducting metabolism and excretion studies is proposed for regulatory filing of TPeps. SIGNIFICANCE STATEMENT: This white paper presents current industry practices for metabolism and excretion studies of therapeutic peptides based on an industry survey, regulatory submission documents, and expert opinions from the participants in the Peptide Absorption, Distribution, Metabolism, and Excretion Working Group of the International Consortium for Innovation and Quality in Pharmaceutical Development. The group also provides recommendations on the Metabolites in Safety Testing considerations and metabolism and excretion studies for regulatory filing of therapeutic peptides.
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Affiliation(s)
- Minxia Michelle He
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
| | - Sean Xiaochun Zhu
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
| | - Joe R Cannon
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
| | - Jesper Kammersgaard Christensen
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
| | - Ruchia Duggal
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
| | - Mithat Gunduz
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
| | - Constanze Hilgendorf
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
| | - Adam Hughes
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
| | - Ivy Kekessie
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
| | - Maximilian Kullmann
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
| | - Dennis Leung
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
| | - Carsten Terjung
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
| | - Kai Wang
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
| | - Frank Wesche
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana (M.M.H.); Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts (S.X.Z.); Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb, Princeton, New Jersey (J.R.C.); Development ADME, Novo Nordisk A/S, Måløv, Denmark (J.K.C.); Preclinical Development ADME, Merck & Co., Boston, Massachusetts (R.D.); PK Sciences/Global Biotransformation, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts (M.G.); DMPK, Research and Early Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden (C.H.); Discovery Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Stevenage, United Kingdom (A.H.); Early Discovery Biochemistry, Genentech, Inc., South San Francisco, California (I.K.); Drug Metabolism and Pharmacokinetics, Bayer AG, Wuppertal, Germany (M.K., C.T.); Small Molecule Pharmaceutical Sciences, Genentech, Inc., South San Francisco, California (D.L.); Translational PK/PD and Investigative Toxicology, Janssen Research & Development, San Diego, California (K.W.); and Department of Drug Discovery Sciences, Discovery Science Technology Group, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach a.d. Riss, Germany (F.W.)
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10
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García de Lucas MD, Caballero I, Fernández-García JC, Domínguez-Rodríguez M, Moreno-Moreno P, Jiménez-Millán A, Botana-López M, Avilés B, Merino-Torres JF, Soto A, Tejera C, Morales C. Influence of chronic kidney disease and its severity on the efficacy of semaglutide in type 2 diabetes patients: a multicenter real-world study. Front Endocrinol (Lausanne) 2023; 14:1240279. [PMID: 37955013 PMCID: PMC10634592 DOI: 10.3389/fendo.2023.1240279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/03/2023] [Indexed: 11/14/2023] Open
Abstract
Objectives Semaglutide is a glucagon-like peptide 1 receptor agonist that improves glycemic control and achieves weight loss in type 2 diabetes (T2D) patients. Subcutaneous (s.c.) semaglutide at 1 mg once weekly (OW) is safe in T2D patients with chronic kidney disease (CKD). Whether or not CKD and its severity influence treatment response remains undetermined. Method This is an observational, ambispective, multicenter, nationwide, real-world study designed to compare safety/efficacy of OW s.c. 1 mg semaglutide in T2D patients with or without CKD. The influence of CKD severity was also addressed. Patients were followed up for 12 months. Primary end-points were glycosylated hemoglobin (HbA1c), weight, and renal outcomes. Secondary end-points included insulin resistance, atherogenic and hepatic steatosis indexes, and changes in antihyperglycemic medications. Results A total of 296 and 190 T2D patients without or with CKD, respectively, were recruited. Baseline CKD risk was moderate, high, or very high in 82, 53, and 45 patients, respectively. Treatment reduced HbA1c by 0.90%-1.20%. Relevant differences were seen neither between non-CKD and CKD patients nor among CKD subgroups. Notable weight losses were achieved in both non-CKD and CKD patients. The median reduction was higher in the former at 6 months (5.90 kg vs. 4.50 kg, P = 0.008) and at end of study (6.90 kg vs. 5.00 kg, P = 0.087). A trend toward slightly lower weight losses as CKD severity increased was observed. CKD markers improved across all CKD subgroups. Relevant differences were not observed for other variables, either between non-CKD and CKD patients, or among CKD subgroups. Safety concerns were not reported. Conclusion The safety/efficacy of OW s.c. semaglutide to improve glycemic control and weight in T2D patients with CKD is not notably lower than that in T2D patients without renal failure. CKD severity barely influences treatment response. OW s.c. semaglutide can be useful to manage T2D patients with CKD in daily clinical practice.
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Affiliation(s)
| | - Irene Caballero
- Endocrinology and Nutrition Department, Virgen Macarena University Hospital, Sevilla, Spain
| | | | | | - Paloma Moreno-Moreno
- Endocrinology and Nutrition Department, Reina Sofía University Hospital, Córdoba, Spain
| | - Anabel Jiménez-Millán
- Endocrinology and Nutrition Department, University Hospital, Puerto Real, Cádiz, Spain
| | - Manuel Botana-López
- Endocrinology and Nutrition Department, Lucus Augusti University Hospital, Lugo, Spain
| | - Beatriz Avilés
- Nephrology Department, Regional University Hospital, Málaga, Spain
| | | | - Alfonso Soto
- Endocrinology and Nutrition Department, A Coruña University Hospital Complex, A Coruña, Spain
| | - Cristina Tejera
- Endocrinology and Nutrition Department, Hospital Básico da Defensa, Ferrol, A Coruña, Spain
| | - Cristóbal Morales
- Endocrinology and Nutrition Department, Virgen Macarena University Hospital, Sevilla, Spain
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11
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Kildemoes RJ, Backeljauw PF, Højby M, Blair JC, Miller BS, Mori J, Lyauk YK. Model-Based Analysis of IGF-I Response, Dosing, and Monitoring for Once-Weekly Somapacitan in Children With GH Deficiency. J Endocr Soc 2023; 7:bvad115. [PMID: 37818403 PMCID: PMC10561011 DOI: 10.1210/jendso/bvad115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Indexed: 10/12/2023] Open
Abstract
Context Growth hormone (GH) replacement therapy improves longitudinal growth and adult height in children with GH deficiency (GHD). GH stimulates insulin-like growth factor (IGF)-I release, the biomarker used for monitoring GH activity during treatment. Objective This study aims to provide model-based insights into the dose-IGF-I responses of once-weekly somapacitan, a novel long-acting GH, compared with daily GH in children with GHD. Methods Analyses included dosing information and 1473 pharmacokinetic samples from 210 somapacitan-treated pediatric patients with GHD across 3 trials, including phase 1 (NCT01973244), phase 2 (NCT02616562; REAL 3), and phase 3 (NCT03811535; REAL 4), as well as 1381 IGF-I samples from 186 patients with GHD treated with somapacitan in REAL 3 and REAL 4. Pharmacokinetic/pharmacodynamic modeling to characterize somapacitan dose-IGF-I response and predict the response to dosing day changes. Results Relationships were established between somapacitan dose, exposure, change from baseline IGF-I SD score (SDS), and height velocity (HV). A linear model permitted the development of a tool to calculate estimated average weekly IGF-I exposure from a single IGF-I sample obtained at any time within the somapacitan dosing interval at steady state. In practice, the use of this tool requires knowledge of somapacitan injection timing relative to IGF-I sample collection timing. IGF-I SDS simulations support flexible dosing day changes while maintaining at least 4 days between doses. Conclusion We characterized the dose-IGF-I response of somapacitan in children with GHD. To support physicians in IGF-I monitoring, we present a practical guide about expected weekly average IGF-I concentrations in these patients and provide insights on dosing day flexibility.
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Affiliation(s)
| | - Philippe F Backeljauw
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Michael Højby
- Clinical Drug Development, Novo Nordisk A/S, Søborg 2860, Denmark
| | - Joanne C Blair
- Department of Endocrinology, Alder Hey Children's NHS Foundation Trust, Liverpool L14 5AB, UK
| | - Bradley S Miller
- Division of Pediatric Endocrinology, University of Minnesota Medical School, MHealth Fairview Masonic Children’s Hospital, Minneapolis, MN 55454, USA
| | - Jun Mori
- Division of Pediatric Endocrinology and Metabolism, Children's Medical Center, Osaka City General Hospital, Osaka, 534-0021, Japan
| | - Yassine K Lyauk
- Clinical Drug Development, Novo Nordisk A/S, Søborg 2860, Denmark
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12
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Zino L, Tack CJ, Richel O, Burger DM. GLP-1 agonists for people living with HIV and obesity, is there a potential? HIV Med 2023; 24:1029-1034. [PMID: 37340561 DOI: 10.1111/hiv.13521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/09/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Obesity trends and metabolic dysregulation are rising in people living with HIV using antiretrovirals (ARVs). Underlying causes and preventive strategies are being investigated. Two glucagon like-peptide 1 (GLP-1) agonists, liraglutide and semaglutide, were formerly approved as glucose-lowering drugs and have been recently approved for long-term weight loss in people with obesity. Due to the lack of therapeutic guidelines or clinical trials in people with HIV, we discuss the potential benefits, safety aspects and pharmacological considerations of prescribing liraglutide and semaglutide in people with HIV. RESULTS Clinical experience is limited to two clinical cases of diabetic people with HIV using liraglutide after which a successful weight loss and glycaemic control were observed. None of the adverse events associated with liraglutide and semaglutide usage indicate an additional risk for people with HIV. Extra caution showed be warranted when initiating GLP-1 agonist therapy in people with HIV taking protease inhibitors who have pre-existing risk factors for heart rate variability to reduce the incidence of RP interval prolongation. GLP-1 agonists are metabolized by endopeptidases, and thus do not generate major drug-drug interactions with most drugs, including ARVs. GLP-s agonists are known to inhibit gastric acid secretion, which warrants caution and close monitoring when combined with atazanavir and oral rilpivirine, two ARVs that require low gastric pH for an optimal absorption. CONCLUSION Theoretical considerations and a few available clinical observations support semaglutide and liraglutide prescription in people with HIV, with, thus far, no indications of concern regarding efficacy, safety or pharmacological interactions with ARVs.
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Affiliation(s)
- L Zino
- Radboud University Medical Center, Department of Pharmacy and Radboudumc Research Institute for Medical Innovation (RIMI), Nijmegen, The Netherlands
| | - C J Tack
- Radboud University Medical Center, Department of Internal Medicine and Radboudumc Research Institute for Medical Innovation (RIMI), Nijmegen, The Netherlands
| | - O Richel
- Radboud University Medical Center, Department of Internal Medicine and Radboudumc Research Institute for Medical Innovation (RIMI), Nijmegen, The Netherlands
| | - D M Burger
- Radboud University Medical Center, Department of Pharmacy and Radboudumc Research Institute for Medical Innovation (RIMI), Nijmegen, The Netherlands
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13
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Machado TR, Honorio T, Souza Domingos TF, Candido de Paula DDS, Cabral LM, Rodrigues CR, Abrahim-Vieira BA, Teles de Souza AM. Physiologically based pharmacokinetic modelling of semaglutide in children and adolescents with healthy and obese body weights. Br J Clin Pharmacol 2023; 89:3175-3194. [PMID: 37293836 DOI: 10.1111/bcp.15816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/23/2023] [Accepted: 05/31/2023] [Indexed: 06/10/2023] Open
Abstract
AIMS To develop paediatric physiologically based pharmacokinetic modelling (PBPK) models of semaglutide to estimate the pharmacokinetic profile for subcutaneous injections in children and adolescents with healthy and obese body weights. METHODS Pharmacokinetic modelling and simulations of semaglutide subcutaneous injections were performed using the Transdermal Compartmental Absorption & Transit model implemented in GastroPlus v.9.5 modules. A PBPK model of semaglutide was developed and verified in the adult population, by comparing the simulated plasma exposure with the observed data, and further scaled to the paediatric populations with normal and obese body weight. RESULTS The semaglutide PBPK model was successfully developed in adults and scaled to the paediatric population. Our paediatric PBPK simulations indicated a significant increase in maximum plasma concentrations for the 10-14 years' paediatric population with healthy body weights, which was higher than the observed values in adults at the reference dose. Since gastrointestinal adverse events are related to increased semaglutide concentrations, peak concentrations outside the target range may represent a safety risk for this paediatric age group. Besides, paediatric PBPK models indicated that body weight was inversely related to semaglutide maximum plasma concentration, corroborating the consensus on the influence of body weight on semaglutide PK in adults. CONCLUSION Paediatric PBPK was successfully achieved using a top-down approach and drug-related parameters. The development of unprecedented PBPK models will support paediatric clinical therapy for applying aid-safe dosing regimens for the paediatric population in diabetes treatment.
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Affiliation(s)
- Thayná Rocco Machado
- Laboratory of Molecular Modeling & QSAR (ModMolQSAR), Faculty of Pharmacy, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thiago Honorio
- Laboratory of Molecular Modeling & QSAR (ModMolQSAR), Faculty of Pharmacy, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Dailane da Silva Candido de Paula
- Laboratory of Molecular Modeling & QSAR (ModMolQSAR), Faculty of Pharmacy, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucio Mendes Cabral
- Laboratory of Molecular Modeling & QSAR (ModMolQSAR), Faculty of Pharmacy, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos R Rodrigues
- Laboratory of Molecular Modeling & QSAR (ModMolQSAR), Faculty of Pharmacy, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bárbara A Abrahim-Vieira
- Laboratory of Molecular Modeling & QSAR (ModMolQSAR), Faculty of Pharmacy, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alessandra Mendonça Teles de Souza
- Laboratory of Molecular Modeling & QSAR (ModMolQSAR), Faculty of Pharmacy, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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14
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Keuper-Navis M, Walles M, Poller B, Myszczyszyn A, van der Made TK, Donkers J, Eslami Amirabadi H, Wilmer MJ, Aan S, Spee B, Masereeuw R, van de Steeg E. The application of organ-on-chip models for the prediction of human pharmacokinetic profiles during drug development. Pharmacol Res 2023; 195:106853. [PMID: 37473876 DOI: 10.1016/j.phrs.2023.106853] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/22/2023]
Abstract
Organ-on-chip (OoC) technology has led to in vitro models with many new possibilities compared to conventional in vitro and in vivo models. In this review, the potential of OoC models to improve the prediction of human oral bioavailability and intrinsic clearance is discussed, with a focus on the functionality of the models and the application in current drug development practice. Multi-OoC models demonstrating the application for pharmacokinetic (PK) studies are summarized and existing challenges are identified. Physiological parameters for a minimal viable platform of a multi-OoC model to study PK are provided, together with PK specific read-outs and recommendations for relevant reference compounds to validate the model. Finally, the translation to in vivo PK profiles is discussed, which will be required to routinely apply OoC models during drug development.
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Affiliation(s)
- Marit Keuper-Navis
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, the Netherlands; Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - Markus Walles
- Pharmacokinetic Sciences, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Birk Poller
- Pharmacokinetic Sciences, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Adam Myszczyszyn
- Faculty of Veterinary Medicine & Regenerative Medicine Center Utrecht (RMCU), Utrecht University, Utrecht, the Netherlands
| | - Thomas K van der Made
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - Joanne Donkers
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, the Netherlands
| | | | | | - Saskia Aan
- Stichting Proefdiervrij, Den Haag, the Netherlands
| | - Bart Spee
- Faculty of Veterinary Medicine & Regenerative Medicine Center Utrecht (RMCU), Utrecht University, Utrecht, the Netherlands
| | - Rosalinde Masereeuw
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - Evita van de Steeg
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, the Netherlands.
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15
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Alorfi NM, Alshehri FS. Usage of Glucagon-Like Peptide-1 for Obesity in Children; Updated Review of Clinicaltrials.gov. J Multidiscip Healthc 2023; 16:2179-2187. [PMID: 37547806 PMCID: PMC10402718 DOI: 10.2147/jmdh.s419245] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/07/2023] [Indexed: 08/08/2023] Open
Abstract
Background Obesity in both adults and children is a primary health concern that can lead to many complications at a young age, including insulin resistance, type 2 diabetes, and other diseases. Glucagon-like peptide-1 receptor agonists (GLP-1) are drugs utilized to treat diabetes, but they are also approved as an adjunct to a low-calorie diet to reduce body weight and to enhance the metabolic profile readings for diabetic and non-diabetic patients. However, their efficacy and safety in children have not been extensively examined. Aim To identify glucagon-like peptide-1 medications for obesity in pediatric participants (aged up to 17 years old). Methods Analysis of all clinical trials registered on ClinicalTrials.gov for obesity using GLP-1 as a treatment for children. Results As of January 26th, 2023, 10,828 clinical trials were found. The search included childhood obesity using GLP-1. The number of trials on the use of GLP-1 to treat childhood obesity is limited. The final number of analyzed trials was 19. GLP-1 has been shown to result in the effective management of body gain among children. Conclusion Exenatide, semaglutide, and liraglutide were the only GLP-1 medications used as the pharmacotherapy option. It has been studied in many circumstances eg, to treat children with severe obesity, PCOS, hypothalamic obesity, glucose tolerance, and as a complementary treatment alongside behavior-lifestyle change and surgery for obesity.
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Affiliation(s)
- Nasser M Alorfi
- Pharmacology and Toxicology Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Fahad S Alshehri
- Pharmacology and Toxicology Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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16
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Gumieniczek A, Berecka-Rycerz A. Metabolism and Chemical Degradation of New Antidiabetic Drugs: A Review of Analytical Approaches for Analysis of Glutides and Gliflozins. Biomedicines 2023; 11:2127. [PMID: 37626624 PMCID: PMC10452759 DOI: 10.3390/biomedicines11082127] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
The drug metabolism and drug degradation pathways may overlap, resulting in the formation of similar constituents. Therefore, the metabolism data can be helpful for deriving safe levels of degradation impurities and improving the quality of respective pharmaceutical products. The present article contains considerations on possible links between metabolic and degradation pathways for new antidiabetic drugs such as glutides, gliflozins, and gliptins. Special attention was paid to their reported metabolites and identified degradation products. At the same time, many interesting analytical approaches to conducting metabolism as well as degradation experiments were mentioned, including chromatographic methods and radioactive labeling of the drugs. The review addresses the analytical approaches elaborated for examining the metabolism and degradation pathways of glutides, i.e., glucagon like peptide 1 (GLP-1) receptor agonists, and gliflozins, i.e., sodium glucose co-transporter 2 (SGLT2) inhibitors. The problems associated with the chromatographic analysis of the peptide compounds (glutides) and the polar drugs (gliflozins) were addressed. Furthermore, issues related to in vitro experiments and the use of stable isotopes were discussed.
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Affiliation(s)
- Anna Gumieniczek
- Department of Medicinal Chemistry, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland;
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17
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Chuong V, Farokhnia M, Khom S, Pince CL, Elvig SK, Vlkolinsky R, Marchette RC, Koob GF, Roberto M, Vendruscolo LF, Leggio L. The glucagon-like peptide-1 (GLP-1) analogue semaglutide reduces alcohol drinking and modulates central GABA neurotransmission. JCI Insight 2023; 8:e170671. [PMID: 37192005 PMCID: PMC10371247 DOI: 10.1172/jci.insight.170671] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/10/2023] [Indexed: 05/17/2023] Open
Abstract
Growing evidence indicates that the glucagon-like peptide-1 (GLP-1) system is involved in the neurobiology of addictive behaviors, and GLP-1 analogues may be used for the treatment of alcohol use disorder (AUD). Here, we examined the effects of semaglutide, a long-acting GLP-1 analogue, on biobehavioral correlates of alcohol use in rodents. A drinking-in-the-dark procedure was used to test the effects of semaglutide on binge-like drinking in male and female mice. We also tested the effects of semaglutide on binge-like and dependence-induced alcohol drinking in male and female rats, as well as acute effects of semaglutide on spontaneous inhibitory postsynaptic currents (sIPSCs) from central amygdala (CeA) and infralimbic cortex (ILC) neurons. Semaglutide dose-dependently reduced binge-like alcohol drinking in mice; a similar effect was observed on the intake of other caloric/noncaloric solutions. Semaglutide also reduced binge-like and dependence-induced alcohol drinking in rats. Semaglutide increased sIPSC frequency in CeA and ILC neurons from alcohol-naive rats, suggesting enhanced GABA release, but had no overall effect on GABA transmission in alcohol-dependent rats. In conclusion, the GLP-1 analogue semaglutide decreased alcohol intake across different drinking models and species and modulated central GABA neurotransmission, providing support for clinical testing of semaglutide as a potentially novel pharmacotherapy for AUD.
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Affiliation(s)
- Vicky Chuong
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program (NIDA IRP) and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research (NIAAA DICBR), NIH, Baltimore and Bethesda, Maryland, USA
- Neurobiology of Addiction Section, NIDA IRP, NIH, Baltimore, Maryland, USA
| | - Mehdi Farokhnia
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program (NIDA IRP) and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research (NIAAA DICBR), NIH, Baltimore and Bethesda, Maryland, USA
| | - Sophia Khom
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, California, USA
- Department of Pharmaceutical Sciences, University of Vienna, Vienna, Austria
| | - Claire L. Pince
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program (NIDA IRP) and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research (NIAAA DICBR), NIH, Baltimore and Bethesda, Maryland, USA
- Neurobiology of Addiction Section, NIDA IRP, NIH, Baltimore, Maryland, USA
| | - Sophie K. Elvig
- Neurobiology of Addiction Section, NIDA IRP, NIH, Baltimore, Maryland, USA
| | - Roman Vlkolinsky
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, California, USA
| | | | - George F. Koob
- Neurobiology of Addiction Section, NIDA IRP, NIH, Baltimore, Maryland, USA
| | - Marisa Roberto
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, California, USA
| | - Leandro F. Vendruscolo
- Stress and Addiction Neuroscience Unit, NIDA IRP and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, Maryland, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program (NIDA IRP) and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research (NIAAA DICBR), NIH, Baltimore and Bethesda, Maryland, USA
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18
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Aranäs C, Edvardsson CE, Shevchouk OT, Zhang Q, Witley S, Blid Sköldheden S, Zentveld L, Vallöf D, Tufvesson-Alm M, Jerlhag E. Semaglutide reduces alcohol intake and relapse-like drinking in male and female rats. EBioMedicine 2023; 93:104642. [PMID: 37295046 PMCID: PMC10363436 DOI: 10.1016/j.ebiom.2023.104642] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Glucagon-like peptide1 receptor (GLP-1R) agonists have been found to reduce alcohol drinking in rodents and overweight patients with alcohol use disorder (AUD). However, the probability of low semaglutide doses, an agonist with higher potency and affinity for GLP-1R, to attenuate alcohol-related responses in rodents and the underlying neuronal mechanisms is unknown. METHODS In the intermittent access model, we examined the ability of semaglutide to decrease alcohol intake and block relapse-like drinking, as well as imaging the binding of fluorescently marked semaglutide to nucleus accumbens (NAc) in both male and female rats. The suppressive effect of semaglutide on alcohol-induced locomotor stimulation and in vivo dopamine release in NAc was tested in male mice. We evaluated effect of semaglutide on the in vivo release of dopamine metabolites (DOPAC and HVA) and gene expression of enzymes metabolising dopamine (MAOA and COMT) in male mice. FINDINGS In male and female rats, acute and repeated semaglutide administration reduced alcohol intake and prevented relapse-like drinking. Moreover, fluorescently labelled semaglutide was detected in NAc of alcohol-drinking male and female rats. Further, semaglutide attenuated the ability of alcohol to cause hyperlocomotion and to elevate dopamine in NAc in male mice. As further shown in male mice, semaglutide enhanced DOPAC and HVA in NAc when alcohol was onboard and increased the gene expression of COMT and MAOA. INTERPRETATION Altogether, this indicates that semaglutide reduces alcohol drinking behaviours, possibly via a reduction in alcohol-induced reward and NAc dependent mechanisms. As semaglutide also decreased body weight of alcohol-drinking rats of both sexes, upcoming clinical studies should test the plausibility that semaglutide reduces alcohol intake and body weight in overweight AUD patients. FUNDING Swedish Research Council (2019-01676), LUA/ALF (723941) from the Sahlgrenska University Hospital and the Swedish brain foundation.
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Affiliation(s)
- Cajsa Aranäs
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Christian E Edvardsson
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Olesya T Shevchouk
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Qian Zhang
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Sarah Witley
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Sebastian Blid Sköldheden
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Lindsay Zentveld
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Daniel Vallöf
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Maximilian Tufvesson-Alm
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Elisabet Jerlhag
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
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19
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Klein G, Petrone M, Yang Y, Hoang T, Hazlett S, Hansen L, Flor A. Pharmacokinetics and Safety of Cotadutide, a GLP-1 and Glucagon Receptor Dual Agonist, in Individuals with Renal Impairment: A Single-Dose, Phase I, Bridging Study. Clin Pharmacokinet 2023; 62:881-890. [PMID: 37140727 PMCID: PMC10256642 DOI: 10.1007/s40262-023-01239-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Cotadutide is a balanced glucagon-like peptide-1 and glucagon receptor dual agonist under development for the treatment of non-alcoholic steatohepatitis and type 2 diabetes with chronic kidney disease. We evaluated the pharmacokinetics (PK), safety and immunogenicity of a single dose of cotadutide in individuals with varying degrees of renal impairment. METHODS In this phase I bridging study, individuals 18-85 years of age, with a body mass index of 17-40 kg/m2 and varying degrees of renal function {end-stage renal disease (ESRD; creatinine clearance [CrCl] < 20 mL/min); severe renal impairment (CrCl ≥ 20 to < 30 mL/min); lower moderate renal impairment (CrCl ≥ 30 to < 44 mL/min); upper moderate renal impairment (CrCl ≥ 45 to < 60 mL/min); normal renal function (CrCl ≥ 90 mL/min)} were treated with a single dose of subcutaneous cotadutide 100 µg under fasted conditions in the lower abdomen. The co-primary endpoints were area under the plasma concentration-time curve from time zero to 48 h (AUC48) and the maximum observed plasma concentration (Cmax) for cotadutide. Safety and immunogenicity were secondary endpoints. This trial is registered with ClinicalTrials.gov (NCT03235375). RESULTS A total of 37 individuals were enrolled in the study (only three enrolled in the ESRD group, therefore this group was excluded from the primary PK analysis). AUC48 and Cmax values for cotadutide were similar across all renal function groups {severe renal impairment vs. normal renal function: AUC48 geometric mean ratio (GMR) 0.99 (90% confidence interval [CI] 0.76-1.29); lower moderate renal impairment versus normal renal function: AUC48 GMR 1.01 (90% CI 0.79-1.30); upper moderate renal impairment versus normal renal function: AUC48 GMR 1.09 (90% CI 0.82-1.43)}. A sensitivity analysis that combined the ESRD and severe renal impairment groups did not show notable changes in the AUC48 and Cmax GMRs. The incidences of treatment-emergent adverse events (TEAE) ranged from 42.9 to 72.7% across all groups and were mostly mild to moderate in severity. Only one patient had a grade III or worse TEAE during the study period. No positive antidrug antibody results were observed. CONCLUSIONS These results suggest that the PK and tolerability of cotadutide are unaffected by renal function and that dose adjustments may not be required in individuals with renal impairment.
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Affiliation(s)
| | - Marcella Petrone
- Clinical Pharmacology and Safety Sciences, AstraZeneca, Cambridge, UK
| | - Ye Yang
- Early Biometrics and Statistical Innovation, Data Science and Artificial Intelligence, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | | | - Sheila Hazlett
- Late-Stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Lars Hansen
- Early Clinical Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Armando Flor
- Early Clinical Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA.
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20
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Lee TS, Park EJ, Choi M, Oh HS, An Y, Kim T, Kim TH, Shin BS, Shin S. Novel LC-MS/MS analysis of the GLP-1 analog semaglutide with its application to pharmacokinetics and brain distribution studies in rats. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1221:123688. [PMID: 36989942 DOI: 10.1016/j.jchromb.2023.123688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023]
Abstract
Semaglutide, one of the most potent glucagon-like peptide (GLP)-1 analogs, has widely been used to treat type II diabetes mellitus and obesity. Recent studies have shown that semaglutide also works on the brain, suggesting its potential utility for various diseases, including Parkinson's disease and Alzheimer's disease. This study aimed to develop a novel liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis of semaglutide in both plasma and brain to characterize the pharmacokinetics and brain distribution in rats. Semaglutide was extracted by simple protein precipitation with methanol from plasma and by solid phase extraction from brain tissue. Liraglutide was used as an internal standard. Gradient elution profiles with mobile phases comprising 0.1 % formic acid in water and acetonitrile were used for chromatographic separation. The lower limit of quantification (LLOQ) of the LC-MS/MS assay was 0.5 ng/mL for both rat plasma and brain. Intra- and inter-day accuracy ranged 89.20-109.50 % in the plasma and 92.00-105.00 % in the brain. Precision was within 8.92 % in the plasma and 7.94 % in the brain. Sprague-Dawley rats were given semaglutide by intravenous (IV, 0.02 mg/kg) and subcutaneous (SC, 0.1 and 0.2 mg/kg) injection. Plasma concentrations of semaglutide showed a multi-exponential decline with an average half-life of 7.22-9.26 hr in rats. The subcutaneous bioavailability of semaglutide was 76.65-82.85 %. The brain tissue to plasma partition coefficient (Kp) value of semaglutide was estimated as <0.01. Among the different regions of the brain, semaglutide concentrations were significantly higher in the hypothalamus. The analytical method and pharmacokinetic information may be helpful toward a better understanding of the effect of semaglutide in the brain and further development of GLP-1 analogs for various brain diseases.
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21
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Esposito S, Krick A, Pasquier O, Bonche F, Ingenito R, Magotti P, Bianchi E, Monteagudo E, Gallo M, Cicero DO, Orsatti L, Veneziano M, Caretti F, Mele R, Roversi D, Gennari N, Brasseur D, Gauzy-Lazo L, Duclos O, Mauriac C, Illiano S, Mallart S. Fatty acid acylated peptide therapeutics: discovery of omega-n oxidation of the lipid chain as a novel metabolic pathway in preclinical species. J Pharm Biomed Anal 2023; 227:115256. [PMID: 36764268 DOI: 10.1016/j.jpba.2023.115256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/11/2023] [Accepted: 01/15/2023] [Indexed: 01/19/2023]
Abstract
We recently described C18 fatty acid acylated peptides as a new class of potent long-lasting single-chain RXFP1 agonists that displayed relaxin-like activities in vivo. Early pharmacokinetics and toxicological studies of these stearic acid acylated peptides revealed a relevant oxidative metabolism occurring in dog and minipig, and also seen at a lower extent in monkey and rat. Mass spectrometry combined to NMR spectroscopy studies revealed that the oxidation occurred, unexpectedly, on the stearic acid chain at ω-1, ω-2 and ω-3 positions. Structure-metabolism relationship studies on acylated analogues with different fatty acids lengths (C15-C20) showed that the extent of oxidation was higher with longer chains. The oxidized metabolites could be generated in vitro using liver microsomes and engineered bacterial CYPs. These systems were correlating poorly with in vivo metabolism observed across species; however, the results suggest that this biotransformation pathway might be catalyzed by some unknown CYP enzymes.
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Affiliation(s)
- Simone Esposito
- Biodistribution, Biotransformation and Analytical Science Unit, Experimental Pharmacology Department, IRBM Spa, Via Pontina Km 30 600, 00 071 Pomezia, Rome, Italy.
| | - Alain Krick
- DMPK France, Sanofi R&D, 1 rue Pierre Brossolette, 91385 Chilly Mazarin, France.
| | - Olivier Pasquier
- DMPK France, Sanofi R&D, 1 rue Pierre Brossolette, 91385 Chilly Mazarin, France
| | - Fabrice Bonche
- DMPK France, Sanofi R&D, 1 rue Pierre Brossolette, 91385 Chilly Mazarin, France
| | - Raffaele Ingenito
- Peptide Chemistry Unit, Peptides & Small Molecules R&D Department, IRBM Spa, Via Pontina Km 30 600, 00 071 Pomezia, Rome, Italy
| | - Paola Magotti
- Peptide Chemistry Unit, Peptides & Small Molecules R&D Department, IRBM Spa, Via Pontina Km 30 600, 00 071 Pomezia, Rome, Italy
| | - Elisabetta Bianchi
- Peptide Chemistry Unit, Peptides & Small Molecules R&D Department, IRBM Spa, Via Pontina Km 30 600, 00 071 Pomezia, Rome, Italy
| | - Edith Monteagudo
- Biodistribution, Biotransformation and Analytical Science Unit, Experimental Pharmacology Department, IRBM Spa, Via Pontina Km 30 600, 00 071 Pomezia, Rome, Italy; PK/PD & Bioanalytics Unit, Experimental Pharmacology Department, IRBM Spa, Via Pontina Km 30 600, 00 071 Pomezia, Rome, Italy
| | - Mariana Gallo
- Structural Biology Unit, Computational Chemistry & Structural Biology Department, IRBM Spa, Via Pontina Km 30 600, 00 071 Pomezia, Rome, Italy
| | - Daniel Oscar Cicero
- Department of Chemical Science and Technology, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Laura Orsatti
- PK/PD & Bioanalytics Unit, Experimental Pharmacology Department, IRBM Spa, Via Pontina Km 30 600, 00 071 Pomezia, Rome, Italy
| | - Maria Veneziano
- PK/PD & Bioanalytics Unit, Experimental Pharmacology Department, IRBM Spa, Via Pontina Km 30 600, 00 071 Pomezia, Rome, Italy
| | - Fulvia Caretti
- PK/PD & Bioanalytics Unit, Experimental Pharmacology Department, IRBM Spa, Via Pontina Km 30 600, 00 071 Pomezia, Rome, Italy
| | - Riccardo Mele
- Biodistribution, Biotransformation and Analytical Science Unit, Experimental Pharmacology Department, IRBM Spa, Via Pontina Km 30 600, 00 071 Pomezia, Rome, Italy
| | - Daniela Roversi
- Peptide Chemistry Unit, Peptides & Small Molecules R&D Department, IRBM Spa, Via Pontina Km 30 600, 00 071 Pomezia, Rome, Italy
| | - Nadia Gennari
- High Throughput Biology & Screening, Translational Research Department, IRBM Spa, Via Pontina Km 30 600, 00 071 Pomezia, Rome, Italy
| | - Denis Brasseur
- Integrated Drug Discovery, Sanofi R&D, 1 rue Pierre Brossolette, 91385 Chilly Mazarin, France
| | - Laurence Gauzy-Lazo
- Integrated Drug Discovery, Sanofi R&D, 1 rue Pierre Brossolette, 91385 Chilly Mazarin, France
| | - Olivier Duclos
- Integrated Drug Discovery, Sanofi R&D, 1 rue Pierre Brossolette, 91385 Chilly Mazarin, France
| | - Christine Mauriac
- DMPK France, Sanofi R&D, 1 rue Pierre Brossolette, 91385 Chilly Mazarin, France
| | - Stephane Illiano
- Investigative Toxicology, Sanofi R&D, 1 rue Pierre Brossolette, 91385 Chilly Mazarin, France
| | - Sergio Mallart
- Integrated Drug Discovery, Sanofi R&D, 1 rue Pierre Brossolette, 91385 Chilly Mazarin, France.
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22
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Violette CJ, Agarwal R, Mandelbaum RS, González JL, Hong KM, Roman LD, Klar M, Wright JD, Paulson RJ, Obermair A, Matsuo K. The potential role of GLP-1 receptor agonist targeting in fertility-sparing treatment in obese patients with endometrial malignant pathology: a call for research. Expert Rev Anticancer Ther 2023; 23:385-395. [PMID: 36944434 DOI: 10.1080/14737140.2023.2194636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Most patients diagnosed with endometrial hyperplasia or cancer are obese. Obesity, along with polycystic ovarian syndrome (PCOS) and type-2 diabetes mellitus (T2DM), may act synergistically to increase risk of malignant endometrial pathology. Incidence of malignant endometrial pathology is increasing, particularly in reproductive aged women. In patients who desire future fertility, the levonorgestrel intrauterine device (LNG-IUD) is often utilized. If the first-line progestin therapy fails, there is not an effective second-line adjunct option. Moreover, pregnancy rates following fertility-sparing treatment are lower-than-expected in these patients. AREAS COVERED This clinical opinion provides a summary of recent studies exploring risk factors for the development of malignant endometrial pathology including obesity, PCOS, and T2DM. Studies assessing efficacy of fertility-sparing treatment of malignant endometrial pathology are reviewed and a potential new adjunct treatment approach to LNG-IUD is explored. EXPERT OPINION There is an unmet-need for a personalized treatment approach in cases of first-line progestin treatment failure. Glucagon-like peptide 1 receptor agonists are a class of anti-diabetic agents, but may have a role in fertility-sparing treatment of obese patients with malignant endometrial pathology by reducing weight, decreasing inflammation, and decreasing insulin resistance; these changes may also improve chances of subsequent pregnancy. This hypothesis warrants further exploration.
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Affiliation(s)
- Caroline J Violette
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Ravi Agarwal
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Rachel S Mandelbaum
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - José L González
- Department of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kurt M Hong
- Center of Clinical Nutrition and Applied Health Research, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Lynda D Roman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Maximilan Klar
- Department of Obstetrics and Gynecology, University of Freiburg Faculty of Medicine, Freiburg, Germany
| | - Jason D Wright
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Richard J Paulson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Andreas Obermair
- Queensland Centre for Gynaecological Cancer, The University of Queensland, Herston, Queensland, Australia
- Centre for Clinical Research, University of Queensland, Brisbane, Australia
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
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23
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Dâ Aquino AI, Maikawa CL, Nguyen LT, Lu K, Hall IA, Prossnitz AN, Chang E, Baker SW, Kasse CM, Jons CK, Yan J, Hovgaard L, Steensgaard DB, Andersen HB, Simonsen L, Appel EA. Sustained Delivery of GLP-1 Receptor Agonists from Injectable Biomimetic Hydrogels Improves Treatment of Diabetes. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.28.526057. [PMID: 36778223 PMCID: PMC9915491 DOI: 10.1101/2023.01.28.526057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Glucagon-like peptide-1 (GLP-1) is an incretin hormone and neurotransmitter secreted from intestinal L-cells in response to nutrients to stimulate insulin and block glucagon secretion in a glucose-dependent manner. GLP-1 in itself is rapidly degraded, but long-acting GLP-1 receptor agonists (GLP-1 RAs) have become central in the treatment of T2D because of the beneficial effects extending also beyond glucose control. Currently, these therapeutics must be injected either daily or weekly or taken daily orally, leaving room for technological innovations that enable less frequent administrations, which will reduce patient burden and increase patient compliance. An ideal GLP-1 RA drug product would provide continuous therapy for upwards of four months from a single administration to match the cadence with which T2D patients typically visit their physician. In this work, we leveraged an injectable hydrogel depot technology to develop a long-acting GLP-1 RA drug product. By modulating the hydrogel properties to tune GLP-1 RA retention within the hydrogel depot, we engineered formulations capable of months-long GLP-1 RA delivery. Using a rat model of T2D, we confirmed that a single injection of hydrogel-based therapies exhibits sustained exposure of GLP-1 RA over 42 days, corresponding to a once-every four month therapy in humans. Moreover, these hydrogel therapies maintained optimal management of blood glucose and weight comparable to daily injections of a leading GLP-1 RA drug molecule. The pharmacokinetics and pharmacodynamics of these hydrogel-based long-acting GLP-1 RA treatments are promising for development of novel therapies reducing treatment burden for more effective management of T2D.
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24
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Kurtzhals P, Østergaard S, Nishimura E, Kjeldsen T. Derivatization with fatty acids in peptide and protein drug discovery. Nat Rev Drug Discov 2023; 22:59-80. [PMID: 36002588 DOI: 10.1038/s41573-022-00529-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2022] [Indexed: 01/28/2023]
Abstract
Peptides and proteins are widely used to treat a range of medical conditions; however, they often have to be injected and their effects are short-lived. These shortcomings of the native structure can be addressed by molecular engineering, but this is a complex undertaking. A molecular engineering technology initially applied to insulin - and which has now been successfully applied to several biopharmaceuticals - entails the derivatization of peptides and proteins with fatty acids. Various protraction mechanisms are enabled by the specific characteristics and positions of the attached fatty acid. Furthermore, the technology can ensure a long half-life following oral administration of peptide drugs, can alter the distribution of peptides and may hold potential for tissue targeting. Due to the inherent safety and well-defined chemical nature of the fatty acids, this technology provides a versatile approach to peptide and protein drug discovery.
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25
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Martins FF, Marinho TS, Cardoso LEM, Barbosa-da-Silva S, Souza-Mello V, Aguila MB, Mandarim-de-Lacerda CA. Semaglutide (GLP-1 receptor agonist) stimulates browning on subcutaneous fat adipocytes and mitigates inflammation and endoplasmic reticulum stress in visceral fat adipocytes of obese mice. Cell Biochem Funct 2022; 40:903-913. [PMID: 36169111 DOI: 10.1002/cbf.3751] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/24/2022] [Accepted: 09/13/2022] [Indexed: 12/15/2022]
Abstract
Semaglutide (GLP-1 agonist) was approved for treating obesity. Although the effects on weight loss and metabolism are known, the responses of adipocytes to semaglutide are yet limited. C57BL/6 male mice (n = 20/group) were fed a control diet (C) or a high-fat (HF) diet for 16 weeks and then separated into four groups (n = 10/group) for an additional four weeks: C, C diet and semaglutide, HF, and HF diet and semaglutide. Epididymal white adipose tissue (eWAT) and subcutaneous white adipose tissue (sWAT) fat pads were studied with biochemistry, immunohistochemistry/fluorescence, stereology, and reverse transcription-quantitative polymerase chain reaction. In obese mice, semaglutide reduced the fat pad masses (eWAT, -55%; sWAT, -40%), plasmatic cytokines, and proinflammatory gene expressions: tumor necrosis factor-alpha (-60%); interleukin (IL)-6 (-55%); IL-1 beta (-40%); monocyte chemoattractant protein-1 (-90%); and leptin (-80%). Semaglutide also lessened endoplasmic reticulum (ER) stress genes of activating transcription factor-4 (-85%), CCAAT enhancer-binding protein homologous protein (-55%), and growth arrest and DNA damage-inducible gene 45 (-45%). The obese mice's adipocyte hypertrophy and macrophage infiltration were equally reduced by semaglutide. Semaglutide enhanced multiloculation and uncoupled protein 1 (UCP1) labeling in obese mice: peroxisome proliferator-activated receptor-alpha (+560%) and gamma (+150%), fibronectin type III domain-containing protein 5 (+215%), peroxisome proliferator-activated receptor-alpha coactivator (+110%), nuclear respiratory factor 1 (+260%), and mitochondrial transcription factor A (+120%). Semaglutide also increased thermogenetic gene expressions for the browning phenotype maintenance: beta-3 adrenergic receptor (+520%), PR domain containing 16 (+90%), and Ucp1 (+110%). In conclusion, semaglutide showed significant beneficial effects beyond weight loss, directly on fat pads and adipocytes of obese mice, remarkably anti-inflammatory, and reduced adipocyte size and ER stress. Besides, semaglutide activated adipocyte browning, improving UCP1, mitochondrial biogenesis, and thermogenic marker expressions help weight loss.
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Affiliation(s)
- Fabiane F Martins
- Biomedical Center, Laboratory of Morphometry, Metabolism and Cardiovascular Diseases, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thatiany S Marinho
- Biomedical Center, Laboratory of Morphometry, Metabolism and Cardiovascular Diseases, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luiz E M Cardoso
- Biomedical Center, Laboratory of Morphometry, Metabolism and Cardiovascular Diseases, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sandra Barbosa-da-Silva
- Biomedical Center, Laboratory of Morphometry, Metabolism and Cardiovascular Diseases, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vanessa Souza-Mello
- Biomedical Center, Laboratory of Morphometry, Metabolism and Cardiovascular Diseases, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia B Aguila
- Biomedical Center, Laboratory of Morphometry, Metabolism and Cardiovascular Diseases, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos A Mandarim-de-Lacerda
- Biomedical Center, Laboratory of Morphometry, Metabolism and Cardiovascular Diseases, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
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26
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Ferrari F, Moretti A, Villa RF. Incretin-based drugs as potential therapy for neurodegenerative diseases: current status and perspectives. Pharmacol Ther 2022; 239:108277. [DOI: 10.1016/j.pharmthera.2022.108277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
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27
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Xie Y, Zhou Q, He Q, Wang X, Wang J. Opportunities and challenges of incretin-based hypoglycemic agents treating type 2 diabetes mellitus from the perspective of physiological disposition. Acta Pharm Sin B 2022. [DOI: 10.1016/j.apsb.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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28
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Esposito S, Orsatti L, Pucci V. Subcutaneous Catabolism of Peptide Therapeutics: Bioanalytical Approaches and ADME Considerations. Xenobiotica 2022; 52:828-839. [PMID: 36039395 DOI: 10.1080/00498254.2022.2119180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Many peptide drugs such as insulin and glucagon-like peptide (GLP-1) analogues are successfully administered subcutaneously (SC). Following SC injection, peptides may undergo catabolism in the SC compartment before entering systemic circulation, which could compromise their bioavailability and in turn affect their efficacy.This review will discuss how both technology and strategy have evolved over the past years to further elucidate peptide SC catabolism.Modern bioanalytical technologies (particularly liquid chromatography-high-resolution mass spectrometry) and bioinformatics platforms for data mining has prompted the development of in silico, in vitro and in vivo tools for characterizing peptide SC catabolism to rapidly address proteolytic liabilities and, ultimately, guide the design of peptides with improved SC bioavailability.More predictive models able to recapitulate the interplay between SC catabolism and other factors driving SC absorption are highly desirable to improve in vitro/in vivo correlations.We envision the routine incorporation of in vitro and in vivo SC catabolism studies in ADME screening funnels to develop more effective peptide drugs for SC delivery.
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Alorfi NM, Algarni AS. Clinical Impact of Semaglutide, a Glucagon-Like Peptide-1 Receptor Agonist, on Obesity Management: A Review. Clin Pharmacol 2022; 14:61-67. [PMID: 35958046 PMCID: PMC9357557 DOI: 10.2147/cpaa.s374741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 07/15/2022] [Indexed: 12/11/2022] Open
Affiliation(s)
- Nasser M Alorfi
- Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
- Correspondence: Nasser M Alorfi, Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia, Tel +966500644261, Email
| | - Alanood S Algarni
- Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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30
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Yang B, Gomes Dos Santos A, Puri S, Bak A, Zhou L. The industrial design, translation, and development strategies for long-acting peptide delivery. Expert Opin Drug Deliv 2022; 19:1233-1245. [PMID: 35787229 DOI: 10.1080/17425247.2022.2098276] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Peptides are widely recognized as therapeutic agents in the treatment of a wide range of diseases, such as cancer, diabetes etc. However, their use has been limited by their short half-life, due to significant metabolism by exo- and endo-peptidases as well as their inherent poor physical and chemical stability. Research with the aim of improving their half-life in the body, and thus improving patient compliance (by decreasing the frequency of injections) has gained significant attention. AREAS COVERED This review outlines the current landscape and industrial approaches to achieve extended peptide exposure and reduce dosing frequency. Emphasis is placed on identifying challenges in drug product manufacturing and desirable critical quality attributes that are essential for activity and safety, providing insights into chemistry and design aspects impacting peptide release, and summarizing important considerations for CMC developability assessments of sustained release peptide drugs. EXPERT OPINION Bring the patient and disease perspective early into development. Substantial advances have been made in the field of sustained delivery of peptides despite their complexity. The article will also highlight considerations for early-stage product design and development, providing an industrial perspective on risk mitigation in developing sustained release peptide drug products.
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Affiliation(s)
- Bin Yang
- Advanced Drug Delivery, Pharmaceutical Sciences, R&D, AstraZeneca, Cambridge, UK
| | - Ana Gomes Dos Santos
- Advanced Drug Delivery, Pharmaceutical Sciences, R&D, AstraZeneca, Cambridge, UK
| | - Sanyogitta Puri
- Advanced Drug Delivery, Pharmaceutical Sciences, R&D, AstraZeneca, Cambridge, UK
| | - Annette Bak
- Advanced Drug Delivery, Pharmaceutical Sciences, R&D, AstraZeneca, Boston, USA
| | - Liping Zhou
- Advanced Drug Delivery, Pharmaceutical Sciences, R&D, AstraZeneca, Boston, USA
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31
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Fernandes EFA, Wilbs J, Raavé R, Jacobsen CB, Toftelund H, Helleberg H, Boswinkel M, Heskamp S, Gustafsson MBF, Bjørnsdottir I. Comparison of the Tissue Distribution of a Long-Circulating Glucagon-like Peptide-1 Agonist Determined by Positron Emission Tomography and Quantitative Whole-Body Autoradiography. ACS Pharmacol Transl Sci 2022; 5:616-624. [DOI: 10.1021/acsptsci.2c00075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | - Jonas Wilbs
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Park 1, DK-2760 Måløv, Denmark
| | - Rene Raavé
- Radboudumc, Department of Medical Imaging − Nuclear Medicine, Radboud Institute for Molecular Life Sciences, 6500 HB Nijmegen, The Netherlands
| | - Christian Borch Jacobsen
- Isotope Chemistry, CMC Development, Novo Nordisk A/S, Novo Nordisk Park 1, DK-2760 Måløv, Denmark
| | - Hanne Toftelund
- Global Drug Discovery, Novo Nordisk A/S, Novo Nordisk Park 1, DK-2760 Måløv, Denmark
| | - Hans Helleberg
- Global Drug Discovery, Novo Nordisk A/S, Novo Nordisk Park 1, DK-2760 Måløv, Denmark
| | - Milou Boswinkel
- Radboudumc, Department of Medical Imaging − Nuclear Medicine, Radboud Institute for Molecular Life Sciences, 6500 HB Nijmegen, The Netherlands
| | - Sandra Heskamp
- Radboudumc, Department of Medical Imaging − Nuclear Medicine, Radboud Institute for Molecular Life Sciences, 6500 HB Nijmegen, The Netherlands
| | | | - Inga Bjørnsdottir
- Global Drug Discovery, Novo Nordisk A/S, Novo Nordisk Park 1, DK-2760 Måløv, Denmark
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32
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Mahapatra MK, Karuppasamy M, Sahoo BM. Semaglutide, a glucagon like peptide-1 receptor agonist with cardiovascular benefits for management of type 2 diabetes. Rev Endocr Metab Disord 2022; 23:521-539. [PMID: 34993760 PMCID: PMC8736331 DOI: 10.1007/s11154-021-09699-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2021] [Indexed: 11/22/2022]
Abstract
Semaglutide, a glucagon like peptide-1 (GLP-1) receptor agonist, is available as monotherapy in both subcutaneous as well as oral dosage form (first approved oral GLP-1 receptor agonist). It has been approved as a second line treatment option for better glycaemic control in type 2 diabetes and currently under scrutiny for anti-obesity purpose. Semaglutide has been proved to be safe in adults and elderly patients with renal or hepatic disorders demanding no dose modification. Cardiovascular (CV) outcome trials established that it can reduce various CV risk factors in patients with established CV disorders. Semaglutide is well tolerated with no risk of hypoglycaemia in monotherapy but suffers from gastrointestinal adverse effects. A large population affected with COVID-19 infection were diabetic; therefore use of semaglutide in diabetes as well as CV patients would be very much supportive in maintaining health care system during this pandemic situation. Hence, this peptidic drug can be truly considered as a quintessential of GLP-1 agonists for management of type 2 diabetes.
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Affiliation(s)
- Manoj Kumar Mahapatra
- Kanak Manjari Institute of Pharmaceutical Sciences, Rourkela, 769015, Odisha, India.
| | - Muthukumar Karuppasamy
- YaAn Pharmaceutical and Medical Communications, 6/691H1, Balaji Nagar, Sithurajapuram, Sivakasi, 626189, Tamilnadu, India
| | - Biswa Mohan Sahoo
- Roland Institute of Pharmaceutical Sciences, Berhampur, 760010, Odisha, India
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33
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Pharmacokinetic and pharmacodynamic studies of supaglutide in rats and monkeys. Eur J Pharm Sci 2022; 175:106218. [PMID: 35618199 DOI: 10.1016/j.ejps.2022.106218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/29/2022] [Accepted: 05/22/2022] [Indexed: 11/21/2022]
Abstract
We demonstrated recently that supaglutide, a novel GLP-1 mimetic generated by recombinant fusion protein techniques, exerted hypoglycemic effects in type 2 diabetes db/db mice and spontaneous diabetic monkeys. In this study, we investigated the pharmacokinetics and pharmacodynamics of supaglutide by single subcutaneous and intravenous injection(s) in rats and rhesus monkeys, as well as fourconsecutive subcutaneous injections in monkeys.We found the half-life (t1/2) of supaglutide was 39.7 hours and 35.8 hours at dosing 0.1 mg/kg upon subcutaneous or intravenous administration respectively, in rhesus monkeys. The plasma supaglutide peaked at 8-10 hours, while the plasma drug exposure levels increased with the increase of dose, showing approximately a linear pharmacokinetic characteristic. The elimination kinetics (Ke) were found to be similar between subcutaneous (∼0.025 in rats and ∼0.018 in monkeys) and intravenous administration (0.021 in rats and 0.020 in monkeys), whereas the bioavailability was found to be 31.1% in rats and 63.9% in monkeys. In monkeys, a single dose injection of supaglutide markedly decreased the random blood glucose levels that reaching the maxima effects in 14-16 hours, gradually recovered and returned to the baseline level approximately after 72 hours. 125I-supaglutide was found mainly distributed in the serum and organs rich in blood supply. Urine was found to be the primary excretion route of supaglutide, following by feces, but mostly not in bile.Our results show that supaglutide possess linear pharmacokinetic characteristics associated with prolonged hypoglycemic effects inanimals,suggestinga potential weekly dosing therapeutic reagent for the treatment of type 2 diabetes and metabolic diseases.
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34
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Polymer-Based Delivery of Peptide Drugs to Treat Diabetes: Normalizing Hyperglycemia and Preventing Diabetic Complications. BIOCHIP JOURNAL 2022. [DOI: 10.1007/s13206-022-00057-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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35
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Cancer-related micropeptides encoded by ncRNAs: Promising drug targets and prognostic biomarkers. Cancer Lett 2022; 547:215723. [DOI: 10.1016/j.canlet.2022.215723] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/14/2022] [Accepted: 05/01/2022] [Indexed: 02/07/2023]
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36
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Levine PM, Craven TW, Li X, Balana AT, Bird GH, Godes M, Salveson PJ, Erickson PW, Lamb M, Ahlrichs M, Murphy M, Ogohara C, Said MY, Walensky LD, Pratt MR, Baker D. Generation of Potent and Stable GLP-1 Analogues Via "Serine Ligation". ACS Chem Biol 2022; 17:804-809. [PMID: 35319882 PMCID: PMC9173702 DOI: 10.1021/acschembio.2c00075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Peptide and protein bioconjugation technologies have revolutionized our ability to site-specifically or chemoselectively install a variety of functional groups for applications in chemical biology and medicine, including the enhancement of bioavailability. Here, we introduce a site-specific bioconjugation strategy inspired by chemical ligation at serine that relies on a noncanonical amino acid containing a 1-amino-2-hydroxy functional group and a salicylaldehyde ester. More specifically, we harness this technology to generate analogues of glucagon-like peptide-1 that resemble Semaglutide, a long-lasting blockbuster drug currently used in the clinic to regulate glucose levels in the blood. We identify peptides that are more potent than unmodified peptide and equipotent to Semaglutide in a cell-based activation assay, improve the stability in human serum, and increase glucose disposal efficiency in vivo. This approach demonstrates the potential of "serine ligation" for various applications in chemical biology, with a particular focus on generating stabilized peptide therapeutics.
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Affiliation(s)
- Paul M. Levine
- Department of Biochemistry and Institute for Protein Design, University of Washington, Seattle, Washington 98195, United States
| | - Timothy W. Craven
- Department of Biochemistry and Institute for Protein Design, University of Washington, Seattle, Washington 98195, United States
| | - Xinting Li
- Department of Biochemistry and Institute for Protein Design, University of Washington, Seattle, Washington 98195, United States
| | | | | | | | - Patrick J. Salveson
- Department of Biochemistry and Institute for Protein Design, University of Washington, Seattle, Washington 98195, United States
| | - Patrick W. Erickson
- Department of Biochemistry and Institute for Protein Design, University of Washington, Seattle, Washington 98195, United States
| | - Mila Lamb
- Department of Biochemistry and Institute for Protein Design, University of Washington, Seattle, Washington 98195, United States
| | - Maggie Ahlrichs
- Department of Biochemistry and Institute for Protein Design, University of Washington, Seattle, Washington 98195, United States
| | - Michael Murphy
- Department of Biochemistry and Institute for Protein Design, University of Washington, Seattle, Washington 98195, United States
| | - Cassandra Ogohara
- Department of Biochemistry and Institute for Protein Design, University of Washington, Seattle, Washington 98195, United States
| | - Meerit Y. Said
- Department of Biochemistry and Institute for Protein Design, University of Washington, Seattle, Washington 98195, United States
| | | | | | - David Baker
- Department of Biochemistry and Institute for Protein Design, University of Washington, Seattle, Washington 98195, United States
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Kalra S, Das S, Zargar AH. A Review of Oral Semaglutide Available Evidence: A New Era of Management of Diabetes with Peptide in a Pill Form. Indian J Endocrinol Metab 2022; 26:98-105. [PMID: 35873937 PMCID: PMC9302409 DOI: 10.4103/ijem.ijem_522_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/28/2022] [Accepted: 03/30/2022] [Indexed: 12/13/2022] Open
Abstract
Glucagon-like peptide 1 receptor agonists (GLP-1RAs) have gained an important place in the management of diabetes management because of their exceptional glucose-lowering, weight lowering and cardiovascular (CV) benefits. Despite recommendations by various clinical practice guidelines and benefits, their usage in clinical practice was limited because of being injectable in nature. Oral semaglutide is a novel GLP-1RA with 94% homology to human GLP-1 which is co-formulated with absorption enhancer sodium N-(8-[2-hydroxybenzoyl] amino) caprylate (SNAC), that overcomes the challenges of peptide absorption in the acidic conditions of the stomach. Oral semaglutide has been evaluated in an extensive phase 3 clinical trial programme named Peptide Innovation for Early Diabetes Treatment (PIONEER) which demonstrated its robust glucose and weight lowering effects against other comparators. The evolution of the GLP-1RA class to include an oral pill will facilitate the use of this class of agents much earlier in the diabetes treatment cascade owing to wider acceptance from patients and clinicians alike. The current review discusses the various aspects of oral semaglutide and its place in clinical practice.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
| | - Sambit Das
- Senior Consultant Endocrinologist Apollo Hospitals, Bhubaneshwar, Odisha, India
| | - Abdul H. Zargar
- Senior Consultant Endocrinologist, Center for Diabetes and Endocrine Care, Srinagar, Jammu and Kashmir, India
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Oligomerization, albumin binding and catabolism of therapeutic peptides in the subcutaneous compartment: An investigation on lipidated GLP-1 analogs. J Pharm Biomed Anal 2022; 210:114566. [PMID: 35042144 DOI: 10.1016/j.jpba.2021.114566] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/22/2021] [Accepted: 12/28/2021] [Indexed: 11/20/2022]
Abstract
Lipidation, a common strategy to improve half-life of therapeutic peptides, affects their tendency to oligomerize, their interaction with plasmatic proteins, and their catabolism. In this work, we have leveraged the use of NMR and SPR spectroscopy to elucidate oligomerization propensity and albumin interaction of different analogs of the two marketed lipidated GLP-1 agonists liraglutide and semaglutide. As most lipidated therapeutic peptides are administered by subcutaneous injection, we have also assessed in vitro their catabolism in the SC tissue using the LC-HRMS-based SCiMetPep assay. We observed that oligomerization had a shielding effect against catabolism. At the same time, binding to albumin may provide only limited protection from proteolysis due to the higher unbound peptide fraction present in the subcutaneous compartment with respect to the plasma. Finally, identification of catabolites in rat plasma after SC dosing of semaglutide showed a good correlation with the in vitro data, with Tyr19-Leu20 being the major cleavage site. Early characterization of the complex interplay between oligomerization, albumin binding, and catabolism at the injection site is essential for the synthesis of lipidated peptides with good pharmacokinetic profiles.
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39
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Bhattacharyya S, Chawla M, Sanyal D. Glycemic treatment effect of oral semaglutide plus other antidiabetic medications: An Indian experience. JOURNAL OF DIABETOLOGY 2022. [DOI: 10.4103/jod.jod_71_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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40
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Phillips A, Clements JN. Clinical review of subcutaneous semaglutide for obesity. J Clin Pharm Ther 2021; 47:184-193. [PMID: 34964141 DOI: 10.1111/jcpt.13574] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/27/2021] [Accepted: 11/03/2021] [Indexed: 12/24/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE The purpose of this review paper is to review the efficacy and safety of subcutaneous semaglutide, marketed as Wegovy, a glucagon-like peptide-1 receptor agonist for obesity management. METHODS A MEDLINE search (1970 to June 2021) was conducted to identify Phase 3 trials of subcutaneous semaglutide for obesity management. Published Phase 3 trials from The Semaglutide Treatment Effect in People with obesity (STEP) program were reviewed and summarized. RESULTS AND DISCUSSION Based on four Phase 3 trials, subcutaneous semaglutide as 2.4 mg once weekly was compared in efficacy and safety among 5000 randomized participants who were overweight or had obesity. A change in body weight from baseline to end of study was the primary outcome in the STEP program. Participants who received semaglutide had a dose-dependent reduction in body weight from baseline, compared to placebo. Higher percentages of participants had 5%-10% weight reduction from baseline when receiving subcutaneous semaglutide. The patient population was mainly middle-aged female participants with Class II obesity. Additional studies are needed, especially active-comparator trials, to determine the efficacy and safety of semaglutide in a diverse patient population. WHAT IS NEW AND CONCLUSION Subcutaneous semaglutide is another available option as adjunct therapy to lifestyle modifications for people who are overweight or have obesity based on body weight and body mass index. It resulted in more weight reduction than placebo with gastrointestinal adverse events being the most common safety concerns. Clinical utilization of subcutaneous semaglutide will be determined, as insurance coverage will be a limitation for this new medication.
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Affiliation(s)
- Anna Phillips
- Presbyterian College School of Pharmacy, Clinton, South Carolina, USA
| | - Jennifer N Clements
- Department of Nursing Administration, Spartanburg Regional Healthcare System, Spartanburg, South Carolina, USA
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Østergaard S, Paulsson JF, Kofoed J, Zosel F, Olsen J, Jeppesen CB, Spetzler J, Ynddal L, Schleiss LG, Christoffersen BØ, Raun K, Sensfuss U, Nielsen FS, Jørgensen R, Wulff BS. The effect of fatty diacid acylation of human PYY 3-36 on Y 2 receptor potency and half-life in minipigs. Sci Rep 2021; 11:21179. [PMID: 34707178 PMCID: PMC8551270 DOI: 10.1038/s41598-021-00654-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/13/2021] [Indexed: 01/02/2023] Open
Abstract
Peptides are notoriously known to display very short in vivo half-lives often measured in minutes which in many cases greatly reduces or eliminates sufficient in vivo efficacy. To obtain long half-lives allowing for up to once-weekly dosing regimen, fatty acid acylation (lipidation) have been used to non-covalently associate the peptide to serum albumin thus serving as a circulating depot. This approach is generally considered in the scientific and patent community as a standard approach to protract almost any given peptide. However, it is not trivial to prolong the half-life of peptides by lipidation and still maintain high potency and good formulation properties. Here we show that attaching a fatty acid to the obesity-drug relevant peptide PYY3-36 is not sufficient for long pharmacokinetics (PK), since the position in the backbone, but also type of fatty acid and linker strongly influences PK and potency. Furthermore, understanding the proteolytic stability of the backbone is key to obtain long half-lives by lipidation, since backbone cleavage still occurs while associated to albumin. Having identified a PYY analogue with a sufficient half-life, we show that in combination with a GLP-1 analogue, liraglutide, additional weight loss can be achieved in the obese minipig model.
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Affiliation(s)
- Søren Østergaard
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark.
| | - Johan F Paulsson
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark
| | - Jacob Kofoed
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark
| | - Franziska Zosel
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark
| | - Jørgen Olsen
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark
| | - Claus Bekker Jeppesen
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark
| | - Jane Spetzler
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark
| | - Lars Ynddal
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark.,Gubra Aps, Hørsholm Kongevej 11B, 2970, Hørsholm, Denmark
| | - Luise Gram Schleiss
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark
| | | | - Kirsten Raun
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark
| | - Ulrich Sensfuss
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark.,STipe Therapeutics, Copenhagen, Denmark
| | - Flemming Seier Nielsen
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark
| | - Rasmus Jørgensen
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark.,CitoKi Pharma, Værløse, Denmark
| | - Birgitte S Wulff
- Global Research Technologies, Novo Nordisk A/S, Novo Nordisk Research Park, 2760, Maaloev, Denmark
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Fernando K, Bain SC, Holmes P, Jones PN, Patel DC. Glucagon-Like Peptide 1 Receptor Agonist Usage in Type 2 Diabetes in Primary Care for the UK and Beyond: A Narrative Review. Diabetes Ther 2021; 12:2267-2288. [PMID: 34309808 PMCID: PMC8312211 DOI: 10.1007/s13300-021-01116-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/07/2021] [Indexed: 11/23/2022] Open
Abstract
The scientific landscape of treatments for type 2 diabetes (T2D) has changed rapidly in the last decade with newer treatments becoming available. However, a large proportion of people with T2D are not able to achieve glycaemic goals because of clinical inertia. The majority of T2D management is in primary care, where clinicians (medical, nursing and pharmacist staff) play an important role in addressing patient needs and achieving treatment goals. However, management of T2D is challenging because of the heterogeneity of T2D and complexity of comorbidity, time constraints, guidance overload and the evolving treatments. Additionally, the current coronavirus disease pandemic poses additional challenges to the management of chronic diseases such as T2D, including routine access to patients for monitoring and communication. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are a class of agents that have evolved rapidly in recent years. These agents act in a glucose-dependent manner to promote insulin secretion and inhibit glucagon secretion, as well as enhancing satiety and reducing hunger. As a result, they are effective treatment options for people with T2D, achieving glycated haemoglobin reductions, weight loss and potential cardiovascular benefit, as monotherapy or as add-on to other glucose-lowering therapies. However, given the complexity of managing T2D, it is important to equip primary care clinicians with clear information regarding efficacy, safety and appropriate positioning of GLP-1 RA therapies in clinical practice. This review provides a summary of clinical and real-world evidence along with practical guidance, with the aim of aiding primary care clinicians in the initiation and monitoring of GLP-1 RAs to help ensure that desired outcomes are realised. Furthermore, a benefit/risk tool has been developed on the basis of current available evidence and guidelines to support primary care clinicians in selecting individuals who are most likely to benefit from GLP-1 RA therapies, in addition to indicating clinical situations where caution is needed.
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Affiliation(s)
- Kevin Fernando
- North Berwick Health Centre, North Berwick Group Practice, 54 St. Baldred's Road, North Berwick, EH39 4PU, UK.
| | | | | | | | - Dipesh C Patel
- University College London, Royal Free Campus, London, UK
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Bækdal TA, Breitschaft A, Donsmark M, Maarbjerg SJ, Søndergaard FL, Borregaard J. Effect of Various Dosing Conditions on the Pharmacokinetics of Oral Semaglutide, a Human Glucagon-Like Peptide-1 Analogue in a Tablet Formulation. Diabetes Ther 2021; 12:1915-1927. [PMID: 34080123 PMCID: PMC8266944 DOI: 10.1007/s13300-021-01078-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/10/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Oral semaglutide is a novel tablet formulation of the human glucagon-like peptide-1 analogue semaglutide. In two trials, the effects of prior food ingestion (food effect), post-dose fasting period and water volume with dosing (dosing conditions) on oral semaglutide pharmacokinetics were investigated. METHODS Subjects received once-daily oral semaglutide for 10 days. In the food-effect trial, 78 healthy subjects were randomised 1:1:1 to fed (meal 30 min pre-dose; 240 mL water with dosing), fasting (overnight until 4 h post-dose; 240 mL) or reference (fasting overnight until 30 min post-dose; 120 mL) arms. In the dosing conditions trial, 161 healthy men were randomised into eight dosing groups (overnight fasted with 50/120 mL water and 15/30/60/120 min post-dose fasting). Semaglutide plasma concentrations were measured frequently until 504 h after the 10th dose. RESULTS In the food-effect trial, limited or no measurable semaglutide exposure was observed in the fed arm, while all subjects in the fasting arm had measurable semaglutide exposure. Area under the semaglutide concentration-time curve (AUC0-24h,semaglutide,day10) and maximum semaglutide concentration (Cmax,semaglutide,day10) were numerically greater by approximately 40% for the fasting versus reference arm (p = 0.082 and p = 0.080, respectively). In the dosing conditions trial, AUC0-24h,semaglutide,day10 and Cmax,semaglutide,day10 were not different between water volumes (p = 0.541 and p = 0.676), but increased with longer post-dose fasting (p < 0.001). CONCLUSION Administration of oral semaglutide in the fasting state with up to 120 mL water and at least 30 min post-dose fasting results in clinically relevant semaglutide exposure. These dosing conditions have been used in the oral semaglutide phase 3 trials and are part of the approved label. TRIAL REGISTRATION ClinicalTrials.gov identifiers NCT02172313, NCT01572753.
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Affiliation(s)
- Tine A Bækdal
- Novo Nordisk A/S, Vandtårnsvej 114, 2860, Søborg, Denmark.
| | - Astrid Breitschaft
- Early Phase Clinical Unit - Berlin, Parexel International GmbH, Klinikum Westend - Haus 18, Spandauer Damm 130, 14050, Berlin, Germany
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Andreassen KV, Larsen AT, Sonne N, Mohamed KE, Karsdal MA, Henriksen K. KBP-066A, a long-acting dual amylin and calcitonin receptor agonist, induces weight loss and improves glycemic control in obese and diabetic rats. Mol Metab 2021; 53:101282. [PMID: 34214708 PMCID: PMC8313742 DOI: 10.1016/j.molmet.2021.101282] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 11/17/2022] Open
Abstract
Objective Dual amylin and calcitonin receptor agonists (DACRAs) are novel therapeutic agents that not only improve insulin sensitivity but also work as an adjunct to established T2DM therapies. DACRAs are currently administered once daily, though it is unknown whether DACRAs with increased plasma half-life can be developed as a once-weekly therapy. Methods The in vitro potencies of the KBP-066A and KBP-066 (non-acylated) were assessed using reporter assays. Acylation functionality was investigated by a combination of pharmacokinetics and acute food intake in rats. in vivo efficacies were investigated head-to-head in obese (HFD) and T2D (ZDF) models. Results In in vitro, KBP-066A activated the CTR and AMY-R potently, with no off-target activity. Acylation functionality was confirmed by acute tests, as KBP-066A demonstrated a prolonged PK and PD response compared to KBP-066. Both compounds induced potent and dose-dependent weight loss in the HFD rat model. In ZDF rats, fasting blood glucose/fasting insulin levels (tAUC) were reduced by 39%/50% and 36%/47% for KBP-066 and KBP-066A, respectively. This effect resulted in a 31% and 46% vehicle-corrected reduction in HbA1c at the end of the study for KBP-066 and KBP-066A, respectively. Conclusions Here, we present pre-clinical data on an acylated DACRA, KBP-066A. The in vivo efficacy of KBP-066A is significantly improved compared to its non-acylated variant regarding weight loss and glycemic control in obese (HFD) and obese diabetic rats (ZDF). This compendium of pre-clinical studies highlights KBP-066A as a promising, once-weekly therapeutic agent for treating T2DM and obesity. DACRAs are promising once daily therapeutic candidates for metabolic diseases. We here present a novel DACRA called KBP-066A optimized for weekly delivery. KBP-066A potently reduced appetite and body weight in obese rats. More importantly, KBP-066A was superior to the corresponding daily DACRA in terms of glucose control. KBP-066A is a novel promising therapy for metabolic diseases.
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Affiliation(s)
| | - A T Larsen
- Nordic Bioscience A/S, Herlev, DK-2730, Denmark
| | - N Sonne
- Nordic Bioscience A/S, Herlev, DK-2730, Denmark
| | - K E Mohamed
- Nordic Bioscience A/S, Herlev, DK-2730, Denmark
| | - M A Karsdal
- Nordic Bioscience A/S, Herlev, DK-2730, Denmark; KeyBioscience AG, Stans, Switzerland
| | - K Henriksen
- Nordic Bioscience A/S, Herlev, DK-2730, Denmark; KeyBioscience AG, Stans, Switzerland.
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45
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Overgaard RV, Navarria A, Ingwersen SH, Bækdal TA, Kildemoes RJ. Clinical Pharmacokinetics of Oral Semaglutide: Analyses of Data from Clinical Pharmacology Trials. Clin Pharmacokinet 2021; 60:1335-1348. [PMID: 33969456 PMCID: PMC8505367 DOI: 10.1007/s40262-021-01025-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 12/14/2022]
Abstract
Objective The absorption, distribution and elimination of oral semaglutide, the first oral glucagon-like peptide-1 receptor agonist for treating type 2 diabetes, was investigated using a population pharmacokinetic model based on data from clinical pharmacology trials. Methods A previously developed, two-compartment pharmacokinetic model, based on subcutaneous and intravenous semaglutide, was extended to include data from six oral semaglutide trials conducted in either healthy volunteers or subjects with renal or hepatic impairment. Five trials employed multiple doses of oral semaglutide (5–10 mg) and one was a single-dose (10 mg) trial. In a separate analysis, the model was re-estimated using data from a trial in subjects with type 2 diabetes. Results The model accurately described concentration profiles across trials. Post-dose fasting time, co-ingestion of a large water volume, and body weight were the most important covariates affecting semaglutide exposure. Bioavailability was 0.8% when oral semaglutide was dosed using the recommended dosing conditions (30 min post-dose fasting time, administered with ≤ 120 mL of water), increasing with a longer post-dose fasting time and decreasing with higher water volume. Within-subject variability in bioavailability was 137%, which with once-daily dosing and a long half-life translates into 33% within-subject variability in steady-state exposure. There was no significant difference in oral bioavailability of semaglutide in healthy subjects and subjects with type 2 diabetes. Conclusions The updated model provided a general characterisation of semaglutide pharmacokinetics following oral, subcutaneous and intravenous administration in healthy subjects and subjects with type 2 diabetes. Within-individual variation of oral bioavailability was relatively high, but reduced considerably at steady state. ClinicalTrials.gov identifiers NCT01572753, NCT01619345, NCT02014259, NCT02016911, NCT02249871, NCT02172313, NCT02877355. Supplementary Information The online version contains supplementary material available at 10.1007/s40262-021-01025-x.
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Jordy AB, Albayaty M, Breitschaft A, Anderson TW, Christiansen E, Houshmand-Øregaard A, Manigandan E, Bækdal TA. Effect of Oral Semaglutide on the Pharmacokinetics of Levonorgestrel and Ethinylestradiol in Healthy Postmenopausal Women and Furosemide and Rosuvastatin in Healthy Subjects. Clin Pharmacokinet 2021; 60:1171-1185. [PMID: 33782832 PMCID: PMC8416862 DOI: 10.1007/s40262-020-00976-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background The first oral glucagon-like peptide-1 receptor agonist (GLP-1RA) comprises semaglutide co-formulated with the absorption enhancer, sodium N-(8-[2-hydroxybenzoyl] amino) caprylate (SNAC). Oral semaglutide may alter the pharmacokinetics of co-administered drugs via effects of semaglutide or SNAC. Two separate one-sequence crossover trials investigated the effects of oral semaglutide and SNAC on the pharmacokinetics of ethinylestradiol, levonorgestrel, furosemide and rosuvastatin. Methods Healthy, postmenopausal women (n = 25) received once-daily combined ethinylestradiol and levonorgestrel (Trial 1) and healthy male and female subjects (n = 41) received single doses of furosemide and rosuvastatin (Trial 2), either alone, with SNAC alone or with oral semaglutide. Lack of drug–drug interaction was concluded if 90% confidence intervals (CIs) for the ratio of area under the plasma concentration–time curve (AUC) or maximum concentration (Cmax), with/without oral semaglutide, were within a pre-specified interval (0.80–1.25). Results The AUC values of ethinylestradiol and levonorgestrel were not affected by oral semaglutide co-administration (estimated ratios [90% CI] 1.06 [1.01–1.10] and 1.06 [0.97–1.17], respectively); Cmax was not affected. The no-effect criterion was not met for furosemide or rosuvastatin for the AUC (1.28 [1.16–1.42] and 1.41 [1.24–1.60], respectively) or Cmax. SNAC alone did not affect the AUC or Cmax of ethinylestradiol, levonorgestrel or rosuvastatin; the Cmax of furosemide was slightly decreased. Adverse events were similar to those previously observed for GLP-1RAs (both trials). Conclusion Co-administration with oral semaglutide did not affect the pharmacokinetics of ethinylestradiol or levonorgestrel. There was a small increase in exposure of furosemide and rosuvastatin; however, these increases are not expected to be of clinical relevance. Clinical Trial Registration Numbers NCT02845219 and NCT03010475. Supplementary Information The online version contains supplementary material available at (10.1007/s40262-020-00976-x).
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Affiliation(s)
- Andreas B Jordy
- Novo Nordisk A/S, Vandtårnsvej 108-110, 2860, Søborg, Denmark
| | - Muna Albayaty
- Parexel Early Phase Clinical Unit, Northwick Park Hospital, Parexel International, Watford Road, Harrow, HA1 3UJ, UK
| | - Astrid Breitschaft
- Parexel International GmbH, Klinikum Westend, Haus 18, Spandauer Damm 130, 14050, Berlin, Germany
| | | | | | | | - Easwaran Manigandan
- Novo Nordisk Service Centre India Private Ltd., Plot No. 148, 2nd Floor, Prestige Featherlite Tech Park, 2nd Phase, EPIP Area, Whitefield, Bangalore, 560 066, India
| | - Tine A Bækdal
- Novo Nordisk A/S, Vandtårnsvej 108-110, 2860, Søborg, Denmark.
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Helmstädter J, Keppeler K, Küster L, Münzel T, Daiber A, Steven S. Glucagon-like peptide-1 (GLP-1) receptor agonists and their cardiovascular benefits-The role of the GLP-1 receptor. Br J Pharmacol 2021; 179:659-676. [PMID: 33764504 PMCID: PMC8820186 DOI: 10.1111/bph.15462] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular outcome trials revealed cardiovascular benefits for type 2 diabetes mellitus patients when treated with long‐acting glucagon‐like peptide‐1 (GLP‐1) receptor agonists. In the last decade, major advances were made characterising the physiological effects of GLP‐1 and its action on numerous targets including brain, liver, kidney, heart and blood vessels. However, the effects of GLP‐1 and receptor agonists, and the GLP‐1 receptor on the cardiovascular system have not been fully elucidated. We compare results from cardiovascular outcome trials of GLP‐1 receptor agonists and review pleiotropic clinical and preclinical data concerning cardiovascular protection beyond glycaemic control. We address current knowledge on GLP‐1 and receptor agonist actions on the heart, vasculature, inflammatory cells and platelets, and discuss evidence for GLP‐1 receptor‐dependent versus independent effects secondary of GLP‐1 metabolites. We conclude that the favourable cardiovascular profile of GLP‐1 receptor agonists might expand their therapeutic use for treating cardiovascular disease even in non‐diabetic populations.
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Affiliation(s)
- Johanna Helmstädter
- Department of Cardiology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - Karin Keppeler
- Department of Cardiology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - Leonie Küster
- Department of Cardiology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany.,Center of Thrombosis and Hemostasis (CTH), University Medical Center, Mainz, Germany.,Partner Site Rhine-Main, German Center for Cardiovascular Research (DZHK), Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany.,Center of Thrombosis and Hemostasis (CTH), University Medical Center, Mainz, Germany.,Partner Site Rhine-Main, German Center for Cardiovascular Research (DZHK), Mainz, Germany
| | - Sebastian Steven
- Department of Cardiology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany.,Center of Thrombosis and Hemostasis (CTH), University Medical Center, Mainz, Germany
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Baekdal TA, Donsmark M, Hartoft-Nielsen ML, Søndergaard FL, Connor A. Relationship Between Oral Semaglutide Tablet Erosion and Pharmacokinetics: A Pharmacoscintigraphic Study. Clin Pharmacol Drug Dev 2021; 10:453-462. [PMID: 33750044 PMCID: PMC8251533 DOI: 10.1002/cpdd.938] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 02/17/2021] [Indexed: 02/06/2023]
Abstract
Semaglutide, a glucagon‐like peptide‐1 (GLP‐1) analogue, has been coformulated in a tablet with the absorption enhancer, sodium N‐(8‐[2‐hydroxybenzoyl] amino) caprylate (SNAC). We investigated tablet erosion and the pharmacokinetics of oral semaglutide administered with 2 different water volumes and evaluated the relationships between these parameters. In a randomized, single‐center (Quotient Sciences, UK), open‐label, 2‐period crossover trial, 26 healthy men received single doses of 10 mg oral semaglutide with 50 or 240 mL water while fasting. Tablet erosion and gastrointestinal transit were assessed by gamma scintigraphy. Semaglutide and SNAC plasma concentrations were measured until 24 and 6 hours, respectively, after administration. Complete tablet erosion (CTE) occurred in the stomach irrespective of water volume administered with the tablet (primary end point). Mean time to CTE was 85 versus 57 minutes with 50 versus 240 mL water (ratio 50/240 mL, 1.51; 95% confidence interval, 0.96‐2.37; P = .072). Area under the semaglutide concentration‐time curve from 0 to 24 hours (AUC0‐24h,semaglutide) and maximum semaglutide concentration (Cmax,semaglutide) were ∼70% higher with 50 versus 240 mL water (P = .056 and P = .048, respectively). Median time to maximum semaglutide concentration (tmax,semaglutide) was 1.5 hours independent of water volume with dosing. Higher AUC0‐24h,semaglutide and Cmax,semaglutide and longer tmax,semaglutide were significantly correlated with longer time to CTE and later gastric emptying of tablet and water (all P < .05). The safety profile was as expected for the GLP‐1 receptor agonist drug class. In conclusion, the oral semaglutide tablet erodes in the stomach irrespective of water volume with dosing. Slower tablet erosion in the stomach results in higher semaglutide plasma exposure.
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Judák P, Esposito S, Coppieters G, Van Eenoo P, Deventer K. Doping control analysis of small peptides: A decade of progress. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1173:122551. [PMID: 33848801 DOI: 10.1016/j.jchromb.2021.122551] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 02/06/2023]
Abstract
Small peptides are handled in the field of sports drug testing analysis as a separate group doping substances. It is a diverse group, which includes but is not limited to growth hormone releasing-factors and gonadotropin-releasing hormone analogues. Significant progress has been achieved during the past decade in the doping control analysis of these peptides. In this article, achievements in the application of liquid chromatography-mass spectrometry-based methodologies are reviewed. To meet the augmenting demands for analyzing an increasing number of samples for the presence of an increasing number of prohibited small peptides, testing methods have been drastically simplified, whilst their performance level remained constant. High-resolution mass spectrometers have been installed in routine laboratories and became the preferred detection technique. The discovery and implementation of metabolites/catabolites in testing methods led to extended detection windows of some peptides, thus, contributed to more efficient testing in the anti-doping community.
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Affiliation(s)
- Péter Judák
- Department of Diagnostic Sciences, Doping Control Laboratory, Ghent University, Zwijnaarde, Belgium.
| | - Simone Esposito
- ADME/DMPK Department, Drug Discovery Division, IRBM S.p.A, Pomezia, Rome, Italy
| | - Gilles Coppieters
- Department of Diagnostic Sciences, Doping Control Laboratory, Ghent University, Zwijnaarde, Belgium
| | - Peter Van Eenoo
- Department of Diagnostic Sciences, Doping Control Laboratory, Ghent University, Zwijnaarde, Belgium
| | - Koen Deventer
- Department of Diagnostic Sciences, Doping Control Laboratory, Ghent University, Zwijnaarde, Belgium
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50
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Ahangarpour M, Kavianinia I, Harris PWR, Brimble MA. Photo-induced radical thiol-ene chemistry: a versatile toolbox for peptide-based drug design. Chem Soc Rev 2021; 50:898-944. [PMID: 33404559 DOI: 10.1039/d0cs00354a] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
While the global market for peptide/protein-based therapeutics is witnessing significant growth, the development of peptide drugs remains challenging due to their low oral bioavailability, poor membrane permeability, and reduced metabolic stability. However, a toolbox of chemical approaches has been explored for peptide modification to overcome these obstacles. In recent years, there has been a revival of interest in photoinduced radical thiol-ene chemistry as a powerful tool for the construction of therapeutic peptides.
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Affiliation(s)
- Marzieh Ahangarpour
- School of Chemical Sciences, The University of Auckland, 23 Symonds Street, Auckland 1010, New Zealand.
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