1
|
Deng W, Zhao Z, Zou T, Kuang T, Wang J. Research Advances in Fusion Protein-Based Drugs for Diabetes Treatment. Diabetes Metab Syndr Obes 2024; 17:343-362. [PMID: 38288338 PMCID: PMC10823413 DOI: 10.2147/dmso.s421527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/22/2023] [Indexed: 01/31/2024] Open
Abstract
Diabetes mellitus (DM) is a chronic metabolic disease characterized by elevated blood glucose levels, resulting in multi-organ dysfunction and various complications. Fusion proteins can form multifunctional complexes by combining the target proteins with partner proteins. It has significant advantages in improving the performance of the target proteins, extending their biological half-life, and enhancing patient drug compliance. Fusion protein-based drugs have emerged as promising new drugs in diabetes therapeutics. However, there has not been a systematic review of fusion protein-based drugs for diabetes therapeutics. Hence, we conducted a comprehensive review of published literature on diabetic fusion protein-based drugs for diabetes, with a primary focus on immunoglobulin G (IgG) fragment crystallizable (Fc) region, albumin, and transferrin (TF). This review aims to provide a reference for the subsequent development and clinical application of fusion protein-based drugs in diabetes therapeutics.
Collapse
Affiliation(s)
- Wenying Deng
- School of Basic Medical Sciences, University of South China, Hengyang, Hunan Province, 421001, People’s Republic of China
| | - Zeyi Zhao
- School of Basic Medical Sciences, University of South China, Hengyang, Hunan Province, 421001, People’s Republic of China
| | - Tao Zou
- Department of Cardiovascular Medicine, First Affiliated Hospital of University of South China, Hengyang, Hunan Province, 421001, People’s Republic of China
| | - Tongdong Kuang
- Guangxi Key Laboratory of Diabetic Systems Medicine, Guilin Medical University, Guilin, Guangxi Province, 541199, People’s Republic of China
| | - Jing Wang
- School of Basic Medical Sciences, University of South China, Hengyang, Hunan Province, 421001, People’s Republic of China
| |
Collapse
|
2
|
Tschöp M, Nogueiras R, Ahrén B. Gut hormone-based pharmacology: novel formulations and future possibilities for metabolic disease therapy. Diabetologia 2023; 66:1796-1808. [PMID: 37209227 PMCID: PMC10474213 DOI: 10.1007/s00125-023-05929-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/27/2023] [Indexed: 05/22/2023]
Abstract
Glucagon-like peptide-1 (GLP-1) receptor agonists are established pharmaceutical therapies for the treatment of type 2 diabetes and obesity. They mimic the action of GLP-1 to reduce glucose levels through stimulation of insulin secretion and inhibition of glucagon secretion. They also reduce body weight by inducing satiety through central actions. The GLP-1 receptor agonists used clinically are based on exendin-4 and native GLP-1 and are available as formulations for daily or weekly s.c. or oral administration. GLP-1 receptor agonism is also achieved by inhibitors of dipeptidyl peptidase-4 (DPP-4), which prevent the inactivation of GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), thereby prolonging their raised levels after meal ingestion. Other developments in GLP-1 receptor agonism include the formation of small orally available agonists and compounds with the potential to pharmaceutically stimulate GLP-1 secretion from the gut. In addition, GLP-1/glucagon and GLP-1/GIP dual receptor agonists and GLP-1/GIP/glucagon triple receptor agonists have shown the potential to reduce blood glucose levels and body weight through their effects on islets and peripheral tissues, improving beta cell function and stimulating energy expenditure. This review summarises developments in gut hormone-based therapies and presents the future outlook for their use in type 2 diabetes and obesity.
Collapse
Affiliation(s)
- Matthias Tschöp
- Institute for Diabetes and Obesity, Helmholtz Zentrum, München, Germany
| | - Ruben Nogueiras
- Department of Physiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Bo Ahrén
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
| |
Collapse
|
3
|
Werner U, Bielohuby M, Korn M, Riedel J, Will M, Méndez M. Preclinical pharmacology of RA15127343: In vitro and in vivo activity of a novel ultralong-acting basal insulin. Diabetes Obes Metab 2022; 24:2411-2419. [PMID: 35892256 DOI: 10.1111/dom.14827] [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: 04/21/2022] [Revised: 07/13/2022] [Accepted: 07/22/2022] [Indexed: 11/28/2022]
Abstract
AIM To report the in vitro and in vivo preclinical pharmacokinetic (PK) and pharmacodynamic (PD) properties of RA15127343, a novel ultralong-acting insulin analogue targeting once-weekly administration, in female Göttingen minipigs. METHODS In vitro binding and activation of human insulin receptor isoforms (IR-A/IR-B), glucose uptake in rat myocytes, as well as mitogenic activity of RA15127343 were evaluated. In vivo, the PK and PD activities of RA15127343 were assessed in female, normoglycaemic Göttingen minipigs. The half-life (t1/2 ) and time to maximum plasma concentration (Tmax ) of subcutaneously (SC) administered RA15127343 (10/30/45/60 nmol/kg) were estimated. In vivo blood glucose and endogenous plasma C-peptide concentrations after single SC administration (10/30/45/60 nmol/kg) or repeated dosing (15 nmol/kg) were analysed. RESULTS In comparison to human insulin, RA15127343 showed lower in vitro binding affinity (19.9/6.31 μM vs. 1.10/1.14 nM) and activation (2.054 μM/669.6 nM vs. 26.04/18.24 nM) of IR-A/IR-B, lower potency to activate glucose uptake (855.2 vs. 3.37 nM) and lower mitogenic activity (17.92 μM vs. 10.78 nM; proliferation in MCF7 cells). In vivo, the mean t1/2 and Tmax of RA15127343 after SC administration ranged from 48 to 59 and 30 to 39 hours, respectively. Blood glucose and plasma C-peptide concentrations were significantly lower with RA15127343 (single/repeated doses) versus vehicle. CONCLUSIONS RA15127343 showed an ultra-long t1/2 with a slow onset of action. The preclinical pharmacological outcomes suggest RA15127343 could be a potential ultralong-acting insulin analogue with low risk of hypoglycaemia in humans.
Collapse
Affiliation(s)
- Ulrich Werner
- Sanofi, R&D, TD Diabetes, Industriepark Hoechst, Frankfurt am Main, Germany
| | | | - Marcus Korn
- Sanofi, R&D, TD Diabetes, Industriepark Hoechst, Frankfurt am Main, Germany
| | - Jens Riedel
- Sanofi, R&D, Drug Metabolism and Pharmacokinetics, Industriepark Hoechst, Frankfurt am Main, Germany
| | - Martin Will
- Sanofi, R&D, Integrated Drug Discovery, Industriepark Hoechst, Frankfurt am Main, Germany
| | - María Méndez
- Sanofi, R&D, Integrated Drug Discovery, Industriepark Hoechst, Frankfurt am Main, Germany
| |
Collapse
|
4
|
Rao S, Somayaji Y, Kulal A. Synthesis and Evaluation of the Insulin-Albumin Conjugate with Prolonged Glycemic Control. ACS OMEGA 2022; 7:5131-5138. [PMID: 35187328 PMCID: PMC8851626 DOI: 10.1021/acsomega.1c06119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/20/2022] [Indexed: 05/17/2023]
Abstract
Engineering therapeutic proteins to improve their half-life so as to sustain physiologically relevant extended activity is the need of the hour in biopharmaceutical research. In this study, insulin and bovine serum albumin (BSA) were independently functionalized rationally and were later conjugated to prolong the half-life of insulin. The thiol functionalization of BSA with 2-imminothiolane in the ratio 1:20 yielded an average of 6-8 thiols/BSA, which then reacted with maleimide-functionalized insulin to form an insulin-albumin conjugate. The bioconjugate was purified by size exclusion chromatography, and the increase in size was confirmed by sodium dodecyl-sulfate polyacrylamide gel electrophoresis. Bioconjugation resulted in a multi-fold increase in the hydrodynamic volume of the insulin-albumin conjugate as measured in DLS when compared to BSA. The glucose uptake assay with 3LT3-L1 cell lines was performed, and the mean fluorescence intensity (MFI) of 16.16 observed for the insulin-albumin conjugate was comparable to insulin (19.42). The blood glucose reducing capacity of the insulin-albumin conjugate in streptozotocin induced diabetic male Wistar rats was well maintained up to 72 h when compared to native insulin. Further, a three-fold increase in plasma insulin concentration was observed in bioconjugate treated animals as against insulin treated animals after 24 h of treatment using ELISA. The histological analysis of different organs of the bioconjugate treated rats indicated that it was non-toxic. This study has paved a way for further detailed studies on similar bioconjugates to develop next-generation biotherapeutics for treating diabetes.
Collapse
Affiliation(s)
- Shrilakshmi
Sheshagiri Rao
- Division
of Biological Sciences, Poornaprajna Institute
of Scientific Research, Poornaprajnapura, Bidalur (Post), Bengaluru 562110, India
- Manipal
Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Yogish Somayaji
- Department
of Post Graduate Studies and Research in Biochemistry, St. Aloysius College (Autonomous), Mangaluru 575 003, Karnataka, India
| | - Ananda Kulal
- Division
of Biological Sciences, Poornaprajna Institute
of Scientific Research, Poornaprajnapura, Bidalur (Post), Bengaluru 562110, India
- . Phone: +91 9945900336
| |
Collapse
|
5
|
Liu H, Sun M, Liu Z, Kong C, Kong W, Ye J, Gong J, Huang DCS, Qian F. KRAS-enhanced macropinocytosis and reduced FcRn-mediated recycling sensitize pancreatic cancer to albumin-conjugated drugs. J Control Release 2019; 296:40-53. [PMID: 30653981 DOI: 10.1016/j.jconrel.2019.01.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 01/09/2019] [Accepted: 01/14/2019] [Indexed: 11/26/2022]
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a dominantly (~95%) KRAS-mutant cancer that has extremely poor prognosis, in part this is due to its strong intrinsic resistance towards almost all therapeutic agents. PDAC relies heavily on KRAS-transformed metabolism, including enhanced macropinocytosis and catabolism of extracellular albumin, to maintain its proliferation and progression. However, it has yet to be validated that whether such transformed metabolism could be exploited for the drug delivery to open therapeutic windows of cytotoxic agents in KRAS-mutant PDAC. In this study, we attempt to answer this question by focusing on the impact of two critical regulators of albumin catabolism, KRAS and the neonatal Fc receptor (FcRn), on the sensitivity of PDAC to doxorubicin (DOX, a model cytotoxic agent) and albumin-conjugated doxorubicin (DOX-ALB). Using cell lines and cell-derived xenografts with different KRAS genotypes and FcRn levels, we demonstrated that KRAS-enhanced macropinocytosis and reduced FcRn expression sensitize PDAC to DOX-ALB but not free DOX. In both in vitro and in vivo comparsion, the DOX-ALB demonstrated ~10 times enlarged therapeutic window compared with free DOX, in PDAC with KRAS mutation and reduced FcRn level, two events appear to occur simultaneously in the investigated PDAC. In summary, we conclude that albumin conjugation is an exploitable drug delivery strategy that significantly opens the therapeutic windows of otherwise undevelopable anti-cancer agents for KRAS-mutant PDAC therapy, and creates a new landscape for clinical evaluation and future translation of such compounds.
Collapse
Affiliation(s)
- Huiqin Liu
- School of Pharmaceutical Sciences and Beijing Advanced Innovation Center for Structural Biology, Tsinghua University, Beijing 100084, China
| | - Mengnan Sun
- School of Pharmaceutical Sciences and Beijing Advanced Innovation Center for Structural Biology, Tsinghua University, Beijing 100084, China
| | - Zhengsheng Liu
- School of Pharmaceutical Sciences and Beijing Advanced Innovation Center for Structural Biology, Tsinghua University, Beijing 100084, China
| | - Chao Kong
- School of Pharmaceutical Sciences and Beijing Advanced Innovation Center for Structural Biology, Tsinghua University, Beijing 100084, China
| | - Weijian Kong
- School of Pharmaceutical Sciences and Beijing Advanced Innovation Center for Structural Biology, Tsinghua University, Beijing 100084, China
| | - Junxiao Ye
- School of Pharmaceutical Sciences and Beijing Advanced Innovation Center for Structural Biology, Tsinghua University, Beijing 100084, China
| | - Jianan Gong
- Departments of Medical Biology, University of Melbourne, Australia; The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia
| | - David C S Huang
- Departments of Medical Biology, University of Melbourne, Australia; The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia
| | - Feng Qian
- School of Pharmaceutical Sciences and Beijing Advanced Innovation Center for Structural Biology, Tsinghua University, Beijing 100084, China.
| |
Collapse
|
6
|
Wismann P, Pedersen SL, Hansen G, Mannerstedt K, Pedersen PJ, Jeppesen PB, Vrang N, Fosgerau K, Jelsing J. Novel GLP-1/GLP-2 co-agonists display marked effects on gut volume and improves glycemic control in mice. Physiol Behav 2018. [PMID: 29540315 DOI: 10.1016/j.physbeh.2018.03.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AIM Analogues of several gastrointestinal peptide hormones have been developed into effective medicines for treatment of diseases such as type 2 diabetes mellitus (T2DM), obesity and short bowel syndrome (SBS). In this study, we aimed to explore whether the combination of glucagon-like peptide-1 (GLP-1) and glucagon-like peptide-2 (GLP-2) into a potent co-agonist could provide additional benefits compared to existing monotherapies. METHODS A short-acting (GUB09-123) and a half-life extended (GUB09-145) GLP-1/GLP-2 co-agonist were generated using solid-phase peptide synthesis and tested for effects on food intake, body weight, glucose homeostasis, and gut proliferation in lean mice and in diabetic db/db mice. RESULTS Sub-chronic administration of GUB09-123 to lean mice significantly reduced food intake, improved glucose tolerance, and increased gut volume, superior to monotherapy with the GLP-2 analogue teduglutide. Chronic administration of GUB09-123 to diabetic mice significantly improved glycemic control and showed persistent effects on gastric emptying, superior to monotherapy with the GLP-1 analogue liraglutide. Due to the short-acting nature of the molecule, no effects on body weight were observed, whereas a marked and robust intestinotrophic effect on mainly the small intestine volume and surface area was obtained. In contrast to GUB09-123, sub-chronic administration of a half-life extended GUB09-145 to lean mice caused marked dose-dependent effects on body weight while maintaining its potent intestinotrophic effect. CONCLUSION Our data demonstrate that the GLP-1/GLP-2 co-agonists have effects on gut morphometry, showing a marked increase in intestinal volume and mucosal surface area. Furthermore, effects on glucose tolerance and long-term glycemic control are evident. Effects on body weight and gastric emptying are also observed depending on the pharmacokinetic properties of the molecule. We suggest that this novel co-agonistic approach could exemplify a novel concept for treatment of T2DM or SBS.
Collapse
Affiliation(s)
| | | | - Gitte Hansen
- Gubra ApS, Hørsholm Kongevej 11B, Hørsholm, DK-2970, Denmark
| | | | | | - Palle B Jeppesen
- Rigshospitalet CA-2121, Blegdamsvej 9, Copenhagen DK-2100, Denmark
| | - Niels Vrang
- Gubra ApS, Hørsholm Kongevej 11B, Hørsholm, DK-2970, Denmark
| | - Keld Fosgerau
- Gubra ApS, Hørsholm Kongevej 11B, Hørsholm, DK-2970, Denmark
| | - Jacob Jelsing
- Gubra ApS, Hørsholm Kongevej 11B, Hørsholm, DK-2970, Denmark
| |
Collapse
|
7
|
Strain WD, Smith C. Cardiovascular Outcome Studies in Diabetes: How Do We Make Sense of These New Data? Diabetes Ther 2016; 7:175-85. [PMID: 27010644 PMCID: PMC4900975 DOI: 10.1007/s13300-016-0165-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Indexed: 12/25/2022] Open
Abstract
Poorly controlled diabetes is characterized by premature cardiovascular mortality and morbidity. The mechanisms linking hyperglycemia with accelerated atherosclerotic disease have not been fully elucidated; however, are thought to be mediated through vascular inflammation, oxidative stress and endothelial dysfunction. The advent of incretin-based therapy, whether by increasing endogenous glucagon-like peptide (GLP)-1 and glucose-dependent inhibitory polypeptide by inhibition of their breakdown using di-peptidyl peptidase 4 inhibitors, or augmenting GLP-1 activity using either exendin-4-based drugs or synthetic GLP-1 analogs promised not just improvements in glycemic control, but improvements in endothelial function, lipid profiles and markers of vascular inflammation. As such, it was anticipated they would demonstrate cardiovascular benefit in those with diabetes, indeed early meta-analyses suggested cardiovascular events would be reduced. To date, however, this benefit has failed to materialize, indeed the cardiovascular outcome trials, whilst meeting their primary endpoint of cardiovascular safety, have failed to demonstrate any improvements in stroke or myocardial infarction. This review will explore the data and attempt to answer the question: what went wrong?
Collapse
Affiliation(s)
- W David Strain
- Diabetes and Vascular Medicine, University of Exeter Medical School, Exeter, UK.
| | | |
Collapse
|
8
|
Taguchi K, Chuang VTG, Yamasaki K, Urata Y, Tanaka R, Anraku M, Seo H, Kawai K, Maruyama T, Komatsu T, Otagiri M. Cross-linked human serum albumin dimer has the potential for use as a plasma-retaining agent for the fatty acid-conjugated antidiabetic drugs. J Pharm Pharmacol 2014; 67:255-63. [DOI: 10.1111/jphp.12338] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 09/28/2014] [Indexed: 01/23/2023]
Abstract
Abstract
Objectives
The half-life of fatty acid-conjugated antidiabetic drugs are prolonged through binding to albumin, but this may not occur in diabetic patients with nephropathy complicated with hypoalbuminemia. We previously showed that human serum albumin (HSA) dimerized at the protein's Cys34 by 1,6-bis(maleimido)hexane has longer half-life than the monomer under high permeability conditions. The aim of this study was to investigate the superior ability of this HSA dimer as a plasma-retaining agent for fatty acid conjugated antidiabetic drugs.
Methods
The diabetic nephropathy rat model was prepared by administering a single injection of streptozotocin (STZ) intravenously, and the pharmacokinetic properties of HSA monomer and dimer were evaluated. Site-specific fluorescent probe displacement experiments were performed using warfarin and dansylsarcosine as site I and site II specific fluorescent probes, respectively.
Key findings
The half-life of the HSA dimer in STZ-induced diabetic nephropathy model rats was 1.5 times longer than the HSA monomer. The fluorescent probe displacement experiment results for HSA monomer and dimer were similar, where fatty acid-conjugated antidiabetic drugs displaced dansylsarcosine but not warfarin in a concentration-dependent manner.
Conclusions
The HSA dimer shows potential for use as a plasma-retaining agent for antidiabetic drugs due to its favourable pharmacokinetic properties.
Collapse
Affiliation(s)
- Kazuaki Taguchi
- Faculty of Pharmaceutical Sciences, Sojo University, Kumamoto, Japan
| | - Victor Tuan Giam Chuang
- School of Pharmacy, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Keishi Yamasaki
- Faculty of Pharmaceutical Sciences, Sojo University, Kumamoto, Japan
- DDS Research Institute, Sojo University, Kumamoto, Japan
| | - Yukino Urata
- Department of Biopharmaceutics, Kumamoto University, Kumamoto, Japan
| | - Ryota Tanaka
- Department of Biopharmaceutics, Kumamoto University, Kumamoto, Japan
| | - Makoto Anraku
- Faculty of Pharmaceutical Sciences, Sojo University, Kumamoto, Japan
| | - Hakaru Seo
- Faculty of Pharmaceutical Sciences, Sojo University, Kumamoto, Japan
- DDS Research Institute, Sojo University, Kumamoto, Japan
| | - Keiichi Kawai
- School of Health Sciences, Faculty of Medicine, Kanazawa University, Kanazawa, Japan
| | - Toru Maruyama
- Department of Biopharmaceutics, Kumamoto University, Kumamoto, Japan
- Center for Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Teruyuki Komatsu
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Bunkyo-ku, Japan
| | - Masaki Otagiri
- Faculty of Pharmaceutical Sciences, Sojo University, Kumamoto, Japan
- Department of Biopharmaceutics, Kumamoto University, Kumamoto, Japan
- DDS Research Institute, Sojo University, Kumamoto, Japan
| |
Collapse
|
9
|
Dalbøge LS, Pedersen SL, van Witteloostuijn SB, Rasmussen JE, Rigbolt KTG, Jensen KJ, Holst B, Vrang N, Jelsing J. Synthesis and evaluation of novel lipidated neuromedin U analogs with increased stability and effects on food intake. J Pept Sci 2014; 21:85-94. [DOI: 10.1002/psc.2727] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 11/26/2014] [Accepted: 11/27/2014] [Indexed: 01/19/2023]
Affiliation(s)
- Louise S. Dalbøge
- Gubra ApS; Agern Alle 1 2970 Hørsholm Denmark
- The Novo Nordisk Foundation Center for Basic Metabolic Research; University of Copenhagen; Blegdamsvej 3B 2200 Copenhagen N Denmark
| | | | - Søren B. van Witteloostuijn
- Gubra ApS; Agern Alle 1 2970 Hørsholm Denmark
- Department of Chemistry; University of Copenhagen; Thorvaldsensvej 40 1871 Frederiksberg C Denmark
| | - Jakob E. Rasmussen
- Department of Chemistry; University of Copenhagen; Thorvaldsensvej 40 1871 Frederiksberg C Denmark
| | | | - Knud J. Jensen
- Department of Chemistry; University of Copenhagen; Thorvaldsensvej 40 1871 Frederiksberg C Denmark
| | - Birgitte Holst
- The Novo Nordisk Foundation Center for Basic Metabolic Research; University of Copenhagen; Blegdamsvej 3B 2200 Copenhagen N Denmark
| | - Niels Vrang
- Gubra ApS; Agern Alle 1 2970 Hørsholm Denmark
| | | |
Collapse
|
10
|
Han J, Sun L, Chu Y, Li Z, Huang D, Zhu X, Qian H, Huang W. Design, Synthesis, and Biological Activity of Novel Dicoumarol Glucagon-like Peptide 1 Conjugates. J Med Chem 2013; 56:9955-68. [DOI: 10.1021/jm4017448] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Jing Han
- Center of Drug Discovery,
State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 210009, P. R. China
| | - Lidan Sun
- Center of Drug Discovery,
State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 210009, P. R. China
| | - Yingying Chu
- Center of Drug Discovery,
State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 210009, P. R. China
| | - Zheng Li
- Center of Drug Discovery,
State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 210009, P. R. China
| | - Dandan Huang
- Center of Drug Discovery,
State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 210009, P. R. China
| | - Xiaoyun Zhu
- Center of Drug Discovery,
State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 210009, P. R. China
| | - Hai Qian
- Center of Drug Discovery,
State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 210009, P. R. China
| | - Wenlong Huang
- Center of Drug Discovery,
State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 210009, P. R. China
| |
Collapse
|
11
|
Wang F, Surh J, Kaur M. Insulin degludec as an ultralong-acting basal insulin once a day: a systematic review. Diabetes Metab Syndr Obes 2012; 5:191-204. [PMID: 22826637 PMCID: PMC3402007 DOI: 10.2147/dmso.s21979] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Insulin degludec (IDeg) is a neutral, ultralong-acting new generation basal insulin analog developed by NovoNordisk currently in Phase III clinical development. IDeg offers a duration of action of more than 42 hours in adults, much longer than current basal insulin formulations. OBJECTIVE The aim of this review is to assess the efficacy and safety data of IDeg in the treatment of type 1 and type 2 diabetes mellitus. METHODS Relevant English language articles from 2010 to 2012 were identified through MEDLINE, PubMed, EMBASE, Scopus, BIOSIS, and Google Scholar. Online conference proceedings of the 71st ADA Scientific Sessions and the 47th EASD Annual Meeting were reviewed. Studies were compared in terms of their study designs, primary and secondary efficacy parameters, and tolerability data. RESULTS There are a total of nine published trials investigating the clinical efficacy and safety of IDeg in over 3000 subjects with type 1 and 2 diabetes. Only three trials were published in full. All were open-label, randomized multicenter trials with durations of 16 to 52 weeks. IDeg and coformulations of IDeg with insulin aspart (IAsp) were compared to insulin glargine (IGlar), detemir, and biphasic IAsp 30 (BIAsp 30). CONCLUSION Based upon the available evidence, there appear to be no reported differences between IDeg and IGlar, detemir, or BIAsp 30 in the reduction of the primary efficacy end-points of HbA(1c) and mean fasting plasma glucose (FPG) concentrations. Only flexible dosing of IDeg provided a significant reduction in FPG compared to IGlar. IDeg demonstrated a significant reduction in nocturnal hypoglycemia in type 1 diabetes. In type 2 diabetes, IDeg reduced the incidence of hypoglycemia by 18% and 58% compared to IGlar and BIAsp 30, respectively.
Collapse
Affiliation(s)
- Fei Wang
- University of Connecticut School of Pharmacy, Department of Pharmacy Practice, Storrs
| | - Justine Surh
- University of Connecticut School of Pharmacy, Department of Pharmacy Practice, Storrs
| | - Manmeet Kaur
- Joslin Diabetes Center Affiliate, Hospital of Central Connecticut, New Britain, CT, USA
| |
Collapse
|