A randomized phase I study of BI 1820237, a novel neuropeptide Y receptor type 2 agonist, alone or in combination with low-dose liraglutide in otherwise healthy men with overweight or obesity.

anti‐obesity drug dose–response relationship obesity therapy phases I and II weight control

Journal

Diabetes, obesity & metabolism
ISSN: 1463-1326
Titre abrégé: Diabetes Obes Metab
Pays: England
ID NLM: 100883645

Informations de publication

Date de publication:
07 Oct 2024
Historique:
revised: 06 09 2024
received: 05 06 2024
accepted: 13 09 2024
medline: 7 10 2024
pubmed: 7 10 2024
entrez: 7 10 2024
Statut: aheadofprint

Résumé

Pharmacotherapeutic options for obesity treatment include glucagon-like peptide-1 receptor (GLP-1R) agonists, for example, liraglutide. However, an unmet need remains, particularly in patients with a high body mass index (BMI), as GLP-1R agonists are associated with gastrointestinal adverse events (AEs) and some patients do not respond to treatment. Neuropeptide Y (NPY) and peptide YY bind G-protein-coupled Y receptors and represent attractive targets for modulating bodyweight. This first-in-human, three-part, partially blinded phase I study (NCT04903509) investigated the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of single ascending doses of the peptidic NPY2R agonist BI 1820237, with/without low-dose liraglutide: part 1 (participants randomized to receive BI 1820237: 0.075-2.4 mg or placebo), part 2 (BI 1820237: 1.2 mg or placebo) and part 3 (BI 1820237: 0.025-1.2 mg + liraglutide 0.6 mg or placebo + liraglutide 0.6 mg). Primary endpoint is the proportion of participants with drug-related AEs. Secondary endpoints are tolerability, PK and PD. In total, 95 otherwise healthy men with increased BMI (25.0-34.9 kg/m BI 1820237 treatment was associated with transient nausea and vomiting at higher doses. No differences in tolerability were observed when combined with liraglutide; effects on gastric emptying appeared additive.

Identifiants

pubmed: 39373311
doi: 10.1111/dom.15984
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Boehringer Ingelheim

Informations de copyright

© 2024 John Wiley & Sons Ltd.

Références

Bhaskaran K, Douglas I, Forbes H, dos‐Santos‐Silva I, Leon DA, Smeeth L. Body‐mass index and risk of 22 specific cancers: a population‐based cohort study of 5·24 million UK adults. Lancet. 2014;384(9945):755‐765. doi:10.1016/s0140‐6736(14)60892‐8
Bray GA, Kim KK, Wilding JPH. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev. 2017;18(7):715‐723. doi:10.1111/obr.12551
Dai H, Alsalhe TA, Chalghaf N, Riccò M, Bragazzi NL, Wu J. The global burden of disease attributable to high body mass index in 195 countries and territories, 1990‐2017: an analysis of the Global Burden of Disease Study. PLoS Med. 2020;17(7):e1003198. doi:10.1371/journal.pmed.1003198
GBD 2017 Causes of Death Collaborators. Global, regional, and national age‐sex‐specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1736‐1788. doi:10.1016/s0140‐6736(18)32203‐7
Godoy‐Matos AF, Silva Júnior WS, Valerio CM. NAFLD as a continuum: from obesity to metabolic syndrome and diabetes. Diabetol Metab Syndr. 2020;12:60. doi:10.1186/s13098‐020‐00570‐y
Garvey WT, Mechanick JI, Brett EM, et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22(Suppl 3):1‐203. doi:10.4158/EP161365.GL
Cornier MA. A review of current guidelines for the treatment of obesity. Am J Manag Care. 2022;28(Suppl 15):S288‐S296. doi:10.37765/ajmc.2022.89292
Forst T, De Block C, Del Prato S, et al. The role of incretin receptor agonists in the treatment of obesity. Diabetes Obes Metab. 2024;26(10):4178‐4196. doi:10.1111/dom.15796
Novo Nordisk A/S. Liraglutide (Saxenda). Prescribing information. 2023 Accessed April 23, 2024. https://www.novo-pi.com/saxenda.pdf
Novo Nordisk A/S. Semaglutide (Rybelsus). Prescribing information. 2024 Accessed April 23, 2024. https://www.novo-pi.com/rybelsus.pdf
U.S. Food and Drug Administration. FDA approves weight management drug for patients aged 12 and older. 2020 Accessed April 23, 2024. https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-weight-management-drug-patients-aged-12-and-older
U.S. Food and Drug Administration. FDA approves new drug treatment for chronic weight management, first since 2014. 2021 Accessed April 23, 2024. https://www.fda.gov/news‐events/press‐announcements/fda‐approves‐new‐drug‐treatment‐chronic‐weight‐management‐first‐2014
le Roux CW, Astrup A, Fujioka K, et al. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double‐blind trial. Lancet. 2017;389(10077):1399‐1409. doi:10.1016/s0140‐6736(17)30069‐7
O'Neil PM, Birkenfeld AL, McGowan B, et al. Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double‐blind, placebo and active controlled, dose‐ranging, phase 2 trial. Lancet. 2018;392(10148):637‐649. doi:10.1016/s0140‐6736(18)31773‐2
Pi‐Sunyer X, Astrup A, Fujioka K, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015;373(1):11‐22. doi:10.1056/NEJMoa1411892
Wilding JPH, Batterham RL, Calanna S, et al. Once‐weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989. doi:10.1056/NEJMoa2032183
Astrup A, Carraro R, Finer N, et al. Safety, tolerability and sustained weight loss over 2 years with the once‐daily human GLP‐1 analog, liraglutide. Int J Obes (Lond). 2012;36(6):843‐854. doi:10.1038/ijo.2011.158
Baggio LL, Drucker DJ. Glucagon‐like peptide‐1 receptor co‐agonists for treating metabolic disease. Mol Metab. 2021;46:101090. doi:10.1016/j.molmet.2020.101090
U.S. Food & Drug Administration. Press Release: FDA Approves New Medication for Chronic Weight Management. 2023 Accessed July 1, 2024. https://www.fda.gov/news-events/press-announcements/fda-approves-new-medication-chronic-weight-management
U.S. Food & Drug Administration. Zepbound (tirzepatide). Product information. 2022 Accessed July 1, 2024. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/217806s000lbl.pdf
Jastreboff Ania M, Aronne Louis J, Ahmad Nadia N, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205‐216. doi:10.1056/NEJMoa2206038
Jungnik A, Martinez JA, Plum‐Mörschel L, et al. Phase I studies of the safety, tolerability, pharmacokinetics and pharmacodynamics of the dual glucagon receptor/glucagon‐like peptide‐1 receptor agonist BI 456906. Diabetes Obes Metab. 2023;25(4):1011‐1023. doi:10.1111/dom.14948
Blüher M, Rosenstock J, Hoefler J, Manuel R, Hennige AM. Dose‐response effects on HbA1c and bodyweight reduction of survodutide, a dual glucagon/GLP‐1 receptor agonist, compared with placebo and open‐label semaglutide in people with type 2 diabetes: a randomised clinical trial. Diabetologia. 2024;67(3):470‐482.
Jastreboff AM, Kaplan LM, Frías JP, et al. Triple‐hormone‐receptor agonist retatrutide for obesity—a phase 2 trial. N Engl J Med. 2023;389(6):514‐526. doi:10.1056/NEJMoa2301972
Sainsbury A, Rohner‐Jeanrenaud F, Cusin I, et al. Chronic central neuropeptide Y infusion in normal rats: status of the hypothalamo‐pituitary‐adrenal axis, and vagal mediation of hyperinsulinaemia. Diabetologia. 1997;40(11):1269‐1277. doi:10.1007/s001250050820
Silva AP, Cavadas C, Grouzmann E. Neuropeptide Y and its receptors as potential therapeutic drug targets. Clin Chim Acta. 2002;326(1–2):3‐25. doi:10.1016/s0009‐8981(02)00301‐7
Sloth B, Holst JJ, Flint A, Gregersen NT, Astrup A. Effects of PYY1‐36 and PYY3‐36 on appetite, energy intake, energy expenditure, glucose and fat metabolism in obese and lean subjects. Am J Physiol Endocrinol Metab. 2007;292(4):E1062‐E1068. doi:10.1152/ajpendo.00450.2006
Vrang N, Madsen AN, Tang‐Christensen M, Hansen G, Larsen PJ. PYY(3‐36) reduces food intake and body weight and improves insulin sensitivity in rodent models of diet‐induced obesity. Am J Physiol Regul Integr Comp Physiol. 2006;291(2):R367‐R375. doi:10.1152/ajpregu.00726.2005
Jones ES, Nunn N, Chambers AP, Østergaard S, Wulff BS, Luckman SM. Modified peptide YY molecule attenuates the activity of NPY/AgRP neurons and reduces food intake in male mice. Endocrinology. 2019;160(11):2737‐2747. doi:10.1210/en.2019‐00100

Auteurs

Nadine Beetz (N)

Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riß, Germany.

Brigitte Kalsch (B)

CRS Clinical Research Services Mannheim GmbH, Mannheim, Germany.

Thomas Forst (T)

CRS Clinical Research Services Mannheim GmbH, Mannheim, Germany.

Bernhard Schmid (B)

Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riß, Germany.

Armin Schultz (A)

CRS Clinical Research Services Mannheim GmbH, Mannheim, Germany.

Anita M Hennige (AM)

Boehringer Ingelheim International GmbH, Biberach an der Riß, Germany.

Classifications MeSH