Receptor occupancy of dual glucagon-like peptide 1/glucagon receptor agonist SAR425899 in individuals with type 2 diabetes.

Abstract

Unimolecular dual agonists for the glucagon-like peptide 1 receptor (GLP1R) and glucagon receptor (GCGR) are emerging as a potential new class of important therapeutics in type 2 diabetes (T2D). Reliable and quantitative assessments of in vivo occupancy on each receptor would improve the understanding of the efficacy of this class of drugs. In this study we investigated the target occupancy of the dual agonist SAR425899 at the GLP1R in pancreas and GCGR in liver by Positron Emission Tomography/Computed Tomography (PET/CT). Patients with T2D were examined by [68Ga]Ga-DO3A-Tuna-2 and [68Ga]Ga-DO3A-Exendin4 by PET, to assess the GCGR in liver and GLP1R in pancreas, respectively. Follow up PET examinations were performed after 17 (GCGR) and 20 (GLP-1R) days of treatment with SAR425899, to assess the occupancy at each receptor. Six out of 13 included patients prematurely discontinued the study due to adverse events. SAR425899 at a dose of 0.2 mg daily demonstrated an average GCGR occupancy of 11.2 ± 14.4% (SD) in N = 5 patients and a GLP1R occupancy of 49.9 ± 13.3%. Fasting Plasma Glucose levels (- 3.30 ± 1.14 mmol/L) and body weight (- 3.87 ± 0.87%) were lowered under treatment with SAR425899. In conclusion, SAR425899 demonstrated strong interactions at the GLP1R, but no clear occupancy at the GCGR. The study demonstrates that quantitative target engagement of dual agonists can be assessed by PET.

• Authors: Olof Eriksson, Torsten Haack, Youssef Hijazi, Lenore Teichert, Veronique Tavernier, Iina Laitinen, Jan Erik Berglund, Gunnar Antoni, Irina Velikyan, Lars Johansson, Stefan Pierrou, Michael Wagner, Joachim Tillner
• Journal: Scientific reports (Sci Rep) Vol. 10 Issue 1 Pg. 16758 (10 07 2020) ISSN: 2045-2322 [Electronic] England
• PMID: 33028880 (Publication Type: Clinical Trial, Phase I, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Glucagon-Like Peptide-1 Receptor
• Hypoglycemic Agents
• Receptors, Glucagon

Topics

• Aged
• Blood Glucose (metabolism)
• Body Weight (drug effects)
• Diabetes Mellitus, Type 2 (diagnostic imaging, drug therapy, metabolism)
• Female
• Glucagon-Like Peptide-1 Receptor (agonists)
• Humans
• Hypoglycemic Agents (pharmacology, therapeutic use)
• Liver (diagnostic imaging, drug effects, metabolism)
• Male
• Middle Aged
• Pancreas (diagnostic imaging, drug effects, metabolism)
• Positron Emission Tomography Computed Tomography
• Receptors, Glucagon (agonists)