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奥福格鲁匹隆(LY3502970),一种新型口服非肽类胰高血糖素样肽-1 受体激动剂:在健康受试者中进行的 1a 期、双盲、安慰剂对照、随机、单次和多次递增剂量研究。

Orforglipron (LY3502970), a novel, oral non-peptide glucagon-like peptide-1 receptor agonist: A Phase 1a, blinded, placebo-controlled, randomized, single- and multiple-ascending-dose study in healthy participants.

机构信息

Lilly Centre for Clinical Pharmacology Pte Ltd, Singapore.

Eli Lilly and Company, Indianapolis, Indiana, USA.

出版信息

Diabetes Obes Metab. 2023 Sep;25(9):2634-2641. doi: 10.1111/dom.15184. Epub 2023 Jun 21.

Abstract

AIM

To evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of single and multiple doses of orforglipron (LY3502970), an oral, non-peptide glucagon-like peptide-1 receptor agonist (GLP-1RA) in healthy participants.

MATERIALS AND METHODS

This was a double-blind, placebo-controlled, Phase 1 study. Overtly healthy adults aged 18 to 65 years with body mass index of 20 to 40 kg/m and glycated haemoglobin concentration of 47.5 mmol/mol (<6.5%) were eligible. In Part A, participants received single-dose orforglipron, with four cohorts receiving escalating doses (0.3-6 mg). In Part B, participants received 4 weeks of daily repeated oral orforglipron with doses escalating weekly to four different final target doses (2-24 mg).

RESULTS

Ninety-two participants enrolled and received at least one study drug dose (32 in Part A [mean age 43.4 years] and 60 in Part B [mean age 42.5 years]). The most common adverse events were gastrointestinal tract-related. Pharmacokinetics were approximately dose proportional, and the mean t was 24.6 to 35.3 hours after a single dose (0.3-6 mg). On Day 28, the mean t was 48.1 to 67.5 hours across the dose range (2-24 mg). Substantial reductions in body weight of up to 5.4 kg were observed after 4 weeks in orforglipron-treated participants, compared to a reduction of 2.4 kg with placebo (P < 0.05). Orforglipron decreased fasting glucose levels across Days 1 to 28, and gastric emptying was delayed on Day 28.

CONCLUSIONS

Orforglipron's long half-life (25-68 hours) allows once-daily oral dosing, without water and food restrictions. Orforglipron had a pharmacodynamic and safety profile similar to that of injectable GLP-1RAs, which supports continued clinical development.

摘要

目的

评估单剂量和多剂量口服非肽类胰高血糖素样肽-1 受体激动剂(GLP-1RA)奥福格鲁匹隆(LY3502970)在健康受试者中的安全性、耐受性、药代动力学和药效学。

材料和方法

这是一项双盲、安慰剂对照、I 期研究。年龄在 18 至 65 岁、体重指数为 20 至 40kg/m² 且糖化血红蛋白浓度为 47.5mmol/mol(<6.5%)的明显健康成年人有资格参加。在 A 部分,参与者接受单剂量奥福格鲁匹隆,有四个队列接受递增剂量(0.3-6mg)。在 B 部分,参与者接受每周递增剂量至四个不同最终目标剂量(2-24mg)的 4 周每日重复口服奥福格鲁匹隆治疗。

结果

92 名参与者入组并接受了至少一剂研究药物(A 部分 32 名[平均年龄 43.4 岁]和 B 部分 60 名[平均年龄 42.5 岁])。最常见的不良事件与胃肠道有关。药代动力学呈近似剂量比例,单剂量(0.3-6mg)后平均 t 为 24.6 至 35.3 小时。在第 28 天,剂量范围(2-24mg)内的平均 t 为 48.1 至 67.5 小时。与安慰剂相比,奥福格鲁匹隆治疗的参与者在 4 周后体重平均下降了 5.4kg,而安慰剂组体重减轻了 2.4kg(P<0.05)。奥福格鲁匹隆在第 1 天至第 28 天降低空腹血糖水平,并且胃排空在第 28 天延迟。

结论

奥福格鲁匹隆的长半衰期(25-68 小时)允许每日口服一次,无需水和食物限制。奥福格鲁匹隆具有与注射用 GLP-1RA 相似的药效学和安全性特征,支持继续临床开发。

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