食物摄入对每日一次口服非肽类胰高血糖素样肽-1(GLP-1)受体激动剂orforglipron(LY3502970)的药代动力学、安全性和耐受性的影响。
Effect of Food Consumption on the Pharmacokinetics, Safety, and Tolerability of Once-Daily Orally Administered Orforglipron (LY3502970), a Non-peptide GLP-1 Receptor Agonist.
作者信息
Ma Xiaosu, Liu Rong, Pratt Edward J, Benson Charles T, Bhattachar Shobha N, Sloop Kyle W
机构信息
Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46240, USA.
出版信息
Diabetes Ther. 2024 Apr;15(4):819-832. doi: 10.1007/s13300-024-01554-1. Epub 2024 Feb 24.
INTRODUCTION
We assessed the effect of the prandial state on the pharmacokinetics, safety, and tolerability of single and multiple doses of orforglipron (LY3502970), an oral, non-peptide glucagon-like peptide 1 receptor agonist (GLP-1 RA), in two studies (A and B).
METHODS
Study A and study B were phase 1, randomized, crossover studies in healthy adults aged 18-65 years and 21-70 years, respectively. Participants received single (3 mg, study A) or multiple (16 mg, study B) oral doses of orforglipron under fasted and fed conditions. Blood samples were collected pre- and postdose to assess area under the concentration-time curve (AUC), maximum observed drug concentration (C), time of C (t), and half-life (t) associated with terminal rate constant. AUC and C were analyzed using a linear mixed-effects model. Treatment differences were presented as ratios of geometric least squares means (GLSM). Treatment-emergent adverse events (TEAEs), adverse events of special interest, and serious adverse events were assessed.
RESULTS
Study A included 12 participants (mean age 45.0 years; male 66.7%); study B included 34 participants (mean age 42.8 years; male 88.2%). GLSM AUC and C were lower by 23.7% and 23.2% in study A, and 17.6% and 20.9% in study B, in the fed versus fasted states, respectively. In both studies, t and median t were comparable between fed and fasted states. The majority of TEAEs in both studies were gastrointestinal tract-related conditions. No serious adverse events or deaths were reported in either study.
CONCLUSION
The observed pharmacokinetic differences due to the prandial state are unlikely to contribute to clinically meaningful differences in the efficacy of orforglipron. The safety profile was consistent with the known profiles of other GLP-1 RAs. Given the absence of prandial restrictions, orforglipron may emerge as a convenient oral treatment option for patients with type 2 diabetes or obesity.
TRIAL REGISTRATION
ClinicalTrials.gov identifiers, NCT03929744 and NCT05110794.
引言
在两项研究(研究A和研究B)中,我们评估了进食状态对口服非肽类胰高血糖素样肽-1受体激动剂(GLP-1 RA)奥佛利肽(LY3502970)单剂量和多剂量给药后的药代动力学、安全性及耐受性的影响。
方法
研究A和研究B均为1期随机交叉研究,研究A的受试者为18至65岁的健康成年人,研究B的受试者为21至70岁的健康成年人。参与者在禁食和进食条件下接受单剂量(3 mg,研究A)或多剂量(16 mg,研究B)的奥佛利肽口服给药。在给药前和给药后采集血样,以评估浓度-时间曲线下面积(AUC)、观察到的最大药物浓度(C)、C出现的时间(t)以及与末端速率常数相关的半衰期(t)。使用线性混合效应模型分析AUC和C。治疗差异以几何最小二乘均值(GLSM)的比值表示。评估治疗中出现的不良事件(TEAE)、特殊关注的不良事件和严重不良事件。
结果
研究A纳入了12名参与者(平均年龄45.0岁;男性占66.7%);研究B纳入了34名参与者(平均年龄42.8岁;男性占88.2%)。在研究A中,进食状态下的GLSM AUC和C分别比禁食状态下低23.7%和23.2%;在研究B中,进食状态下的GLSM AUC和C分别比禁食状态下低17.6%和20.9%。在两项研究中,进食和禁食状态下的t和t中位数相当。两项研究中的大多数TEAE均为胃肠道相关病症。两项研究均未报告严重不良事件或死亡病例。
结论
观察到的因进食状态导致的药代动力学差异不太可能造成奥佛利肽疗效方面具有临床意义的差异。安全性特征与其他GLP-1 RA的已知特征一致。鉴于无需进食限制,奥佛利肽可能成为2型糖尿病或肥胖症患者方便的口服治疗选择。
试验注册
ClinicalTrials.gov标识符,NCT03929744和NCT05110794。