Evaluation of efficacy and safety of the glucagon receptor antagonist LY2409021 in patients with type 2 diabetes: 12-and 24-week phase 2 studies

CM Kazda, Y Ding, RP Kelly, P Garhyan, C Shi… - Diabetes …, 2016 - Am Diabetes Assoc
CM Kazda, Y Ding, RP Kelly, P Garhyan, C Shi, CN Lim, H Fu, DE Watson, AJ Lewin…
Diabetes Care, 2016Am Diabetes Assoc
OBJECTIVE Type 2 diabetes pathophysiology is characterized by dysregulated glucagon
secretion. LY2409021, a potent, selective small-molecule glucagon receptor antagonist that
lowers glucose was evaluated for efficacy and safety in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS The efficacy (HbA1c and glucose) and safety (serum
aminotransferase) of once-daily oral administration of LY2409021 was assessed in two
double-blind studies. Phase 2a study patients were randomized to 10, 30, or 60 mg of …
OBJECTIVE
Type 2 diabetes pathophysiology is characterized by dysregulated glucagon secretion. LY2409021, a potent, selective small-molecule glucagon receptor antagonist that lowers glucose was evaluated for efficacy and safety in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS
The efficacy (HbA1c and glucose) and safety (serum aminotransferase) of once-daily oral administration of LY2409021 was assessed in two double-blind studies. Phase 2a study patients were randomized to 10, 30, or 60 mg of LY2409021 or placebo for 12 weeks. Phase 2b study patients were randomized to 2.5, 10, or 20 mg LY2409021 or placebo for 24 weeks.
RESULTS
LY2409021 produced reductions in HbA1c that were significantly different from placebo over both 12 and 24 weeks. After 12 weeks, least squares (LS) mean change from baseline in HbA1c was –0.83% (10 mg), –0.65% (30 mg), and –0.66% (60 mg) (all P < 0.05) vs. placebo, 0.11%. After 24 weeks, LS mean change from baseline in HbA1c was –0.45% (2.5 mg), –0.78% (10 mg, P < 0.05), –0.92% (20 mg, P < 0.05), and –0.15% with placebo. Increases in serum aminotransferase, fasting glucagon, and total fasting glucagon-like peptide-1 (GLP-1) were observed; levels returned to baseline after drug washout. Fasting glucose was also lowered with LY2409021 at doses associated with only modest increases in aminotransferases (mean increase in alanine aminotransferase [ALT] ≤10 units/L). The incidence of hypoglycemia in the LY2409021 groups was not statistically different from placebo.
CONCLUSIONS
In patients with type 2 diabetes, glucagon receptor antagonist treatment significantly lowered HbA1c and glucose levels with good overall tolerability and a low risk for hypoglycemia. Modest, reversible increases in serum aminotransferases were observed.
Am Diabetes Assoc