A new era for oral peptides: SNAC and the development of oral semaglutide for the treatment of type 2 diabetes

Aroda Vanita R.; Blonde Lawrence; Pratley Richard E.

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A new era for oral peptides: SNAC and the development of oral semaglutide for the treatment of type 2 diabetes

机译：A new era for oral peptides: SNAC and the development of oral semaglutide for the treatment of type 2 diabetes

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Glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) were first introduced for the treatment of type 2 diabetes (T2D) in 2005. Despite the high efficacy and other benefits of GLP-1RAs, their uptake was initially limited by the fact that they could only be administered by injection. Semaglutide is a human GLP-1 analog that has been shown to significantly improve glycemic control and reduce body weight, in addition to improving cardiovascular outcomes, in patients with T2D. First approved as a once-weekly subcutaneous injection, semaglutide was considered an ideal peptide candidate for oral delivery with a permeation enhancer on account of its low molecular weight, long half-life, and high potency. An oral formulation of semaglutide was therefore developed by co-formulating semaglutide with sodium N-(8-[2-hydroxybenzoyl]amino)caprylate, a well-characterized transcellular permeation enhancer, to produce the first orally administered GLP-1RA. Pharmacokinetic analysis showed that stable steady-state concentrations could be achieved with once-daily dosing owing to the long half-life of oral semaglutide. Upper gastrointestinal disease and renal and hepatic impairment did not affect the pharmacokinetic profile. In the phase III PIONEER clinical trial program, oral semaglutide was shown to reduce glycated hemoglobin and body weight compared with placebo and active comparators in patients with T2D, with no new safety signals reported. Cardiovascular efficacy and safety are currently being assessed in a dedicated outcomes trial. The development of an oral GLP-1RA represents a significant milestone in the management of T2D, providing an additional efficacious treatment option for patients.

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《Reviews in endocrine & metabolic disorders》 |2022年第5期|979-994|共16页
作者
Aroda Vanita R.; Blonde Lawrence; Pratley Richard E.;
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作者单位

AdventHlth Translat Res Inst;

Harvard University,Harvard Med Sch;

Endocrinol Dept,Ochsner Hlth;

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正文语种英语
中图分类内分泌腺疾病及代谢病;
关键词
Sodium N-(8-2-hydroxybenzoylamino)caprylate; SNAC; Semaglutide; Glucagon-like peptide-1 receptor agonists; GLP-1RA; Type 2 diabetes; Oral; Peptides; GLP-1 RECEPTOR AGONISTS; ONCE-WEEKLY SEMAGLUTIDE; OPEN-LABEL; PHASE 3A; JAPANESE PATIENTS; PARALLEL-GROUP; DOUBLE-BLIND; ADD-ON; SAFETY; EFFICACY;

A new era for oral peptides: SNAC and the development of oral semaglutide for the treatment of type 2 diabetes

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