Objective: Polypharmacotherapy shows superior efficacy compared to monotherapy in correcting obesity and its co-morbidities in preclinical studies and clinical trials. Female organisms have been traditionally neglected in this research potentially contributing to an increased rate of adverse advents in women. To address this disparity we herein determined the efficacy of our monomeric peptide with a balanced agonism at the receptors for glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) to correct obesity, glucose metabolism, nonalcoholic fatty liver disease (NAFLD) and dyslipidemia in both sexes of a mouse model for diet-induced obesity (DIO) by combining physiological treatment endpoints with plasma proteomic profiling (PPP), a new unbiased diagnostic tool for the efficacy and optimization of pharmacological interventions.

Methods: We performed metabolic phenotyping along with PPP in body weight matched male and female DIO mice treated for 21 days with either PBS, the single GIP and GLP-1 monoagonists, or our GLP-1/GIP coagonist.

Results: GLP-1R/GIPR coagonism improved obesity, glucose intolerance, NAFLD and dyslipidemia with superior efficacy in both male and female mice compared to monoagonist treatments. PPP revealed in both sexes broader changes of plasma proteins after GLP-1/GIP coagonist compared to monoagonist treatments, including established and novel biomarkers for systemic inflammation, NAFLD and atherosclerosis. Subtle sex-specific differences have been observed in metabolic phenotyping and PPP.

Conclusions: We herein report enhanced efficacy of our GLP-1/GIP coagonist in both sexes relative to monoagonists for the treatment of metabolic disease. Wider sex-specific reductions of circulating proteins after GLP-1/GIP coagonist treatment may reflect additional metabolic benefits that are currently achieved exclusively after bariatric surgery.

Disclosure

S.M. Hofmann: Advisory Panel; Spouse/Partner; Novo Nordisk A/S. N.J. Wewer Albrechtsen: Research Support; Self; Mercodia, Novo Nordisk A/S, Novo Nordisk Foundation. Speaker’s Bureau; Self; Merck Sharp & Dohme Corp. M.H. Tschöp: Advisory Panel; Self; ERX Pharmaceuticals, Novo Nordisk Foundation. A. Feuchtinger: None. M. Brielmeier: None. B. Finan: Employee; Self; Novo Nordisk A/S. R. DiMarchi: Employee; Self; Novo Nordisk Inc. M. Kleinert: None. S. Sachs: None. T.D. Müller: Research Support; Self; Novo Nordisk Inc., Sanofi-Aventis. K. Stemmer: None. M. Mann: None.

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