Background and Aims: Previously, cotadutide demonstrated significant glucose- and body weight-lowering effects in doses up to 300 µg. We examined the safety and efficacy of cotadutide in doses up to 600 µg in patients with T2DM.
Methods: In this double-blind, phase 2a study, 20 adults with T2DM (HbA1c ≤8.5%) were randomized to receive QD SC cotadutide (n=15) or placebo (n=5) for 77 days. A dose-escalation committee approved titrations >400 µg and ≤600 µg following a safety data review. Patients underwent continuous glucose monitoring.
Results: The adverse event profile suggests that the highest clinically tolerated dose has not been identified. Nausea was reported by 3 (20%) patients treated with cotadutide, with one episode of vomiting. There was a significant reduction from baseline in the 7-day average glucose levels (Figure). By day 77, 76.9% of patients in the cotadutide group achieved a >5% body weight loss. A significant reduction in least-squares mean from baseline in ALT level with cotadutide versus placebo was reported (-7.17 U/L, 90% CI: -12.21, -2.14).
Conclusions: Cotadutide was well-tolerated at doses up to 600 µg and reduced hyperglycemia, with clinically significant weight loss and beneficial effects on liver enzymes.
D. Robertson: Employee; Self; AstraZeneca. Stock/Shareholder; Self; AstraZeneca. L. Hansen: Employee; Self; AstraZeneca. M. Jain: Employee; Self; CSL Behring. Stock/Shareholder; Self; AstraZeneca. M. Petrone: Employee; Self; AstraZeneca. T. Wang: Employee; Self; AstraZeneca. T. Heise: Advisory Panel; Self; Mylan, Novo Nordisk A/S. Research Support; Self; ADOCIA, Aerami, Becton, Dickinson and Company, Biocon, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Gan & Lee Pharmaceuticals, MedImmune, Merck KGaA, Mylan, Nordic Bioscience, Novo Nordisk A/S, Poxel SA, Sanofi, Xeris Pharmaceuticals, Inc., Zealand Pharma A/S. Speaker’s Bureau; Self; Eli Lilly and Company, Novo Nordisk A/S. L. Jermutus: Employee; Self; AstraZeneca. Stock/Shareholder; Self; AstraZeneca.