Novo Nordisk: Awiqli is a once-weekly insulin injection for patients with type 2 diabetes

1. Awiqli led to greater glycated hemoglobin (HbA1c) reduction, superior blood sugar reduction, and time spent within the recommended blood sugar range compared to daily basal insulin.
2. The rate of hypoglycemia and other adverse events were similar in the Awiqli group compared to the standard basal insulin group.

The Latest

Insulin icodec (Awiqli) is an ultra-long-acting insulin analog designed for once-weekly administration compared to the traditional daily administrated long-acting insulin. In total, there have been more than 5 phase-3 clinical trials comparing Awiqli to basal insulin in 3764 patients with type 2 diabetes. Metanalysis of these trials showed that Awiqli led to greater glycated hemoglobin (HbA1c) reduction, superior blood sugar reduction, and time spent within the recommended blood sugar range compared to daily basal insulin. In addition, the rate of hypoglycemia and other adverse events were similar in the Awiqli group compared to standard basal insulin.

Physician’s Perspective

Type 2 diabetes is a chronic disease affecting a large population of patients worldwide and it is well-recognized as a cardiovascular risk factor. Insulin is a pillar of pharmacological blood glucose control in patients with diabetes but can often be challenging for patients and caregivers. Currently, patients often require daily injections of long-acting insulin and as needed short-acting insulin injections with meals. The development of a longer-acting insulin analog could help improve therapy adherence and long-term insulin presence within the blood to help with sustained blood glucose control.

Molecular Target of Therapy

Awiqli is an insulin analog with two unique features that enable it to be longer-acting than the current basal insulin available. Firstly, it has a lower binding affinity for the insulin receptor compared to the current form of basal insulin. Secondly, it has a strong, but reversible binding affinity to serum albumin, the protein carrier in blood for insulin. These features allow albumin-bound Awiqli to circulate in blood, being continuously released and able to bind insulin receptors over time to help lower blood glucose.

Company History

Novo Nordisk started as two small Danish companies in the 1920s with a focus on developing novel strategies to treat diabetes, including the development of the first insulin pen device. These companies merged in 1989 to become Novo Nordisk. Awiqli is currently waiting for FDA approval, with the FDA’s Endocrinologic and Metabolic Drugs Advisory Committee set to meet on May 24.

Further reading: https://pubmed.ncbi.nlm.nih.gov/38192022/

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