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Pharmacokinetic and Pharmacodynamic Characteristics of Insulin Icodec After Subcutaneous Administration in the Thigh, Abdomen or Upper Arm in Individuals with Type 2 Diabetes Mellitus
Ist Teil von
Clinical drug investigation, 2023-02, Vol.43 (2), p.119-127
Ort / Verlag
Cham: Springer International Publishing
Erscheinungsjahr
2023
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
Background and Objective
Individuals with diabetes mellitus may prefer different body regions for subcutaneous insulin administration. This trial investigated whether choice of injection region affects exposure and glucose-lowering effect of once-weekly basal insulin icodec.
Methods
In a randomised, open-label, crossover trial, 25 individuals with type 2 diabetes received single subcutaneous icodec injections (5.6 U/kg) in the thigh, abdomen or upper arm (9–13 weeks’ washout). Pharmacokinetic blood sampling occurred frequently until 35 days post-dose. Partial glucose-lowering effect was assessed 36–60 h post-dose in a glucose clamp (target 7.5 mmol/L). Steady-state pharmacokinetics following multiple once-weekly dosing were simulated using a two-compartment pharmacokinetic model.
Results
Total icodec exposure (area under the curve from zero to infinity after single dose; AUC
0–
∞
,SD
) was similar between injection in the thigh, abdomen and upper arm (estimated AUC
0–
∞
,SD
ratios [95% confidence interval]: abdomen/thigh 1.02 [0.96–1.09],
p =
0.473; upper arm/thigh 1.04 [0.98–1.10],
p =
0.162; abdomen/upper arm 0.98 [0.93–1.05],
p =
0.610). Maximum icodec concentration (
C
max
) after single dose was higher for abdomen (by 17%,
p =
0.002) and upper arm (by 24%,
p <
0.001) versus thigh. When simulated to steady state, smaller differences in
C
max
were seen for abdomen (by 11%,
p =
0.004) and upper arm (by 16%,
p <
0.001) versus thigh. Geometric mean [coefficient of variation] glucose-lowering effect 36–60 h post-dose was comparable between the thigh (1961 mg/kg [51%]), abdomen (2130 mg/kg [52%]) and upper arm (2391 mg/kg [40%]).
Conclusion
Icodec can be administered subcutaneously in the thigh, abdomen or upper arm with no clinically relevant difference in exposure and with a similar glucose-lowering effect.
ClinicalTrials.gov Identifier
NCT04582448.