EASL 2020 – Astra’s dual agonist holds up, as Merck & Co jumps in

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Novo Nordisk might have cast off its GLP-1/glucagon receptor dual agonist, but Astrazeneca and Merck & Co are keeping faith with the mechanism for now. Data revealed in an EASL press release today show that Astra’s contender cotadutide continues to show efficacy at one year. Full details from a phase IIb trial in 834 obese type II diabetics will be presented at the medical meeting tomorrow; for now, we know that cotadutide outperformed both placebo and Novo Nordisk’s Victoza on spurring weight loss and decreases in ALT, a marker of liver damage, at 54 weeks. Tolerability is something to watch, as a previous cut of these data revealed a 20% drop-out rate in the high dose group, and 15% in the low dose group; GI toxicity is a known issue with these targets. Astra is still treading carefully with this project, with only smaller studies being initiated; Novo recently abandoned its co-agonist programme, citing better efficacy with its more advanced GLP-1 agonist, semaglutide, which is emerging as the metabolic agent to beat in this space. But Merck & Co recently paid $10m for rights to a Hanmi GLP-1/glucagon dual agonist in Nash – the project had been dumped by J&J the previous year.

Targeting GLP-1 and glucagon – selected projects
Project  Company  Notes
Cotadutide  Astrazeneca Phase II trials in NASH with obesity recruiting, kidney disease to start soon 
Efinopegdutide  Merck & Co (Hanmi) Nash trials planned; obesity trials completed and abandoned by J&J
NN9277 Novo Nordisk Abandoned in obesity in 2020
MK-8251 Merck & Co  Presumed abandoned approx 2015
Source: EvaluatePharma. 

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