Insulin glargine (Tianmai Biotechnology)

After achieving primary endpoint by demonstrating non-inferiority in HbA1C reduction from baseline at week 52, investigative insulin icodec helped patients achieve significantly more time in target blood glucose range (Time in Range) vs. once-daily basal insulin glargine U100 in ONWARDS 11 In the ONWARDS 1 and 3 trials, more people achieved blood glucose targets without clinically significant or severe hypoglycemia with once-weekly insulin icodec vs. once-daily basal insulin comparators1-2 Novo Nordisk submitted a biologics license application to the US FDA for insulin icodec, the first investigational once-weekly insulin, based on data from the ONWARDS program SAN DIEGO, June 24, 2023 /PRNewswire/ -- Novo Nordisk today announced that data from the phase 3a ONWARDS 1 and 3 trials evaluating investigative once-weekly insulin icodec, which were presented at the 83rd Annual Scientific Sessions of the American Diabetes Association (ADA), showed the studies met their primary endpoints and insulin icodec provided similar glucose-lowering effects (change in HbA1C from baseline) while reducing injections from seven to one per week compared with once-daily basal insulin1-2. Additionally, data from the ONWARDS 1 and 3 studies demonstrated that more insulin-naïve adults with type 2 diabetes treated with insulin icodec achieved an HbA1c target of <7.0% without experiencing clinically significant or severe hypoglycemia compared with once-daily basal insulin comparators at 52 and 26 weeks, respectively1-2. In ONWARDS 1, as a confirmatory secondary endpoint, superior Time in Range (blood glucose 70-180 mg/dL) was achieved with once-weekly insulin icodec vs. once-daily basal insulin glargine U100 (71.9% vs. 66.9%, respectively; p=0.0004) from week 48-521. Comparable Time below Range (blood glucose <54 mg/dL) was achieved with once-weekly insulin icodec vs. once-daily basal insulin glargine U100 (0.3% vs. 0.2%, respectively) from week 48–52 in ONWARDS 11. Both values are in line with internationally recommended targets3. "Time in Range provides additional information to help us assess glycemic control and is an increasingly important tool to complement HbA1c measurements which were substantially reduced by once-weekly basal insulin icodec. In ONWARDS 1, insulin icodec allowed people to spend significantly more Time in Range, with comparable Time below Range vs. once-daily basal insulin glargine U100," said Dr. Julio Rosenstock, Lead trial Investigator and Director of Velocity Clinical Research at Medical City Dallas and Clinical Professor of Medicine, University of Texas Southwestern Medical Center. "A once-weekly basal insulin has the potential to change how we treat people with type 2 diabetes needing basal insulin replacement." In ONWARDS 1, there were no statistically significant differences in mean weekly insulin dose (week 50-52) or in body weight change from baseline. Level 2 (blood glucose <54 mg/dL) or 3 (symptomatic hypoglycemia requiring third party assistance regardless of blood glucose measurement) hypoglycemia rates (baseline to week 52) were low in both treatment groups, with numerically higher rates with insulin icodec. Rates of clinically significant (level 2) or severe (level 3) hypoglycemia were 0.30 events per patient year exposed and 0.16 events per patient year exposed to once-weekly insulin icodec and once-daily insulin glargine U100, respectively. A higher proportion of participants achieved an HbA1C target of <7% without level 2 or 3 hypoglycemia with insulin icodec vs. insulin glargine U100 (52.6% vs. 42.6%, p=0.0028). In ONWARDS 3, level 2 or 3 hypoglycemia rates were numerically higher with once-weekly insulin icodec vs. once-daily insulin degludec. Rates of clinically significant (level 2) or severe (level 3) hypoglycemia were 0.31 events per patient year exposed and 0.15 events per patient year exposed to insulin icodec and insulin degludec, respectively. The estimated proportion of participants achieving an HbA1C target of <7% without level 2 or 3 hypoglycemia was statistically significantly higher with insulin icodec vs. insulin degludec. There were no significant differences in mean weekly insulin dose from week 24 to 26 or body weight change from baseline to week 26 between treatment arms. No unexpected safety findings were observed1-2. "These data reinforce our confidence in the potential of once-weekly insulin icodec," said Florian M.M. Baeres, Corporate Vice President, Global Medical Affairs at Novo Nordisk. "If approved, we believe this innovation – which would be the world's first once-weekly basal insulin – could help people living with type 2 diabetes ready to start insulin treatment by reducing the number of injections needed per week." Based on data from the ONWARDS clinical trial program, Novo Nordisk submitted a biologics license application (BLA) in April 2023 to the US Food & Drug Administration (FDA) for once-weekly insulin icodec for the treatment of diabetes. A decision from the agency is anticipated in April of 2024. If approved, insulin icodec will represent the first and only once-weekly basal insulin option for adults with diabetes, addressing an unmet need in treatment vs. a daily basal insulin option4-9. About insulin icodec Insulin icodec is an investigational novel once-weekly basal insulin analog designed to cover the basal insulin requirements for a full week with a single subcutaneous injection. About the ONWARDS clinical program The ONWARDS phase 3a trial program for once-weekly insulin icodec comprises six phase 3a global clinical trials, including a trial with real-world elements, involving more than 4,000 adults with type 1 or type 2 diabetes4-9. All trials have met their primary endpoints. About ONWARDS 17 ONWARDS 1 is a phase 3a, 78-week, open-label efficacy and safety treat-to-target trial investigating once-weekly insulin icodec vs. once-daily insulin glargine U100, both in combination with non-insulin anti-diabetic treatment, in 984 insulin-naïve adults with type 2 diabetes. The primary endpoint was change in HbA1C from baseline to week 52 with insulin icodec compared to insulin glargine U100. Secondary endpoints included time in target blood glucose range (70-180 mg/dL), change in fasting plasma glucose (FPG) from baseline to week 52 and number of clinically significant (level 2) or severe (level 3) hypoglycemia episodes. Following the completion of the 52-week main phase of the trial, a 26-week extension phase to further assess safety was undertaken and is now finalized. About ONWARDS 36 ONWARDS 3 is a phase 3a, double-blind 26-week efficacy and safety treat-to-target trial investigating once-weekly insulin icodec vs. insulin degludec, both in combination with non-insulin anti-diabetic treatment. The objective of the trial was to assess the efficacy and safety of insulin icodec in 588 insulin-naïve adults with type 2 diabetes. The primary endpoint was change in HbA1C from baseline to week 26. Secondary endpoints included change in fasting plasma glucose (FPG) from baseline to week 26 and number of clinically significant (level 2) or severe (level 3) hypoglycemia episodes. About Novo Nordisk Novo Nordisk is a leading global healthcare company that has been making innovative medicines to help people with diabetes lead longer, healthier lives for 100 years. This heritage has given us experience and capabilities that also enable us to drive change to help people defeat other serious chronic diseases such as obesity and rare blood and endocrine disorders. We remain steadfast in our conviction that the formula for lasting success is to stay focused, think long-term and do business in a financially, socially, and environmentally responsible way. With U.S. headquarters in New Jersey and production and research facilities in seven states, Novo Nordisk employs nearly 6,000 people throughout the country. For more information, visit novonordisk-us.com, Facebook, Instagram, and Twitter. Contact for further information Further information Media: Nicole Ferreira (US) +1 609 786 5868 [email protected] Investors: Mark Joseph Root (US) +1 848 213 3219 [email protected] References Rosenstock J, Bain SC, Gowda A, et al. Improved A1C and TIR with Once-Weekly Insulin Icodec vs Insulin Glargine U100 in Insulin-Naïve T2D: ONWARDS 1. 83rd Annual Scientific Sessions of the American Diabetes Association (ADA) 23-26 June 2023, San Diego, US. 179-OR. Lingvay I, Asong M, Desouza C, et al. Better Glycemic Control with Once-Weekly Insulin Icodec versus Once–Daily Insulin Degludec in Insulin-Naïve Type 2 Diabetes (ONWARDS 3). 83rd Annual Scientific Sessions of the American Diabetes Association (ADA) 23-26 June 2023, San Diego, US. 178-OR. Battelino T, Danne T, Bergenstal RM, et al. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range. Diabetes Care. 2019;42:1593-1603. ClinicalTrials.gov. A Research Study to Compare a New Weekly Insulin, Insulin Icodec, and an Available Daily Insulin, Insulin Degludec, Both in Combination With Mealtime Insulin in People With Type 1 Diabetes (ONWARDS 6). Available at: Last accessed: June 2023. ClinicalTrials.gov. A Research Study to Compare Two Types of Insulin, a New Weekly Insulin, Insulin Icodec and an Available Daily Insulin, Insulin Glargine, Both in Combination With Mealtime Insulin, in People With Type 2 Diabetes Who Use Daily Insulin and Mealtime Insulin (ONWARDS 4). Available at: Last accessed: June 2023. ClinicalTrials.gov. A Research Study to Compare Two Types of Insulin, a New Insulin, Insulin Icodec and an Available Insulin, Insulin Degludec, in People With Type 2 Diabetes Who Have Not Used Insulin Before (ONWARDS 3). Available at: Last accessed: June 2023. ClinicalTrials.gov. A Research Study to Compare Two Types of Insulin, a New Insulin, Insulin Icodec and an Available Insulin, Insulin Glargine, in People With Type 2 Diabetes Who Have Not Used Insulin Before (ONWARDS 1). Available at: Last accessed: June 2023. ClinicalTrials.gov. A Research Study to Compare Two Types of Insulin, a New Weekly Insulin, Insulin Icodec and an Available Daily Insulin, Insulin Degludec, in People With Type 2 Diabetes Who Use Daily Insulin (ONWARDS 2). Available at: Last accessed: June 2023. ClinicalTrials.gov. A Research Study to Compare a New Weekly Insulin, Insulin Icodec Used With DoseGuide App, and Daily Insulins in People With Type 2 Diabetes Who Have Not Used Insulin Before (ONWARDS 5). Available at: Last accessed: June 2023. Novo Nordisk is a registered trademark of Novo Nordisk A/S. © 2023 Novo Nordisk All rights reserved. US23DI00142 June 2023 SOURCE Novo Nordisk

As it looks to broaden the label for its diabetes drug Mounjaro (tirzepatide) with a weight-loss indication, Eli Lilly is also stepping up efforts in obesity with a trio of late-stage studies on another candidate. Recent updates to the ClinicalTrials.gov database outline three Phase III studies kicking off for its new oral GLP-1 candidate orforglipron.The updates come on the heels of Eli Lilly unveiling a second positive study for its once-weekly injectable treatment Mounjaro, which targets receptors for both GLP-1 and GIP. The SURMOUNT-2 trial showed Mounjaro was associated with weight loss of up to 15.7% at 72 weeks, while in the earlier SURMOUNT-1 study, the drug led to weight loss of up to 22.5% over the same time period.Readouts in 2025Eli Lilly acquired rights to orforglipron, also known as LY3502970 and OWL833, through a deal with Chugai Pharmaceutical in 2018. According to newly posted entries on ClinialTrials.gov, the orforglipron programme includes the ATTAIN-1 and ATTAIN-2 trials. The Phase III studies are looking to recruit 3000 and 1500 obese or overweight adult participants, respectively. The first will include subjects with weight-related comorbidities, while the second will recruit people who have type 2 diabetes. Both will measure mean change from baseline in body weight versus placebo, and are expected to read out in 2025.The third Phase III trial, ACHIEVE-4, got under way in April and is looking to enrol 2620 overweight or obese adults who have type 2 diabetes and are at increased cardiovascular risk. The primary endpoint will compare time to first occurrence of any major adverse cardiovascular event (MACE-4) versus insulin glargine. Results for ACHIEVE-4 are also expected in 2025.Potential rivalsMounjaro was cleared by the FDA last year to improve glucose control in adults with type 2 diabetes, with the product generating sales of $568.5 million in the first quarter of 2023. Following the SURMOUNT-2 readout late last month, Eli Lilly said it was in the process of completing a supplemental filing to the FDA in obesity, with a decision from the US regulator expected possibly in late 2023. Meanwhile, Novo Nordisk, which already markets the injectable GLP-1 receptor agonist Wegovy (semaglutide) for obesity, recently unveiled positive data for an oral formulation. According to findings reported this week from the Phase IIIa OASIS 1 trial, patients who took oral Wegovy achieved weight loss of 17.4% versus a 1.8% reduction with placebo after 68 weeks. Pfizer has been testing oral GLP-1 receptor agonists as well. This week it said its danuglipron candidate showed promise in a Phase II trial, while it expects mid-stage study data from its second asset, called lotiglipron, later this year.In a note to clients last December, Jefferies analysts said top-line Phase II results for orforglipron looked "similar to injectable drugs Wegovy and Mounjaro at the data cut-off." They also cited Eli Lilly's chief scientific officer Daniel Skovronsky as saying orforglipron "at least should be able to meet or exceed the efficacy seen with injectable GLP-1 agonists."