Cotadutide confers benefits for glucose control, weight loss in obese T2D patients

Treatment with the dual GLP-1 and glucagon receptor agonist cotadutide leads to improved glycaemic control and weight loss in type 2 diabetes (T2D) patients who are overweight or obese, according to a phase IIb study.

Additionally, the drug produces improvements in hepatic parameters.

The study included 834 adult patients with T2D inadequately controlled with metformin (glycated haemoglobin A1c [HbA1c] of 7.0–10.5 percent [53–91 mmol/mol]). They were randomized to receive cotadutide 100 μg (n=100), 200 μg (n=256), or 300 μg (n=256); placebo (n=110); or open-label liraglutide 1.8 mg (n=110), all of which were administered subcutaneously.

At baseline, the body mass index (BMI) of the patients was ≥25 kg/m². At week 14, the coprimary endpoints of HbA1c and body weight decreased significantly with cotadutide vs placebo (p<0.001). Week-54 results followed the same pattern (p<0.001).

Compared with placebo, cotadutide 300 μg also produced improvements in lipid profile, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, propeptide of type III collagen level, fibrosis-4 index, and nonalcoholic fatty liver disease fibrosis score. The changes seen with liraglutide were not significant as compared with placebo.

Meanwhile, weight loss with cotadutide 200 μg was comparable to that with liraglutide 1.8 mg and greater with cotadutide 300 μg as opposed to liraglutide 1.8 mg.

The most frequent adverse events seen in the cotadutide groups were nausea (35 percent) and vomiting (17 percent), both of which decreased over time.