WO2001035988A1 - Use of glp-1 agonists for the inhibition of beta cell degeneration - Google Patents
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- WO2001035988A1 WO2001035988A1 PCT/DK2000/000625 DK0000625W WO0135988A1 WO 2001035988 A1 WO2001035988 A1 WO 2001035988A1 DK 0000625 W DK0000625 W DK 0000625W WO 0135988 A1 WO0135988 A1 WO 0135988A1
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
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- A61P3/00—Drugs for disorders of the metabolism
- A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
- A61P3/10—Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics
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- A—HUMAN NECESSITIES
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Definitions
- the present invention relates to a method for modulating, inhibiting or decreasing or preventing beta cell degeneration, loss of beta cell function, beta cell dysfunction, and/or death of beta cells, such as necrosis or apoptosis of beta cells in a subject comprising adminis- tering a GLP-1 agonist to said subject.
- coagulative necrosis This is an abnormal morphological appearance, detected in tissue examined under the microscope.
- the changes, which affect aggregates of adjacent cells or functionally related cohorts of cells, are seen in a variety of contexts produced by accident, injury, or disease.
- oxygen deprivation oxygen deprivation
- hyper- thermia hyper- thermia
- immunological attack and exposure to various toxins that inhibit crucial intracellular metabolic processes.
- Coagulative necrosis is the classical form of cell change seen when tis- sues autolyze (digest themselves) in vitro.
- Apoptosis is an active process of cellular self-destruction that is regulated by extrinsic and intrinsic signals occurring during normal development. It is well documented that apoptosis plays a key role in regulation of pancreatic endocrine beta cells. There is increasing evidence that in adult mammalians the beta-cell mass is submitted to dynamic changes to adapt insulin production for maintaining euglycemia in particular conditions, such as pregnancy and obesity (J. Dev. Physiol. 5: 373, 1983 and Endocrinology 130: 1459, 1992). The control of beta cell mass depends on a subtle balance between cell proliferation, growth and cell death (apoptosis). A disruption of this balance may lead to impairment of glucose homeostasis.
- glucose intolerance develops with aging when beta cell replica- tion rates are reduced (Diabetes 32: 14, 1983) and human autopsy studies repeatedly showed a 40-60% reduction of beta cell mass in patients with non- insulin-dependent-diabetes mellitus compared with nondiabetic subjects (Am. J. Med. 70: 105, 1981 and Diabetes Res. 9: 151, 1988). It is generally agreed that insulin resistance is an invariable accompaniment of obesity but that normoglycemia is maintained by compensatory hyperinsulinemia until the beta cells become unable to meet the increased demand for insulin, at which point Type 2 Diabetes begins. Apoptosis is also associated with diseases states such as cancer, immunological disorders, like multiple sclerosis, and AIDS, and neurodegenerative disorders (Science 267: 1449, 1995), like Alzheimers disease, stroke, and Parkinson's disease.
- the present invention relates to use of a GLP-1 agonist for the preparation of a medicament for treatment of beta cell degeneration, such as necrosis or apoptosis of * ⁇ -cells.
- the present invention relates to use of a GLP-1 agonist for the prepara- tion of a medicament for modulation of beta cell degeneration, such as necrosis or apoptosis of ⁇ -cells.
- the present invention relates to use of a GLP-1 agonist for the preparation of a medicament for inhibition of beta cell degeneration, such as necrosis or apoptosis of ⁇ -cells. Furthermore, the present invention relates to use of a GLP-1 agonist for the preparation of a medicament for decreasing beta cell degeneration, such as necrosis or apoptosis of ⁇ - cells.
- the present invention relates to use of a GLP-1 agonist for the preparation of a medicament for reduction of beta cell degeneration, such as necrosis or apoptosis of ⁇ -cells.
- the present invention relates to use of a GLP-1 agonist for the preparation of a medicament for arresting beta cell degeneration, such as necrosis or apoptosis of ⁇ - cells.
- the present invention relates to use of a GLP-1 agonist preventing beta cell degeneration for the preparation of a medicament for prevention of beta cell degeneration, such as necrosis or apoptosis of ⁇ -cells.
- the invention relates to a method for treatment of beta cell degeneration, such as necrosis or apoptosis of ⁇ -cells, in a subject comprising administering a GLP-1 agonist to said subject. Furthermore, the invention relates to a method for modulation of beta cell degeneration, such as necrosis or apoptosis of ⁇ -cells, in a subject comprising administering a GLP-1 agonist to said subject. Furthermore, the invention relates to a method for inhibition of beta cell degeneration- such as necrosis or apoptosis of ⁇ -cells, in a subject comprising administering a GLP-1 agonist to said subject.
- the invention relates to a method for decreasing beta cell degeneration, such as necrosis or apoptosis of ⁇ -cells, in a subject comprising administering a GLP-1 agonist to said subject.
- the invention relates to a method for reduction of beta cell degeneration- such as necrosis or apoptosis of ⁇ -cells, in a subject comprising administering a GLP-1 agonist to said subject. Furthermore, the invention relates to a method for arresting beta cell degeneration, such as necrosis or apoptosis of ⁇ -cells, in a subject comprising administering a GLP-1 agonist to said subject.
- the invention relates to a method for prevention of beta cell degeneration, such as necrosis or apoptosis of ⁇ -cells, in a subject comprising administering a GLP-1 agonist to said subject.
- beta cell degeneration is necrosis of beta cells.
- beta cell degeneration is apoptosis of beta cells.
- said apoptosis is induced by a cytokine.
- the cytokine may be any cytokine or mixtures thereof, such as interleukin 1 (IL-1), IL-2, IL-3, IL-5, IL-6, IL-7, IL- 8, IL-9, IL-12, IL-14, IL-17, interferon- ⁇ , tumor necrosis factor- ⁇ , TNF- ⁇ , granulocyte macrophage colony stimulating factor, monocyte chemoattractant protein- 1 , or mixtures thereof.
- the subject is preferably a mammal, more preferably a human.
- the use according any of the above uses in a regimen which additionally comprises treatment with human growth hormone, a growth hormone releasing agent or a growth factor such as prolactin or placental lactogen; the use of human growth hormone, a growth hormone releasing agent or a growth factor such as prolactin or placental lactogen for the preparation of a medicament for inhibiting the beta cell degeneration, such as necrosis or apoptosis of ⁇ -cells in a subject; the use of human growth hormone, a growth hormone releasing agent or a growth factor such as prolactin or placental lactogen for the preparation of a medicament for treatment of beta cell degeneration, such as necrosis or apoptosis of ⁇ -cells in a subject.
- the GLP-1 agonist is GLP-l(7-37) or GLP-1(7- 36) amide.
- the GLP-1 agonist is a GLP-1 analogue.
- the GLP-1 analogue is selected from the Thr 8 , Met 8 , Gly 8 and Val 8 analogues of GLP-1 (7-37) and GLP-l(7-36) amide, more preferred the Gly 8 and Val 8 analogues of GLP- 1 (7-37) and GLP- 1 (7-36) amide, most preferred the Val 8 analogues of GLP- 1(7-37) and GLP-1 (7-36) amide.
- the GLP-1 analogue has the formula II: 7 8 9 10 11 12 13 14 15 16 17 His-Xaa-Xaa-Gly-Xaa-Phe-Thr-Xaa-Asp-Xaa-Xaa-
- Xaa at position 8 is Ala, Gly, Ser, Thr, Leu, He, Val, Glu, Asp, Met, or Lys,
- Xaa at position 9 is Glu, Asp, or Lys
- Xaa at position 11 is Thr, Ala, Gly, Ser, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 14 is Ser, Ala, Gly, Thr, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 16 is Val, Ala, Gly, Ser, Thr, Leu, He, Tyr, Glu, Asp, or Lys,
- Xaa at position 17 is Ser, Ala, Gly, Thr, Leu, He, Val, Glu, Asp, or Lys,
- Xaa at position 18 is Ser, Ala, Gly, Thr, Leu, He, Val, Glu, Asp, or Lys,
- Xaa at position 19 is Tyr, Phe, Tip, Glu, Asp, or Lys
- Xaa at position 20 is Leu, Ala, Gly, Ser, Thr, Leu, He. Val, Glu, Asp, or Lys
- Xaa at position 21 is Glu, Asp, or Lys
- Xaa at position 22 is Gly, Ala, Ser, Thr, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 23 is Gin, Asn, Arg, Glu, Asp, or Lys
- Xaa at position 24 is Ala, Gly, Ser, Thr, Leu, He, Val, Arg, Glu, Asp, or Lys
- Xaa at position 25 is Ala, Gly, Ser, Thr, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 26 is Lys, Arg, Gin, Glu, Asp, or His
- Xaa at position 27 is Glu, Asp, or Lys
- Xaa at position 30 is Ala, Gly, Ser, Thr, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 31 is Trp, Phe, Tyr, Glu, Asp, or Lys
- Xaa at position 32 is Leu, Gly, Ala, Ser, Thr, He, Val, Glu, Asp, or Lys
- Xaa at position 33 is Val, Gly, Ala, Ser, Thr, Leu, He, Glu, Asp, or Lys
- Xaa at position 34 is Lys, Arg, Glu, Asp, or His
- Xaa at position 35 is Gly, Ala, Ser, Thr, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 36 is Arg, Lys, Glu, Asp, or His
- Xaa at position 37 is Gly, Ala, Ser, Thr, Leu, He, Val, Glu, Asp, or Lys, or is deleted
- Xaa at position 38 is Arg, Lys, Glu, Asp, or His, or is deleted
- Xaa at position 39 is Arg, Lys, Glu, Asp, or His, or is deleted
- Xaa at position 40 is Asp, Glu, or Lys, or is deleted
- Xaa at position 41 is Phe, Trp, Tyr, Glu, Asp, or Lys, or is deleted
- Xaa at position 42 is Pro, Lys, Glu, or Asp, or is deleted
- Xaa at position 43 is Glu, Asp, or Lys, or is deleted
- Xaa at position 44 is Glu, Asp, or Lys, or is deleted, and
- Xaa at position 45 is Val, Glu, Asp, or Lys, or is deleted, or (a) a C-l-6-ester thereof, (b) amide, C-l-6-alkylamide, or C-l-6-dialkylamide thereof and/or (c) a pharmaceutically acceptable salt thereof, provided that (i) when the amino acid at position 37, 38, 39, 40, 41, 42, 43 or 44 is deleted, then each amino acid downstream of the amino acid is also deleted.
- the amino acids at positions 37-45 are absent.
- the amino acids at posi- tions 38-45 are absent.
- the amino acids at positions 39-45 are absent.
- Xaa at position 8 is Ala, Gly, Ser, Thr, Met, or Val.
- Xaa at position 8 is Gly, Thr, Met, or Val. In another embodiment of the GLP-1 analogue of formula II, Xaa at position 8 is Val.
- Xaa at position 9 is Glu. In another embodiment of the GLP-1 analogue of formula II, Xaa at position 11 is Thr. In another embodiment of the GLP-1 analogue of formula II, Xaa at position 14 is Ser. In another embodiment of the GLP-1 analogue of formula II, Xaa at position 16 is Val. In another embodiment of the GLP- 1 analogue of formula II, Xaa at position 17 is Ser.
- Xaa at position 18 is Ser, Lys, Glu, or Asp.
- Xaa at position 19 is Tyr, Lys, Glu, or Asp.
- Xaa at position 20 is Leu,
- Xaa at position 21 is Glu, Lys, or Asp.
- Xaa at position 22 is Gly, Glu, Asp, or Lys.
- Xaa at position 23 is Gin, Glu, Asp, or Lys.
- Xaa at position 24 is Ala, Glu, Asp, or Lys.
- Xaa at position 25 is Ala,
- Xaa at position 26 is Lys, Glu, Asp, or Arg.
- Xaa at position 27 is Glu, Asp, or Lys.
- Xaa at position 30 is Ala, Glu, Asp, or Lys.
- Xaa at position 31 is Trp, Glu, Asp, or Lys.
- Xaa at position 32 is Leu, Glu, Asp, or Lys. In another embodiment of the GLP-1 analogue of formula II, Xaa at position 33 is Val,
- Xaa at position 34 is Lys, Arg, Glu, or Asp.
- Xaa at position 35 is Gly, Glu, Asp, or Lys.
- Xaa at position 36 is Arg, Lys, Glu, or Asp.
- Xaa at position 37 is Gly, Glu, Asp, or Lys.
- Xaa at position 38 is Arg, or Lys, or is deleted.
- Xaa at position 40 is de- leted.
- Xaa at position 42 is deleted.
- Xaa at position 43 is deleted.
- Xaa at position 45 is de- leted.
- Xaa at position 26 is Arg, each of Xaa at positions 37-45 is deleted, and each of the other Xaa is the amino acid in native GLP- 1(7-36).
- Xaa at position 26 is Arg
- each of Xaa at positions 38-45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-37).
- Xaa at position 26 is Arg
- each of Xaa at positions 39-45 is deleted
- each of the other Xaa is the amino acid in native GLP-l(7-38).
- Xaa at position 34 is Arg
- each of Xaa at positions 37-45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-36).
- Xaa at position 34 is Arg
- each of Xaa at positions 38-45 is deleted
- each of the other Xaa is the amino acid in native GLP-l(7-37).
- Xaa at position 34 is Arg
- each of Xaa at positions 39-45 is deleted
- each of the other Xaa is the amino acid in native GLP-l(7-38).
- Xaa at positions 26 and 34 is Arg
- Xaa at position 36 is Lys
- each of Xaa at positions 37-45 is deleted
- each of the other Xaa is the amino acid in native GLP-1 (7-36).
- Xaa at positions 26 and 34 is Arg
- Xaa at position 36 is Lys
- each of Xaa at positions 38-45 is deleted
- each of the other Xaa is the amino acid in native GLP-1 (7-37).
- Xaa at positions 26 and 34 is Arg
- Xaa at position 36 is Lys
- each of Xaa at positions 39-45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-38).
- Xaa at positions 26 and 34 is Arg
- Xaa at position 38 is Lys
- each of Xaa at positions 39-45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-38).
- Xaa at position 8 is Thr, Ser, Gly, or Val
- Xaa at position 37 is Glu
- Xaa at position 36 is Lys
- each of Xaa at positions 38- 45 is deleted
- each of the other Xaa is the amino acid in native GLP-1 (7-37).
- Xaa at position 8 is Thr, Ser, Gly, or Val
- Xaa at position 37 is Glu
- Xaa at position 36 is Lys
- each of Xaa at positions 39- 45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-38).
- Xaa at position 8 is Thr, Ser, Gly or Val
- Xaa at position 37 is Glu
- Xaa at position 38 is Lys
- each of Xaa at positions 39- 45 is deleted
- each of the other Xaa is the amino acid in native GLP-l(7-38).
- Xaa at position 18, 23 or 27 is Lys
- Xaa at positions 26 and 34 is Arg
- each of Xaa at positions 38-45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1 (7-37).
- Xaa at position 18, 23 or 27 is Lys
- Xaa at positions 26 and 34 is Arg
- each of Xaa at positions 39-45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-38).
- Xaa at position 8 is Thr, Ser, Gly, or Val
- Xaa at position 18, 23 or 27 is Lys
- Xaa at position 26 and 34 is Arg
- each of Xaa at positions 37-45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-36).
- Xaa at position 8 is Thr, Ser, Gly, or Val
- Xaa at position 18, 23 or 27 is Lys
- Xaa at position 26 and 34 is Arg
- each of Xaa at positions 38-45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-37).
- Xaa at position 8 is Thr, Ser, Gly, or Val
- Xaa at position 18, 23 or 27 is Lys
- Xaa at position 26 and 34 is Arg
- each of Xaa at positions 39-45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-38).
- Such GLP-1 analogues includes, but is not limited to, Arg 26 -GLP- 1(7-37); Arg 34 -GLP- 1(7-37); Lys 36 -GLP- 1(7-37); Arg 26 ' 34 Lys 36 -GLP- 1(7-37); Arg 26 ' 34 Lys 38 GLP-l(7-38); Arg 26 4 Lys 39 -GLP- 1(7-39); Arg 26 4 Lys 40 -GLP- 1(7-40); Arg 26 Lys 36 -GLP-l(7-37); Arg 34 Lys 36 -
- Arg 26 ' 34 Lys 40 GLP- 1 (2-40); Arg 26 ' 34 Lys 41 GLP- 1 (2-41 ); Arg 26 ' 34 Lys 42 GLP- 1 (2-42); Arg 26 ' 34 Lys 43 GLP- 1(2-43); Arg 26,34 Lys 44 GLP-l(2-44); Arg 26 ' 34 Lys 45 GLP-l(2-45);
- Arg 26 ' 34 Lys 39 GLP-l(4-39); Arg 26 - 34 Lys 40 GLP-l(4-40); Arg 26 ' 34 Lys 1 GLP-l(4-41); Arg 26 ' 34 Lys 42 GLP- 1 (4-42); Arg 26 ' 34 Lys 43 GLP- 1 (4-43); Arg 26 ' 34 Lys 44 GLP- 1 (4-44);
- Arg 26 - 34 Lys 38 GLP-l(6-38); Arg 26 ' 34 Lys 39 GLP-l(6-39); Arg 26 ' 34 Lys 40 GLP-l(6-4O); Arg 26 - 34 Lys 41 GLP-l(6-41); Arg 26 ' 34 Lys 42 GLP- 1(6-42); Arg 26 ' 34 Lys 43 GLP- 1(6-43);
- the GLP-1 agonist is a GLP-1 derivative.
- the GLP-1 derivative has one or more lipophilic substituents attached to the parent peptide. The lipophilic substituents make the profile of action of the parent GLP-1 peptide more protracted, make the parent GLP-1 peptide more me- tabolically and physically stable, and/or increase the water solubility of the parent GLP-1 pep- tide.
- the lipophilic substituent is characterised by having a solubility in water at 20°C in the range from about 0.1 mg/100 ml water to about 250 mg/100 ml water, preferable in the range from about 0.3 mg/100 ml water to about 75 mg/100 ml water.
- octanoic acid (C8) has a solubility in water at 20°C of 68 mg/100 ml
- decanoic acid (CIO) has a solubility in water at 20°C of 15 mg/100 ml
- octadecanoic acid (C 18) has a solubility in water at 20°C of 0.3 mg/100 ml.
- the GLP-1 derivatives preferably have three lipophilic substituents, more preferably two lipophilic substituents, and most preferably one lipophilic substituent.
- Each lipophilic substituent(s) preferably has 4-40 carbon atoms, more preferably 8-30 carbon atoms, even more preferably 8-25 carbon atoms, even more preferably 12-25 carbon atoms, and most preferably 14-18 carbon atoms.
- the lipophilic substituent(s) contain a functional group which can be attached to one of the following functional groups of an amino acid of the parent GLP-1 peptide: (a) the amino group attached to the alpha-carbon of the N-terminal amino acid,
- a lipophilic 'substituent is attached to the carboxy group of the R group of any Asp and Glu residue.
- a lipophilic substituent is attached to the carboxy group attached to the alpha-carbon of the C-terminal amino acid.
- a lipophilic substituent is attached to the epsilon- amino group of any Lys residue.
- Each lipophilic substituent contains a functional group which may be attached to a functional group of an amino acid of the parent GLP-1 peptide.
- a lipophilic substituent may contain a carboxy 1 group which can be attached to an amino group of the parent GLP-1 peptide by means of an amide bond.
- the lipophilic substituent comprises a partially or completely hydrogenated cyclopentanophenathrene skeleton.
- the lipophilic substituent is a straight-chain or branched alkyl group.
- the lipophilic substituent is an acyl group of a straight-chain or branched fatty acid.
- the lipophilic substituent is an acyl group having the formula CH 3 (CH 2 ) n CO-, wherein n is an integer from 4 to 38, preferably an integer from 12 to 38, and most preferably is CH 3 (CH 2 ) 12 CO-, CH 3 (CH 2 ) ⁇ 4 CO-, CH 3 (CH 2 ) ⁇ 6 CO-, CH 3 (CH 2 ) ⁇ 8 C0-, CH 3 (CH 2 ) 20 CO- and CH 3 (CH 2 ) 22 CO-.
- the lipophilic substituent is tetradecanoyl.
- the lipophilic substituent is hexadecanoyl.
- the lipophilic substituent has a group which is negatively charged such as a carboxylic acid group.
- the lipophilic substituent may be an acyl group of a straight-chain or branched alkane ⁇ , ⁇ -dicarboxylic acid of the formula HOOC(CH 2 ) m CO-, wherein m is an integer from 4 to 38, preferably an integer from 12 to 38, and most preferably is HOOC(CH 2 )* 4 CO-, HOOC(CH 2 ) ⁇ 6 CO-, HOOC(CH 2 )* 8 CO-, HOOC(CH 2 ) 20 CO- or HOOC(CH 2 ) 22 CO-.
- the lipophilic substituent is attached to the parent GLP-1 peptide by means of a spacer.
- a spacer must contain at least two functional groups, one to attach to a functional group of the lipophilic substituent and the other to a functional group of the parent GLP-1 peptide.
- the spacer is an amino acid residue except Cys or Met, or a dipeptide such as Gly-Lys.
- a dipeptide such as Gly- Lys means any combination of two amino acids except Cys or Met, preferably a dipeptide wherein the C-terminal amino acid residue is Lys, His or Trp, preferably Lys, and the N-terminal amino acid residue is Ala, Arg, Asp, Asn, Gly, Glu, Gin, He, Leu, Val, Phe, Pro, Ser, Tyr, Thr, Lys, His and Trp.
- an amino group of the parent peptide forms an amide bond with a carboxylic group of the amino acid residue or dipeptide spacer
- an amino group of the amino acid residue or dipeptide spacer forms an amide bond with a carboxyl group of the lipophilic substituent
- Preferred spacers are lysyl, glutamyl, asparagyl, glycyl, beta-alanyl and gamma- aminobutanoyl, each of which constitutes an individual embodiment. Most preferred spacers are glutamyl and beta-alanyl.
- the spacer is Lys, Glu or Asp
- the carboxyl group thereof may form an amide bond with an amino group of the amino acid residue
- the amino group thereof may form an amide bond with a carboxyl group of the lipophilic substituent.
- a further spacer may in some instances be inserted between the ⁇ -amino group of Lys and the lipophilic substituent.
- such a further spacer is succinic acid which forms an amide bond with the ⁇ -amino group of Lys and with an amino group present in the lipophilic substituent.
- such a further spacer is Glu or Asp which forms an amide bond with the ⁇ -amino group of Lys and another amide bond with a carboxyl group present in the lipophilic substituent, that is, the lipophilic substituent is a N ⁇ -acylated lysine residue.
- the spacer is an unbranched alkane , ⁇ -dicarboxylic acid group having from 1 to 7 methylene groups, which spacer forms a bridge between an amino group of the parent peptide and an amino group of the lipophilic substituent.
- the spacer is succinic acid.
- the lipophilic substituent with the attached spacer is a group of the formula CH 3 (CH 2 ) p NH-CO(CH 2 ) q CO-, wherein p is an integer from 8 to 33 , preferably from 12 to 28 and q is an integer from 1 to 6, preferably 2.
- the lipophilic substituent with the attached spacer is a group of the formula CH 3 (CH 2 ) r CO-NHCH(COOH)(CH 2 ) 2 CO-, wherein r is an integer from 4 to 24, preferably from 10 to 24.
- the lipophilic substituent with the attached spacer is a group of the formula CH 3 (CH 2 ) S CO-NHCH((CH 2 ) 2 COOH)CO-, wherein s is an integer from 4 to 24, preferably from 10 to 24.
- the lipophilic substituent is a group of the formula COOH(CH 2 ) t CO- wherein t is an integer from 6 to 24.
- the lipophilic substituent with the attached spacer is a group of the formula -NHCH(COOH)(CH 2 ) 4 NH-CO(CH 2 ) u CH 3 , wherein u is an integer from 8 to 18.
- the lipophilic substituent with the attached spacer is a group of the formula CH 3 (CH 2 ) v CO-NH-(CH 2 ) z -CO, wherein v is an integer from 4 to 24 and z is an integer from 1 to 6.
- the lipophilic substituent with the attached spacer is a group of the formula -NHCH(COOH)(CH 2 ) 4 NH-COCH((CH 2 ) 2 COOH)NH-CO(CH 2 ) w CH 3 , wherein w is an integer from 10 to 16.
- the lipophilic substituent with the attached spacer is a group of the formula -NHCH(COOH)(CH 2 ) 4 NH-CO(CH 2 ) 2 CH(COOH)NHCO(CH 2 ) x CH 3 , wherein x is zero or an integer from 1 to 22, preferably 10 to 16.
- the GLP- 1 derivative is derived from a GLP- 1 fragment selected from the group comprising GLP-l(7-35), GLP-1 (7-36), GLP-1 (7-36)amide, GLP-l(7-37), GLP- 1(7-38), GLP-l(7-39), GLP-1 (7-40) and GLP-1 (7-41) or an analogue thereof.
- the designation analogue comprises derivatives wherein a total of up to fifteen, preferably up to ten amino acid residues have been exchanged with any -amino acid residue.
- the designation analogue comprises derivatives wherein a total of up to fifteen, preferably up to ten amino acid residues have been exchanged with any ⁇ -amino acid residue which can be coded for by the genetic code.
- the designation analogue comprises de- rivatives wherein a total of up to six amino acid residues have been exchanged with another ⁇ - arnino acid residue which can be coded for by the genetic code.
- the GLP-1 derivative is a GLP-1 derivative of formula I:
- Xaa at position 8 is Ala, Gly, Ser, Thr, Leu, He, Val, Glu, Asp, Met, or Lys
- Xaa at position 9 is Glu, Asp, or Lys
- Xaa at position 11 is Thr, Ala, Gly, Ser, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 14 is Ser, Ala, Gly, Thr, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 16 is Val, Ala, Gly, Ser, Thr, Leu, He, Tyr, Glu, Asp, or Lys
- Xaa at position 17 is Ser, Ala, Gly, Thr, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 18 is Ser, Ala, Gly, Thr, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 19 is Tyr, Phe, Tip, Glu, Asp, or Lys
- Xaa at position 20 i is Leu, Ala, Gly, Ser, Thr, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 21 is Glu, Asp, or Lys
- Xaa at position 22 is Gly, Ala, Ser, Thr, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 23 is Gin, Asn, Arg, Glu, Asp, or Lys
- Xaa at position 24 ⁇ is Ala, Gly, Ser, Thr, Leu, He, Val, Arg, Glu, Asp, or Lys
- Xaa at position 25 > is Ala, Gly, Ser, Thr, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 26 i is Lys, Arg, Gin, Glu, Asp, or His
- Xaa at position 27 ' is Glu, Asp, or Lys,
- Xaa at position 31 is Trp, Phe, Tyr, Glu, Asp, or Lys
- Xaa at position 32 is Leu, Gly, -Ala, Ser, Thr, He, Val, Glu, Asp, or Lys
- Xaa at position 33 is Val, Gly, Ala, Ser, Thr, Leu, He, Glu, Asp, or Lys
- Xaa at position 34 is Lys, Arg, Glu, Asp, or His
- Xaa at position 35 is Gly, Ala, Ser, Thr, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 36 is Arg, Lys, Glu, Asp, or His
- Xaa at position 37 is Gly, Ala, Ser, Thr, Leu, He, Val, Glu, Asp, or Lys, or is deleted
- Xaa at position 38 is Arg, Lys, Glu, Asp, or His, or is deleted
- Xaa at position 39 is Arg, Lys, Glu, Asp, or His, or is deleted
- Xaa at position 40 is Asp, Glu, or Lys, or is deleted
- Xaa at position 41 is Phe, Trp, Tyr, Glu, Asp, or Lys, or is deleted
- Xaa at position 42 is Pro, Lys, Glu, or Asp, or is deleted, Xaa at position 43 is Glu, Asp, or Lys, or is deleted, Xaa at position 44 is Glu, Asp, or Lys, or is deleted, and Xaa at position 45 is Val, Glu, Asp, or Lys, or is deleted, or (a) a C- 1 -6-ester thereof, (b) amide, C- 1 -6-alkylamide, or C- 1 -6-dialkylamide thereof and/or (c) a pharmaceutically acceptable salt thereof, provided that
- the total number of different amino acids between the derivative of the GLP-1 analog and the corresponding native form of GLP-1 does not exceed six.
- the amino acids at positions 37-45 are absent.
- the amino acids at positions 38-45 are absent.
- the amino acids at posi- tions 39-45 are absent.
- Xaa at position 8 is Ala, Gly, Ser, Thr, Leu, He, Val, Glu, Asp, or Lys
- Xaa at position 8 is Ala, Gly, Ser, Thr, or Nal.
- Xaa at position 9 is Glu. In another embodiment of the GLP-1 derivative of formula I, Xaa at position 11 is Thr. In another embodiment of the GLP-1 derivative of formula I, Xaa at position 14 is Ser.
- Xaa at position 16 is Val. In another embodiment of the GLP-1 derivative of formula I, Xaa at position 17 is Ser. In another embodiment of the GLP-1 derivative of formula I, Xaa at position 18 is Ser, Lys, Glu, or Asp. In another embodiment of the GLP- 1 derivative of formula I, Xaa at position 19 is Tyr,
- Xaa at position 20 is Leu, Lys, Glu, or Asp.
- Xaa at position 21 is Glu, Lys, or Asp.
- Xaa at position 22 is Gly, Glu, Asp, or Lys.
- Xaa at position 23 is Gin, Glu, Asp, or Lys.
- Xaa at position 24 is Ala
- Xaa at position 25 is Ala, Glu, Asp, or Lys.
- Xaa at position 26 is Lys, Glu, Asp, or Arg.
- Xaa at position 27 is Glu, Asp, or Lys.
- Xaa at position 30 is Ala, Glu, Asp, or Lys.
- Xaa at position 31 is Trp ,
- Xaa at position 32 is Leu, Glu, Asp, or Lys.
- Xaa at position 33 is Val, Glu, Asp, or Lys. In another embodiment of the GLP-1 derivative of formula I, Xaa at position 34 is Lys,
- Xaa at position 35 is Gly, Glu, Asp, or Lys.
- Xaa at position 36 is Arg, Lys, Glu, or Asp.
- Xaa at position 37 is Gly, Glu, Asp, or Lys.
- Xaa at position 38 is Arg, or Lys, or is deleted. In another embodiment of the GLP-1 derivative of formula I, Xaa at position 39 is deleted.
- Xaa at position 41 is de- leted.
- Xaa at position 43 is deleted. In another embodiment of the GLP-1 derivative of formula I, Xaa at position 44 is deleted.
- Xaa at position 26 is Arg, each of Xaa at positions 37-45 is deleted, and each of the other Xaa is the amino acid in native GLP-l(7-36).
- Xaa at position 26 is Arg, each of Xaa at positions 38-45 is deleted, and each of the other Xaa is the amino acid in native GLP-1 (7-37).
- Xaa at position 26 is Arg
- each of Xaa at positions 39-45 is deleted
- each of the other Xaa is the amino acid in native GLP-l(7-38).
- Xaa at position 34 is Arg, each of Xaa at positions 37-45 is deleted, and each of the other Xaa is the amino acid in native GLP-l(7-36).
- Xaa at position 34 is Arg, each of Xaa at positions 38-45 is deleted, and each of the other Xaa is the amino acid in native GLP-1 (7-37).
- Xaa at position 34 is Arg
- each of Xaa at positions 39-45 is deleted
- each of the other Xaa is the amino acid in native GLP-1 (7-38).
- Xaa at positions 26 and 34 is Arg
- Xaa at position 36 is Lys
- each of Xaa at positions 37-45 is deleted
- each of the other Xaa is the amino acid in native GLP-l(7.-36).
- Xaa at positions 26 and 34 is Arg
- Xaa at position 36 is Lys
- each of Xaa at positions 38-45 is deleted
- each of the other Xaa is the amino acid in native GLP-1 (7-37).
- Xaa at positions 26 and 34 is Arg
- Xaa at position 36 is Lys
- each of Xaa at positions 39-45 is deleted
- each of the other Xaa is the amino acid in native GLP-l(7-38).
- Xaa at positions 26 and 34 is Arg
- Xaa at position 38 is Lys
- each of Xaa at positions 39-45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-38).
- Xaa at position 8 is Thr, Ser, Gly or Val
- Xaa at position 37 is Glu
- Xaa at position 36 is Lys
- each of Xaa at positions 38- 45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-37).
- Xaa at position 8 is Thr, Ser, Gly or Val
- Xaa at position 37 is Glu
- Xaa at position 36 is Lys
- each of Xaa at positions 39- 45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-38).
- Xaa at position 8 is Thr, Ser, Gly or Val
- Xaa at position 37 is Glu
- Xaa at position 38 is Lys
- each of Xaa at positions 39- 45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-38).
- Xaa at position 18, 23 or 27 is Lys, and Xaa at positions 26 and 34 is Arg, each of Xaa at positions 37-45 is deleted, and each of the other Xaa is the amino acid in native GLP- 1(7-36).
- Xaa at position 18, 23 or 27 is Lys, and Xaa at positions 26 and 34 is Arg, each of Xaa at positions 37-45 is deleted, and each of the other Xaa is the amino acid in native GLP- 1(7-36).
- Xaa at position 18, 23 or 27 is Lys, and Xaa at positions 26 and 34 is Arg, each of Xaa at positions 39-45 is deleted, and each of the other Xaa is the amino acid in native GLP-l(7-38).
- Xaa at position 8 is Thr, Ser, Gly, or Val, Xaa at position 18, 23 or 27 is Lys, and Xaa at position 26 and 34 is Arg, each of Xaa at positions 37-45 is deleted, and each of the other Xaa is the amino acid in native GLP- 1(7-36).
- Xaa at position 8 is Thr, Ser, Gly, or Val, Xaa at position 18, 23 or 27 is Lys, and Xaa at position 26 and 34 is Arg, each of Xaa at positions 37-45 is deleted, and each of the other Xaa is the amino acid in native GLP- 1(7-36).
- Xaa at position 8 is Thr, Ser, Gly, or Val, Xaa at position 18, 23 or 27 is Lys, and Xaa at position 26 and 34 is Arg, each of Xaa at positions 37-45 is deleted, and each of the other Xaa is the amino acid in native GLP- 1
- Xaa at position 18, 23 or 27 is Lys
- Xaa at position 26 and 34 is Arg
- each of Xaa at positions 38-45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-37).
- Xaa at position 8 is Thr, Ser, Gly, or Val
- Xaa at position 18, 23 or 27 is Lys
- Xaa at position 26 and 34 is Arg
- each of Xaa at positions 39-45 is deleted
- each of the other Xaa is the amino acid in native GLP- 1(7-38).
- Such GLP-1 derivatives includes, but is not limited to, Lys 34 (N ⁇ -( ⁇ -glutamyl(N ⁇ -tetradecanoyl))) GLP-1 (7-37), Arg 26 ' 34 ,Lys 8 (N ⁇ -( ⁇ -glutamyl(N ⁇ -hexadecanoyl))) GLP-1 (7-37), Arg 34 ,Lys 2o (N ⁇ -( ⁇ -gh ⁇ tamyl(N ⁇ -dodecanoyl))) GLP-1 (7-37), Arg 34 ,Lys 26 (N ⁇ -( ⁇ -alanyl(N ⁇ -hexadecanoyl))) GLP-1 (7-37), Arg 34 ,Lys 26 (N ⁇ -( ⁇ -glutamyl(N ⁇ -hexadecanoyl))) GLP-1 (7-37), Arg 34 ,Lys 26 (N
- Lys 26 - 34 bis(N ⁇ -( ⁇ -glutamyl(N ⁇ -tetradecanoyl)))-GLP- 1 (7-37)-OH,
- Ly s 26 - 34 bis(N ⁇ -( ⁇ -glutamyl(N ⁇ -hexadecanoyl)))-GLP- 1(7-37)-OH,
- Arg 26 ' 34 Lys 38 (N ⁇ -( ⁇ -glutamyl(N ⁇ -tetradecanoyl)))-GLP- 1 (7-38)-OH
- Arg 26 ' 34 Lys 38 (N ⁇ -( ⁇ -glutamyl(N ⁇ -hexadecanoyl)))-GLP- 1 (7-38)-OH
- Arg 2634 Lys 38 (N ⁇ -( ⁇ -glutamyl(N ⁇ -octadecanoyl)))-GLP- 1 (7-38)-OH.
- Lys 26 ' 34 bis(N ⁇ -( ⁇ -glutamyl(N ⁇ -tetradecanoyl)))-GLP-l(7-37)-OH,
- Lys 26 - 34 bis(N ⁇ -( ⁇ -glutamyl(N ⁇ -hexadecanoyl)))-GLP- 1 (7-37)-OH,
- Arg 34 Lys 26 (N ⁇ -( ⁇ -glutamyl(N ⁇ -hexadecanoyl)))-GLP-l(7-37)-OH
- Arg 26 ' 34 Lys 38 (N ⁇ -( ⁇ -glutamyl(N ⁇ -tetradecanoyl)))-GLP- 1 (7-38)-OH
- Arg 26,34 Lys 38 (N ⁇ -( ⁇ -carboxytridecanoyl))-GLP-l(7-38)-OH
- Arg 34 Lys 26 (N ⁇ -( ⁇ -glutamy l(N ⁇ -tetradecanoyl)))-GLP- 1(7-37)-OH
- Arg 34 Lys 26 (N ⁇ -( ⁇ -alanyl(N ⁇ -tetradecanoyl)))-GLP-l(7-37)-OH
- Arg 26 ' 34 Lys 38 (N ⁇ -( ⁇ -alanyl(N ⁇ -octadecanoyl)))-GLP- 1 (7-38)-OH.
- Lys 38 (N ⁇ -( ⁇ -alanyl(N ⁇ -octadecanoyl)))-GLP- 1 (7-38)-OH, Lys 26 (N ⁇ -tetradecanoyl)-GLP-l(7-37);
- Lys 34 (N ⁇ -tetradecanoyl)-GLP-l(7-37);
- Gly 8 Lys 34 (N ⁇ -tetradecanoyl)-GLP- 1 (7-37);
- Lys 34 (N ⁇ -tetradecanoyl)-GLP-l(7-37); Lys 26 (N ⁇ -tetradecanoyl)-GLP- 1 (7-38);
- Lys 34 (N ⁇ -tetradecanoyl)-GLP-l(7-38);
- Gly 8 Lys 3 (N ⁇ -tetradecanoyl)-GLP- 1 (7-38); Gly 8 Lys 26 ' 34 -bis(N ⁇ -tetradecanoyl)-GLP-l(7-38); Arg 26 Lys 34 (N ⁇ -tetradecanoyl)-GLP- 1 (7-38); Lys 26 (N ⁇ -tetradecanoyl)-GLP- 1 (7-39); Lys 34 (N ⁇ -tetradecanoyl)-GLP-l(7-39); Lys 26*34 -bis(N ⁇ -tetradecanoyl)-GLP-l(7-39); Gly 8 Lys 26 (N ⁇ -tetradecanoyl)-GLP-l(7-39); Gly 8 Lys 34 (N ⁇ -tetradecanoyl)-GLP-l(7-39); Gly 8 Lys 26 ' 34 -bis(N
- Lys 26 (N ⁇ -tetradecanoyl)-GLP-l(7-36);
- Lys 34 (N ⁇ -tetradecanoyl)-GLP- 1 (7-36);
- Gly 8 Lys 26 (N ⁇ -tetradecanoyl)-GLP-l(7-36);
- Gly 8 Lys 34 (N ⁇ -tetradecanoyl)-GLP-l(7-36);
- Lys 26 (N ⁇ -tetradecanoyl)-GLP-l(7-35);
- Lys 34 (N ⁇ -tetradecanoyl)-GLP-l(7-35); Lys 2634 -bis(N ⁇ -tetradecanoyl)-GLP-l(7-35);
- Lys 34 (N ⁇ -tetradecanoyl)-GLP- 1 (7-35); Lys 26 (N ⁇ -tetradecanoyl)-GLP- 1 (7-36)amide; Lys 34 (N ⁇ -tetradecanoy 1)-GLP- 1(7-36)amide;
- Gly 8 Lys 34 (N ⁇ -tetradecanoyl)-GLP-l(7-36)amide; Gly 8 Lys 26 - 34 -bis(N ⁇ -tetradecanoyl)-GLP- 1 (7-36)amide;
- Lys 26 (N ⁇ -tetradecanoyl)Arg 34 -GLP-l(7-37);
- Lys 26 (N ⁇ -tetradecanoyl)Arg 34 -GLP- 1 (7-38);
- Lys 26 (N ⁇ -tetradecanoyl)Arg 34 -GLP-l(7-39); Gly 8 Lys 26 (N ⁇ -tetradecanoyl)Arg 34 -GLP- 1 (7-39);
- Lys 26 (N ⁇ -tetradecanoyl)Arg 34 -GLP- 1 (7-40); Gly 8 Lys 26 (N ⁇ -tetradecanoyl)Arg 34 -GLP- 1 (7-40);
- Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP-l(7-37);
- Lys 34 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP-l(7-37); Lys 26 ' 34 -bis(N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-37); Gly 8 Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP-l(7-37);
- Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-38); Lys 34 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-38);
- Lys 26 - 34 bis(N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP-l(7-38);
- Lys j4 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP-l(7-39);
- Lys 26 ' 34 bis(N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP-l(7-39);
- Gly 8 Lys 34 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-39); Gly 8 Lys 26 ' 34 -bis(N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP-l (7-39);
- Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-40);
- Lys 34 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-40);
- Lys 26 ' 34 bis(N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-40);
- Gly 8 Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-40); Gly 8 Lys 34 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1(7-40);
- Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP-l(7-36);
- Lys 34 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP-l(7-36);
- Lys 26 - 34 bis(N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP-l(7-36); Gly 8 Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-36);
- Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP-l(7-36)amide;
- Lys 34 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP-l(7-36)amide; Lys 2634 -bis(N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-36)amide; Gly 8 Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-36)amide; Gly 8 Lys 34 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-36)amide; Gly 8 Lys 26 ' 34 -bis(N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP-l(7-36)amide; Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-35); Lys 34 (N ⁇ -( ⁇ -carboxynonade
- Gly 8 Arg 26 Lys 34 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-37) ; Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))Arg 34 -GLP- 1 (7-37); Gly 8 Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))Arg 34 -GLP-l(7-37); Arg 26 ' 34 Lys 36 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-37); Gly 8 Arg 26 ' 34 Lys 36 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-37) ; Arg 26 Lys 34 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-37) ; Arg 26 Lys 34 (N ⁇
- Gly 8 Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))Arg 34 -GLP-l(7-39); Arg 26 ' 34 Lys 36 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-39); Gly 8 Arg 26 ' 34 Lys 36 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-39); Arg 26 Lys 34 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-40); Gly 8 Arg 26 Lys 34 (N ⁇ -( ⁇ -carboxynonadecanoyl))-GLP- 1 (7-40); Lys 26 (N ⁇ -( ⁇ -carboxynonadecanoyl))Arg 34 -GLP- 1 (7-40); Gly 8 Lys 26 (N ⁇ -( ⁇ -carboxyn
- Lys 34 (N ⁇ -(7-deoxycholoyl))-GLP- 1 (7-36); Lys 26 (N ⁇ -(7-deoxycholoyl))-GLP- 1 (7-35);
- Lys 34 (N ⁇ -(7-deoxycholoyl))-GLP- 1 (7-35);
- Lys 26 - 34 bis(N ⁇ -(7-deoxycholoyl))-GLP-l(7-35);
- Gly 8 Lys 34 (N ⁇ -(7-deoxycholoyl))-GLP- 1 (7-35);
- Lys 26 (N ⁇ -(7-deoxycholoyl))-GLP- 1 (7-36)amide;
- Lys 34 (N ⁇ -(7-deoxycholoyl))-GLP- 1 (7-36)amide;
- Lys 26 ' 34 bis(N ⁇ -(7-deoxycholoyl))-GLP- 1 (7-36)amide; Gly 8 Lys 26 (N ⁇ -(7-deoxycholoyl))-GLP- 1 (7-36)amide;
- Lys 26 (N ⁇ -(choloyl))-GLP-l(7-37); Lys 34 (N ⁇ -(choloyl))-GLP-l(7-37); Lys neglect26 0 .3 J 4 4 -bis(N ⁇ -(choloyl))-GLP- 1 (7-37);
- Lys 26 (N ⁇ -(7-deoxycholoyl))Arg 34 -GLP- 1 (7-38);
- Arg 26 - 34 Lys 36 (N ⁇ -(7-deoxycholoyl))-GL ⁇ > - 1 (7-38);
- Arg 26 ' 34 Lys 38 (N ⁇ -(7-deoxycholoyl))-GLP- 1 (7-38);
- Lys 26 (N ⁇ -(choloyl))-GLP-l(7-38);
- Lys 34 (N ⁇ -(choloyl))-GLP-l(7-38);
- Lys 26 (N ⁇ -(choloyl))-GLP-l(7-39); Lys 34 (N ⁇ -(choloyl))-GLP-l(7-39);
- Lys 26 (N ⁇ -(choloyl))-GLP- 1(7-40);
- Lys 34 (N ⁇ -(choloyl))-GLP- 1 (7-40);
- Lys 2634 bis(N ⁇ -(choloyl))-GLP- 1 (7-40);
- Gly 8 Lys 26 (N ⁇ -(choloyl))-GLP- 1 (7-40): Gly 8 Lys 34 (N ⁇ -(choloyl))-GLP- 1 (7-40);
- Lys 26 (N ⁇ -(choloyl))-GLP- 1 (7-36);
- Lys 34 (N ⁇ -(choloyl))-GLP- 1 (7-36); Lys 26 ' 34 -bis(N ⁇ -(choloyl))-GLP- 1 (7-36);
- Lys 34 (N ⁇ -(choloyl))-GLP- 1(7-36); Lys 26 (N ⁇ -(choloyl))-GLP-l(7-35):
- Lys 34 (N ⁇ -(choloyl))-GLP-l(7-35);
- Lys 2634 bis(N ⁇ -(choloyl))-GLP- 1 (7-35);
- Gly 8 Lys 34 (N ⁇ -(choloyl))-GLP-l(7-35): ' Gly 8 Lys 26 - 34 -bis( ⁇ -(choloyl))-GLP- 1(7-35);
- Lys 26 (N ⁇ -(choloyl))-GLP-l(7-36)amide
- Lys 34 (N ⁇ -(choloyl))-GLP- 1 (7-36)amide;
- Lys 26 (N ⁇ -(lithocholoyl))-GLP- 1 (7-37); .
- Lys 34 (N ⁇ -(lithocholoyl))-GLP- 1 (7-37);
- Lys 2634 bis(N ⁇ -(lithocholoyl))-GLP- 1 (7-37);
- Lys 26 (N ⁇ -(choloyl))Arg 34 -GLP-l(7-38);
- Lys 26 (N ⁇ -(lithocholoyl))-GLP- 1 (7-38);
- Lys 34 (N ⁇ -(lithocholoyl))-GLP- 1 (7-38):
- Lys 26 4 bis(N ⁇ -(lithocholoyl))-GLP-l(7-38); Gly 8 Lys 26 (N ⁇ -(lithocholoyl))-GLP- 1(7-38);
- Gly 8 Lys 34 (N ⁇ -(lithocholoyl))-GLP- 1 (7-38); Gly 8 Lys 2634 -bis(N ⁇ -(lithocholoyl))-GLP- 1 (7 Arg 26 Lys 34 (N ⁇ -(lithocholoyl))-GLP- 1 (7-38); Gly 8 Arg 26 Lys 34 (N ⁇ -(choloyl))-GLP- 1 (7-39); Lys 26 (N ⁇ -(choloyl))Arg 34 -GLP-l(7-39); Gly 8 Lys 26 (N ⁇ -(choloyl))Arg 34 -GLP-l(7-39);
- Lys 26 (N ⁇ -(lithocholoyl))-GLP-l(7-39); Lys 34 (N ⁇ -(lithocholoyl))-GLP-l(7-39);
- Lys 26 (N ⁇ -(choloyl))Arg 34 -GLP- 1 (7-40);
- Lys 26 (N ⁇ -(lithocholoyl))-GLP- 1 (7-40);
- Lys 34 (N ⁇ -(lithocholoyl))-GLP- 1 (7-40);
- Lys 2634 bis(N ⁇ -(lithocholoyl))-GLP- 1 (7-40);
- Gly 8 Lys 26 (N ⁇ -(lithocholoyl))-GLP- 1 (7-40);
- Gly 8 Lys 34 (N ⁇ -(lithocholoyl))-GLP- 1 (7-40);
- Lys 26 (N ⁇ -(lithocholoyl))-GLP- 1 (7-36);
- Lys 34 (N ⁇ -(lithocholoyl))-GLP-l(7-36); • Lys 26 4 -bis(N ⁇ -(lithocholoyl))-GLP-l(7-36);
- Lys 34 (N ⁇ -(lithocholoyl))-GLP-l(7-36); Lys 26 (N ⁇ -(lithocholoyl))-GLP-l(7-35); Lys 34 (N ⁇ -(lithocholoyl))-GLP-l(7-35);
- Gly 8 Lys 34 (N ⁇ -(lithocholoyl))-GLP- 1 (7-35);
- Gly 8 Lys 26 4 -bis(N ⁇ -(lithocholoyl))-GLP- 1 (7-35);
- Lys 26 (N ⁇ -(lithocholoyl))-GLP-l(7-36)amide;
- Lys 34 (N ⁇ -(lithocholoyl))-GLP-l(7-36)amide
- Lys 26 4 bis(N ⁇ -(lithocholoyl))-GLP- 1 (7 36)amide; Gly 8 Lys 26 (N ⁇ -(lithocholoyl))-GLP- 1 (7-36)amide;
- Gly 8 Arg 26 4 Lys 36 (N ⁇ -(lithocholoyl))-GLP-l(7-37);
- Gly 8 Arg 26 Lys 34 (N ⁇ -(lithocholoyl))-GLP- 1 (7-38);
- Lys 26 (N ⁇ -(lithocholoyl))Arg 34 -GLP- 1 (7-38);
- Lys 26 (N ⁇ -(lithocholoyl))Arg 34 -GLP- 1 (7-39);
- Lys 26 (N ⁇ -(lithocholoyl))Arg 34 -GLP- 1 (7-40);
- the most preferred GLP-1 derivative is Arg 34 , Lys 26 (N ⁇ -( ⁇ -Glu(N ⁇ -hexadecanoyl)))-
- a parent peptide for a derivative of the invention is
- a parent peptide for a derivative of the invention is:
- the parent peptide is selected from the group comprising Arg 26 -GLP-l(7-37), Arg 34 -GLP-l(7-37), Lys 36 -GLP- 1(7-37), Arg 26 ' 34 Lys 36 - GLP-l(7-37), Arg 26 Lys 36 -GLP-l(7-37), Arg 34 Lys 36 -GLP- 1(7-37), Gly 8 Arg 26 -GLP- 1(7-37), Gly 8 Arg 34 -GLP-l(7-37), Gly 8 Lys 36 -GLP-l(7-37), Gly 8 Lys 36 -GLP-l(7-37), Gly 8 Arg 26 4 Lys 36 -GLP-l(7-37), Gly 8 Arg 26 Lys 36 -GLP- 1(7-37) and Gly 8 Arg 34 Lys 36 -GLP-l(7-37).
- the parent peptide is selected from the group comprising Arg 26 Lys 38 -GLP-l(7-38), Arg 26 4 Lys 38 -GLP-l(7-38), Arg 26 4 Lys 36 ' 38 -GLP- 1(7-38), Gly 8 Arg 26 Lys 38 -GLP-l(7-38) and Gly 8 Arg 26 4 Lys 3638 -GLP-l(7-38).
- the parent peptide is selected from the group comprising Arg 26 Lys 39 -GLP- 1(7-39), Arg 26 4 Lys 3639 -GLP-l(7-39), Gly 8 Arg 26 Lys 39 -GLP- 1(7-39) and Gly 8 Arg 26 4 Lys 36 9 -GLP- 1(7-39).
- the parent peptide is selected from the group comprising Arg 34 Lys 40 -GLP- 1(7-40), Arg 26 4 Lys 36 ' 40 -GLP- 1(7-40), Gly 8 Arg 34 Lys 40 -GLP- 1(7-40) and Gly 8 Arg 26 4 Lys 36,40 -GLP- 1(7-40).
- the parent peptide is:
- the parent peptide is:
- GLP-1 analogues and derivatives which can be used according to the present invention includes those referred to in WO 99/43705 ( ⁇ ovo Nordisk A/S), WO 99/43706 (Novo Nordisk A/S), WO 99/43707 (Novo Nordisk A/S), WO 98/08871 (Novo Nordisk A/S), WO 99/43708 (Novo Nordisk A/S), WO 99/43341 (Novo Nordisk A/S), WO 87/06941 (The General Hospital Corporation), WO 90/11296 (The General Hospital Corporation), WO 91/11457 (Buckley et al.), WO 98/43658 (Eli Lilly & Co.), EP 0708179-A2 (Eli Lilly & Co.), EP 0699686-A2 (Eli Lilly & Co.) which are included herein by reference.
- protracted acting GLP-1 derivatives in particular those described in WO 98/08871 are more preferred.
- the most preferred GLP-1 derivatives are those in which the parent peptide has the formula GLP-1 (7-C), wherein C is 36, 37, 38, 39, 40, 41 , 42, 43, 44 and 45, wherein optionally a total of up to fifteen, preferably up to ten amino acid residues have been exchanged with any ⁇ -amino acid residue which can be coded for by the genetic code, said parent peptide comprising one or two lipophilic substituents having 4 to 40 carbon atoms, preferably from 8 to 25 carbon atoms, optionally via a spacer (such as ⁇ -Glu or ⁇ -Ala).
- the substituents are preferably selected from acyl groups of straight-chained or branched fatty acids.
- GLP-1 analogues and derivatives that include an N-terminal imidazole group and optionally an unbranched C 6 -C ⁇ o acyl group attached to the lysine residue in position 34 are also embodiments of the invention.
- the GLP-1 agonist is selected from ex- endin as well as analogs, derivatives, and fragments thereof, e.g. exendin-3 and -4.
- exendin examples include those disclosed in WO 9746584 and US 5424286.
- US 5424286 describes a method for stimulating insulin release with exendin polypeptide(s).
- exendin-3 and -4 and fragments are useful in treatment of diabetes mellitus (types I or II) and prevention of hyperglycaemia. They normalise hyperglycaemia through glucose-dependent, insulin-independent and insulin- dependent mechanisms.
- Exendin-4 is specific for exendin receptors, i.e. it does not interact with vasoactive intestinal peptide receptors.
- WO 9746584 describes truncated versions of exendin peptide(s) for treating diabetes. The disclosed peptides increase secretion and biosynthesis of insulin, but reduce those of glucagon. The truncated peptides can be made more economically than full length versions.
- the GLP-1 agonist is a non-peptide.
- the GLP-1 agonist is a molecule, preferably a non-peptide, which binds to a GLP-1 receptor with an affinity constant, KTJ, below 1 ⁇ M, preferably below
- GLP-1 means GLP-l(7-37) or GLP-1 (7-36) amide.
- treatment is defined as the management and care of a patient for the purpose of combating the disease, condition, or disorder and includes the administration of a GLP-1 agonist to prevent the onset of the symptoms or complications, or alleviating the symptoms or complications, or eliminating the disease, condition, or disorder.
- Treatment includes modulate, inhibit, decrease, reduce or arrest beta cell degeneration, such as necrosis or apoptosis of beta cells, in particular the programmed ⁇ -cell death known as apoptosis of ⁇ - cells as well as prevention of beta cell degeneration, such as necrosis or apoptosis of beta cells, in particular prevention of apoptosis of ⁇ -cells
- beta cell degeneration is intended to mean loss of beta cell function, beta cell dysfunction, and death of beta cells, such as necrosis or apoptosis of beta cells.
- a GLP-1 agonist is intended to indicate a molecule, preferably
- GLP-1 or an analogue or a derivative thereof, or exendin or an analogue or a derivative thereof, or a non-peptide which binds to a GLP-1 receptor with an affinity constant, K-Q, below 1 ⁇ M, preferably below 100 nM.
- K-Q affinity constant
- Methods for identifying GLP-1 agonists are described in WO 93/19175 (Novo Nordisk A/S).
- a GLP-1 agonist is also intended to comprise active metabolites and prodrugs thereof, such as active metabolites and prodrugs of GLP- 1 or an analogue or a derivative thereof, or exendin or an analogue or a derivative thereof, or a non-peptide.
- a “metabolite” is an active derivative of a GLP-1 agonist produced when the GLP-1 agonist is metabolized.
- a “prodrug” is a compound which is either metabolized to a GLP-1 agonist or is metabolized to the same metabolite(s) as a GLP- 1 agonist.
- an analogue is used to designate a peptide wherein one or more amino acid residues of the parent peptide have been substituted by another amino acid residue and/or wherein one or more amino acid residues of the parent peptide have been deleted and/or wherein one or more amino acid residues have been added to trie parent peptide. Such addition can take place either in the peptide, at the N-terminal end or at the C-terminal end of the parent peptide, or any combination thereof.
- derivative is used in the present text to designate a peptide in which one or more of the amino acid residues of the parent peptide have been chemically modified, e.g. by alkylation, acylation, ester formation or amide formation.
- a GLP-1 derivative is used in the present text to designate a derivative of GLP-1 or an analogue thereof.
- the parent peptide from which such a deriva- tive is formally derived is in some places referred to as the "GLP-1 moiety" of the derivative.
- WO 98/08871 Novo Nordisk A/S.
- the route of administration may be any route, which effectively transports the active compound to the appropriate or desired site of action, such as oral, nasal, pulmonary, trans- dermal or parenteral.
- compositions (or medicaments) containing a GLP-1 agonist may be administered parenterally to patients in need of such a treatment.
- Parenteral administration may be performed by subcutaneous, intramuscular or intravenous injection by means of a syringe, optionally a pen-like syringe.
- parenteral administration can be performed by means of an infusion pump.
- a further option is a composition which may be a powder or a liquid for the administration of the GLP-1 agonist in the form of a nasal or pulmonal spray.
- the GLP-1 agonist can also be administered transdermally, e.g. from a patch, optionally a iontophoretic patch, or transmucosally, e.g.
- the GLP-1 agonist in particular GLP-1 or an analogue thereof
- the implanted cells may be encapsulated in semi permeable membranes, e.g. macro- or microen- capsulated.
- compositions containing a GLP-1 agonist may be prepared by conventional techniques, e.g. as described in Remington's Pharmaceutical Sciences, 1985 or in Remington: The Science and Practice of Pharmacy, 19 th edition, 1995.
- the injectable compositions of the GLP-1 agonist can be prepared using the conventional techniques of the pharmaceutical industry which involves dissolving and mixing the ingredients as appropriate to give the desired end product.
- the GLP-1 agonist is dissolved in an amount of water which is somewhat less than the final volume of the composition to be prepared.
- An isotonic agent, a preservative and a buffer is added as required and the pH value of the solution is adjusted - if necessary - using an acid, e.g. hydrochloric acid, or a base, e.g. aqueous sodium hydroxide as needed.
- the volume of the solution is adjusted with water to give the desired concentration of the ingredients.
- isotonic agents are sodium chloride, mannitol and glycerol.
- preservatives examples include phenol, m-cresol, methyl p-hydroxybenzoate and benzyl alcohol.
- solutions containing a GLP-1 agonist may also contain a surfactant in order to improve the solubility and/or the stability of the GLP-1 agonist.
- a composition for nasal administration of certain peptides may, for example, be prepared as described in European Patent No. 272097 (to Novo Nordisk A/S) or in WO 93/18785.
- the GLP-1 agonist is provided in the form of a composition suitable for administration by injection.
- a composition can either be an injectable solution ready for use or it can be an amount of a solid composition, e.g. a lyophilised product, which has to be dissolved in a solvent before it can be injected.
- the injectable solution preferably contains not less than about 2 mg/ml, preferably not less than about 5 mg/ml, more preferred not less than about 10 mg/ml of the GLP-1 agonist and, preferably, not more than about 100 mg/ml of the GLP-1 agonist.
- the GLP-1 agonist can be used in the treatment of various diseases. The particular GLP-1 agonist to be used and the optimal dose level for any patient will depend on the disease to be treated and on a variety of factors including the efficacy of the specific peptide derivative employed, the age, body weight, physical activity, and diet of the patient, on a possible combination with other drugs, and on the severity of the case. It is recommended that the dosage of the GLP-1 agonist be determined for each individual patient by those skilled in the art.
- the male Zucker Diabetic Fatty fa/fa (ZDF) rat is a model of Type 2 diabetes.
- the rats are insulin resistant but normoglycemic from birth and they develop diabetes from about week 7 to week 10 of age.
- the animals go through a state of impaired glucose tolerance.
- the animals are hyperinsulinemic before diabetes onset and during the early stages of diabetes, they later lose glucose-stimulated insulin secretion and finally become almost completely insulinopenic.
- Bromodeoxyuridine (BrDU) is incorporated in newly synthesized DNA and thus will label replicating cells.
- the rats Six hours before sacrifice the rats were given an injection of 100 mg BrDU/kg intraperitoneally. After sacrifice the pancreata were fixed in 4% PFA, dehydrated, embedded in paraffin, and 3-4 mm sections double stained for BrDU and insulin for the measurement of beta-cell proliferation rate.
- Insulin was stained with guinea pig anti-insulin, peroxidase-coupled rabbit anti-guinea pig Ig, and developed with AEC to give a red stain.
- BrDU was stained by monoclonal mouse anti- BrDU, biotinylated goat anti-mouse Ig, avidin peroxidase, and developed with DAB and CuS0 4 to give a dark brown stain.
- BrDU stained nuclei of cells with insulin stained cytoplasm was examined in more than 1500 cells per section. The examination of the sections were carried out with the origin of the sections blinded to the observer.
- the beta-cells were stained for insulin as described above.
- the nonbeta-cells were stained with a mixture of monoclonal mouse anti-glucagon + rabbit anti-somatostatin + rabbit anti-pancreatic polypeptide, detected by biotinylated swine anti-multible Ig' s, avidin peroxi- dase, and developed with DAB and CuS0 to give a dark brown stain.
- the volume fractions of beta- and nonbeta-cells were estimated by point counting stereologic techniques.
- the beta-cell fraction of the total pancreas was significantly higher in the rats given Arg 34 , Lys 26 (N- ⁇ -( ⁇ -Glu(N- ⁇ -hexadecanoyl)))-GLP-l(7-37) at 30 ng/g for 6 weeks compared to vehicle treated rats, while there was no further increase in rats given doses of 150 ng/g (fig. 2).
- Arg 34 Lys 26 (N- ⁇ -( ⁇ -Glu(N- ⁇ -hexadecanoyl)))-GLP- 1(7-37)
- This difference strongly indicates that an inhibition of apoptosis facilitated by the administered GLP-1 compound has taken place.
- beta-cell apoptosis by GLP-1 or GLP-1 analogs, that is GLP-1 agonists, can be shown in vitro by measuring inhibition of free fatty acid (FFA), glu- cose, sulfonylurea, or cytokine induced apoptosis in beta cells.
- FFA free fatty acid
- glu- cose glu- cose
- sulfonylurea sulfonylurea
- cytokine induced apoptosis in beta cells.
- pancreatic islet e.g. rat, mouse and human, isolated and cultured as described in, e.g. Diabetologia 19, 439, 1980; Transplantation, 68, 597, 1999; J. Mol. Med., 77, 93, 1999, Diabetes 48, 1230, 1999, J. Bio. Chem. 274, 18686, 1999; Proc. Natl. Acad. Sci. 95, 2498, 1999; . J. Bio.
- islets can be isolated and cultured as described in J. Bio. Chem, 273, 33501, 1998, and incubated in O-30 mM glucose as described in. J. Bio. Chem, 273, 33501, 1998, in order to induce apoptosis.
- the islets can be co-incubated with GLP-1 or GLP-1 analogs.
- apoptosis can be induced with 100-500 microM tolbutamide as described in J. Bio. Chem, 273, 33501, 1998.
- the islets can be co-incubated with GLP-1 or GLP-1 analogs. Characterization of apoptotic beta cells can be analyzed as described below and as in . J. Bio. Chem, 273, 33501, 1998.
- In vitro assays for characterizing the effect of GLP-1 or analogs thereof on the prevention of beta-cell apoptosis induced by cytokines Briefly, human and rat islets can be isolated and cultured as described in, e.g. Diabetologia 42, 55, 1999. Cytokine induced apoptosis of rat and human beta cells can be done as describe in Diabetologia 42, 55, 1999.
- the islets can be co-incubated with GLP-1 or GLP-1 analogs. Characterization of apoptotic beta cells can be analyzed as described below and as described in Diabetologia 42, 55, 1999.
- Apoptosis and inhibition thereof can be detected in the following way:
- the free 3' OH strand breaks resulting from DNA degradation which is associated with apoptosis can be detected with the terminal deoxynucleotidyl transferase-mediated dUTP-X3' nick end-labeling (TUNEL) technique (J Cell Biol 199: 493, 1992) or using the following kits e.g. In Situ Cell Death Detection kit; Boehringer Mannheim, Mannheim or ApoTag, Oncor, Gaithersburg, MD).
- TUNEL terminal deoxynucleotidyl transferase-mediated dUTP-X3' nick end-labeling
- Apoptosis can also be detected by electrophoresis of the soluble DNA fraction isolated from cultured islets by quantifying the ladder-like appearance as described in (PNAS 95: 2498, 1998).
- apoptosis can be detected by double staining of cultured beta cells/islets with the DNA binding dyes Hoechst 33342 and propidium iodide as described in (Diabetologia 42 : 55, 1999).
- Example 2
- Neonatal rats were sacrificed and pancreata were aseptically isolated. Islets of Langerhans were isolated by standard techniques. Intact islets were cultured in 6-well tissue culture plates at 750 islets/well (Nunc, Roskilde, Denmark) with or without 40 U/ml recombinant rat inter- leukin 1, 100 U/ml interferon- ⁇ , and 100 U/ml tumor necrosis factor- ⁇ (all from Peprotech, London, UK) and the indicated doses of the GLP-1 derivative, Arg 34 , Lys 26 (N- ⁇ -( ⁇ -Glu(N- ⁇ - hexadecanoyl)))-GLP- 1(7-37).
- Figure 3 shows that 24 hours incubation with the cytokine mix induced a substantial apoptosis in the neonatal rat islets cells.
- islet cells were cultures in the presence of 100 nM of Arg 34 , Lys 26 (N- ⁇ -( ⁇ -Glu(N- ⁇ -hexadecanoyl)))-GLP-l(7-37), an approximately 50 % reduc- tion in the cytokine-induced apoptosis was observed.
- the figure also shows that Arg 34 ,
- Lys 26 (N- ⁇ -( ⁇ -Glu(N- ⁇ -hexadecanoyl)))-GLP- 1(7-37) itself had no effect on the level of islet cell apoptosis.
- Arg 34 Lys 26 (N- ⁇ -( ⁇ -Glu(N- ⁇ -hexadecanoyl)))- GLP-l(7-37), is able to block cytokine-induced apoptosis in islet cells ex vivo.
Abstract
Description
Claims
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AU12695/01A AU1269501A (en) | 1999-11-12 | 2000-11-10 | Use of glp-1 agonists for the inhibition of beta cell degeneration |
EP00974350A EP1239871A1 (en) | 1999-11-12 | 2000-11-10 | Use of glp-1 agonists for the inhibition of beta cell degeneration |
JP2001537978A JP2003516322A (en) | 1999-11-12 | 2000-11-10 | Use of a GLP-1 agonist for inhibiting beta-cell degeneration |
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WO2003084563A1 (en) * | 2002-04-04 | 2003-10-16 | Novo Nordisk A/S | Glp-1 agonist and cardiovascular complications |
WO2003105897A1 (en) | 2002-06-14 | 2003-12-24 | Novo Nordisk A/S | Combined use of a modulator of cd3 and a glp-1 compound |
WO2004074315A3 (en) * | 2003-02-19 | 2004-11-25 | Sod Conseils Rech Applic | Analogues of glp-1 |
JP2005516968A (en) * | 2001-12-29 | 2005-06-09 | ノボ ノルディスク アクティーゼルスカブ | Combination use of GLP-1 compound and late diabetic complication modulator |
EP1263458B1 (en) * | 2000-03-08 | 2005-11-16 | Novo Nordisk A/S | Lowering serum cholesterol |
US7235628B2 (en) | 1998-12-07 | 2007-06-26 | Societe De Conseils De Recherches Et D'applications Scientifiques, Sas | Analogues of GLP-1 |
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US7459432B2 (en) | 2001-09-24 | 2008-12-02 | Imperial College Innovations Ltd. | Modification of feeding behavior |
US7897566B2 (en) | 2003-12-16 | 2011-03-01 | Ipsen Pharma S.A.S. | Analogues of GLP-1 |
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AU1269501A (en) | 2001-05-30 |
JP2003516322A (en) | 2003-05-13 |
EP1239871A1 (en) | 2002-09-18 |
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