There are new diabetes medications to watch, according to Farrah Wong, PharmD, director, pipeline and drug surveillance, OptumRx. They include semaglutide, sotagliflozin, and insulin tregopil.
Semaglutide is a GLP-1 agonist in development for glycemic control in patients with type 2 diabetes. At press time, it was being developed as both subcutaneous (Novo Nordisk) and oral (Novartis) formulations. The subcutaneous formulation is under FDA review first and may be approved in December 2017. Oral semaglutide may become the first oral GLP-1 receptor agonist on the market, with the potential advantage of easier and less-invasive administration.
Sotagliflozin is a sodium-dependent glucose transporter (SGLT-1 and SLG-2) inhibitor in development for both type 1 and type 2 diabetes at press time. If approved (anticipated in the second half 2018), it would be the first oral drug approved for type 1 diabetes, a disease that typically has been managed by lifestyle modifications and insulins, according to Wong.
New insulin products may also be approved soon. Insulin tregopil is an oral insulin in phase 2 development for both type 1 and type 2 diabetes and has the potential to be the first oral insulin on the market, with anticipated approval to be in 2020. Basalog, an insulin glargine product, was in phase 3 development at press time. It is unknown whether manufacturer Mylan/Biocon will seek approval as a competing brand insulin or as a generic to Sanofi’s Lantus.
Also in the diabetes management armamentarium is Medtronic’s hybrid closed-loop system for patients with type 1 diabetes. The MiniMed 670G System, which was FDA approved in September 2016, features an advanced algorithm that automates and personalizes the delivery of basal insulin 24 hours a day to maintain glucose levels.
“The hybrid closed loop system requires minimal input, with patients only needing to enter mealtime carbohydrates, accept bolus correction recommendations, and periodically calibrate the sensor,” says Mike Hill, vice president of Global Marketing, Intensive Insulin Management, Medtronic. “With a fully automated closed loop system, Medtronic is working toward decreasing this interaction to further simplify diabetes management for patients with type 1 diabetes.”