Dulaglutide

2024年05月09日，美国旧金山和中国苏州——信达生物制药集团（香港联交所股票代码：01801），一家致力于研发、生产和销售肿瘤、自身免疫、代谢及心血管、眼科等重大疾病领域创新药物的生物制药公司，今日宣布胰高血糖素样肽-1受体（GLP-1R）/胰高血糖素受体（GCGR）双重激动剂玛仕度肽（研发代号：IBI362）在中国2型糖尿病受试者开展的III期临床研究（DREAMS-2）达到首要终点。研究结果提示玛仕度肽降糖疗效显著优于度拉糖肽，并在减重、血脂、血压、血尿酸、肝酶等代谢指标均展示出了更优越的综合获益。DREAMS-2（NCT05606913）是一项在二甲双胍单药治疗或联合其他口服药物治疗血糖控制不佳的中国2型糖尿病受试者中对比玛仕度肽和度拉糖肽的有效性和安全性的多中心、随机的III期临床研究。研究纳入731例受试者，随机接受玛仕度肽4.0 mg、玛仕度肽6.0 mg或度拉糖肽1.5 mg治疗共28周。DREAMS-2研究首要终点为糖化血红蛋白（HbA1c）相对基线的变化；研究使用非劣效设计，在达成非劣效后进一步进行优效检验。首要终点顺利达成，玛仕度肽降糖疗效强劲治疗28周后玛仕度肽4.0 mg和玛仕度肽6.0 mg HbA1c较基线改善均非劣效于度拉糖肽1.5 mg。在此基础上进一步进行优效检验，玛仕度肽4.0 mg和6.0 mg较度拉糖肽1.5 mg降糖均达成优效。关键次要终点显示玛仕度肽降糖减重双优效于度拉糖肽玛仕度肽4.0 mg和玛仕度肽6.0 mg受试者治疗28周后HbA1c较基线的变化（优效性）、体重较基线的百分比变化、HbA1c<7.0%且体重较基线下降≥5%的受试者比例、HbA1c<7.0%的受试者比例均达成统计优效性*。玛仕度肽在更多的降糖减重和心血管代谢指标（血压、血脂、血尿酸和肝酶）中均展现显著综合优势相较于度拉糖肽，玛仕度肽各项指标结果均展现出了显著优势，包括：HbA1c≤6.5%的受试者比例、空腹血糖和七点指尖血糖较基线变化、体重较基线下降≥5%和≥10%的受试者比例、体重较基线的绝对值变化以及腰围、体重指数（BMI）、收缩压（SBP）、甘油三酯（TG）、血尿酸（UA）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）等指标。安全性和耐受性良好，无额外安全性信号治疗期间，胃肠道不良反应是最常见的不良事件，性质为轻中度一过性，主要发生在前12周滴定期。未发生重度低血糖，中度及以上低血糖发生率与度拉糖肽相当，且低血糖发生率横向对比在同类GLP-1药物注册研究中为低。治疗期间未见心血管风险增加的安全性信号，且与度拉糖肽特征相同。整体安全性特征与玛仕度肽既往临床研究一致，未发现新的安全性信号。玛仕度肽是全球临床研发进度最快的GLP-1R/GCGR双激动剂，首个减重适应症已在国家药品监督管理局（NMPA）药品审评中心（CDE）审评中。DREAMS-2作为玛仕度肽降糖适应症的关键临床研究之一，在进一步证明玛仕度肽疗效和安全性的同时，将为中国血糖控制不佳的2型糖尿病研究提供高质量的循证医学证据。信达生物计划于2024年中读出另一项DREAMS-1临床III期结果，并向CDE递交玛仕度肽治疗2型糖尿病的新药上市申请。DREAMS-1和DREAMS-2详细研究数据将进一步分析并将于学术大会或学术期刊上发布。该临床研究的主要研究者，北京医院内分泌科郭立新教授表示：“我国2型糖尿病患者常合并多种慢性疾病，包括肥胖、高脂血症、冠心病、高血压等。因此2型糖尿病的管理应从血糖、血脂、血压等多方面着手。当前GLP-1类药物是内分泌研发的热点，多靶点带来的疗效增益受到了学术和临床各界的关注。DREAMS-2是国内首个和度拉糖肽头对头比较的三期临床研究，具有很高的临床意义和学术价值。该研究结果显示，玛仕度肽相对于度拉糖肽不但具有更强的血糖获益，在减重，血脂、血压、血尿酸，肝酶等多方面也带来了更多的综合获益，同时玛仕度肽也延续了良好的安全性特征。我们期待玛仕度肽糖尿病适应症早日申报上市，以惠及更多适合应用此药物的糖尿病患者，助力改善糖尿病患者临床结局。”该临床研究的主要研究者，中日友好医院内分泌科杨文英教授表示：“我国是世界上糖尿病患者最多的国家，中国成人中糖尿病患病率已高达11.9%。我和该试验的研究者们非常欣喜地看到，玛仕度肽作为新一代GLP-1R/GCGR双靶点激动剂，在中国2型糖尿病患者的关键III期研究（DREAMS-2研究）达到主要终点，展示出了相对于度拉糖肽的优效和其他多重获益，这也是全球该靶点的第一项成功的糖尿病注册研究，具有里程碑意义。我相信玛仕度肽在不久的将来，将为我国2型糖尿病患者的治疗提供新的和更好的选择。”信达生物制药集团临床开发副总裁钱镭博士表示：“我国糖尿病人群庞大，防治任务艰巨，亟需更有效、更安全、更便捷的创新药物。玛仕度肽是全球同类首创也是开发进度最快的GLP-1R/GCGR双重激动剂。玛仕度肽在DREAMS-2研究中展现出了强大的降糖疗效，优效于国际主流降糖药物度拉糖肽，并在体重、血脂、血压、血尿酸、肝酶等方面实现了更佳的代谢综合获益，总体安全性良好。我们将进一步分析研究数据，争取早日递交玛仕度肽降糖适应症的上市申请，助力中国糖尿病人群血糖达标，兼具多重代谢获益。同时，我们也期待玛仕度肽在与司美格鲁肽头对头比较的DREAMS-3研究中有更加亮眼表现。”关于糖尿病- 滑动查看更多介绍 -据国际糖尿病联盟2021年发布的全球糖尿病概览，中国糖尿病受试者人数居世界第一，预估2021年超1.4亿人，2045年超1.74亿人[1]。血糖控制不佳会导致不可逆的微血管和大血管并发症如视力下降、失明、肾功能不全、外周神经病变、心肌梗死、中风和截肢等[2]。糖尿病发病率高、隐匿性强、并发症严重，这三大特征严重威胁着人类的健康。目前针对糖尿病的治疗方案较多，新型降糖类药物的开发除有效控制血糖外，也在探索对糖尿病患者在减轻体重、降低心血管风险、保护肾脏等方面的额外获益[3]。关于玛仕度肽（IBI362）- 滑动查看更多介绍 -玛仕度肽（IBI362）是信达生物与礼来制药共同推进的一款胰高血糖素样肽-1受体（GLP-1R）/胰高血糖素受体（GCGR）双重激动剂。作为一种哺乳动物胃泌酸调节素（OXM）类似物，玛仕度肽除了通过激动GLP-1R促进胰岛素分泌、降低血糖和减轻体重外，还可通过激动GCGR增加能量消耗增强减重疗效，同时改善肝脏脂肪代谢。玛仕度肽已在多项临床研究中展现出优秀的减重和降糖疗效，以及降低腰围、血脂、血压、血尿酸、肝酶及肝脏脂肪含量，以及改善胰岛素敏感性，带来多重代谢获益。目前，玛仕度肽共有五项III期注册研究，包括GLORY-1（4 mg和6 mg玛仕度肽治疗中国超重或肥胖受试者）、GLORY-2（9 mg玛仕度肽治疗中国肥胖受试者）、DREAMS-1、DREAMS-2和DREAMS-3（玛仕度肽治疗2型糖尿病受试者）。其中，GLORY-1研究及DREAMS-2研究均已达成终点。关于信达生物- 滑动查看更多介绍 -“始于信，达于行”，开发出老百姓用得起的高质量生物药，是信达生物的使命和目标。信达生物成立于2011年，致力于开发、生产和销售肿瘤、代谢及心血管、自身免疫、眼科等重大疾病领域的创新药物。公司已有10款产品获得批准上市，同时还有3个品种在NMPA审评中，4个新药分子进入III期或关键性临床研究，另外还有19个新药品种已进入临床研究。公司与海内外药企深入合作加速药物创新，与礼来、罗氏、赛诺菲、Adimab、Incyte和MD Anderson癌症中心等国际合作方达成30多项战略合作。信达生物在不断开发创新药物、谋求自身发展的同时，始终心怀科学善念，坚守“以患者为中心”，心系患者并关注患者家庭，积极履行社会责任。信达生物希望和大家一起努力，提高中国生物制药产业的发展水平，以满足百姓用药可及性和人民对生命健康美好愿望的追求。详情请访问公司网站：www.innoventbio.com或公司领英账号Innovent Biologics。声明：信达生物不推荐未获批的药品/适应症的使用。*基于疗效估计方法。研究使用疗效和疗法策略进行统计分析，结论方面显示了高度的一致性。参考文献：[1]. Sun H, Saeedi P, Karuranga S, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045 [published correction appears in Diabetes Res Clin Pract. 2023 Oct;204:110945]. Diabetes Res Clin Pract. 2022;183:109119. doi:10.1016/j.diabres.2021.109119[2]. Gregg EW, Sattar N, Ali MK. The changing face of diabetes complications. Lancet Diabetes Endocrinol. Published online 2016. doi:10.1016/S2213-8587(16)30010-9[3]. Nauck MA, Quast DR, Wefers J, Meier JJ. GLP-1 receptor agonists in the treatment of type 2 diabetes – state-of-the-art. Mol Metab. Published online 2020. doi:10.1016/j.molmet.2020.101102前瞻性声明本新闻稿所发布的信息中可能会包含某些前瞻性表述。这些表述本质上具有相当风险和不确定性。在使用“预期”、“相信”、“预测”、“期望”、“打算”及其他类似词语进行表述时，凡与本公司有关的，目的均是要指明其属前瞻性表述。本公司并无义务不断地更新这些预测性陈述。这些前瞻性表述乃基于本公司管理层在做出表述时对未来事务的现有看法、假设、期望、估计、预测和理解。这些表述并非对未来发展的保证，会受到风险、不确性及其他因素的影响，有些乃超出本公司的控制范围，难以预计。因此，受我们的业务、竞争环境、政治、经济、法律和社会情况的未来变化及发展的影响，实际结果可能会与前瞻性表述所含资料有较大差别。

SAN FRANCISCO and SUZHOU, China, May 8, 2024 /PRNewswire/ -- Innovent Biologics, Inc. (Innovent) (HKEX: 01801), a world-class biopharmaceutical company that develops, manufactures and commercializes high-quality medicines for the treatment of oncology, autoimmune, cardiovascular and metabolic, ophthalmology and other major diseases, announces that the Phase 3 clinical trial (DREAMS-2) of mazdutide (Innovent R&D code: IBI362), a glucagon-like peptide-1 receptor (GLP-1R) and glucagon receptor (GCGR) dual agonist, in Chinese subjects with type 2 diabetes (T2D) met the primary endpoint. The study results suggested that mazdutide was superior compared with dulaglutide for glycaemic control, and mazdutide also showed multiple cardiometabolic benefits in T2D patients including weight loss, blood lipid, blood pressure, serum uric acid, liver enzymes, etc. DREAMS-2 (ClinicalTrials.gov, NCT05606913) is a multi-center, randomized Phase 3 clinical study to compare the efficacy and safety of mazdutide and dulaglutide in Chinese subjects with T2D who have inadequate glycemic control with metformin monotherapy or combination therapy of metformin with other oral drugs. The study enrolled 731 subjects to receive either mazdutide 4.0 mg, mazdutide 6.0 mg or dulaglutide 1.5 mg for 28 weeks. The primary endpoint was the change from baseline to week 28 in glycated hemoglobin (HbA1c) levels. The study used a non-inferiority design, and further superiority testing was performed after non-inferiority was achieved. The primary endpoint was successfully met, showing a robust glucose-lowering efficacy of mazdutide After 28 weeks of treatment, mazdutide 4.0 mg and mazdutide 6.0 mg showed non-inferiority to dulaglutide 1.5 mg in terms of improvement in HbA1c level from baseline. Based on these results, the superiority test was further performed, and both mazdutide 4.0 mg and 6.0 mg achieved superiority to dulaglutide 1.5 mg. The key secondary endpoints showed mazdutide's superior benefits in both glucose-lowering and weight loss Statistical superiority was achieved in the following endpoints in both mazdutide 4.0 mg and mazdutide 6.0 mg groups after 28 weeks of treatment, including the change from baseline in HbA1c (superiority), percent change from baseline in body weight, proportion of subjects with HbA1c < 7.0% and weight loss of ≥ 5%, and proportion of subjects with HbA1c < 7.0%*. Mazdutide showed comprehensive benefits beyond glucose-lowering and weight loss in multiple cardiometabolic indicators (blood pressure, blood lipids, serum uric acid, and liver enzymes) Mazdutide also showed significant advantages compared with dulaglutide in various indicators, including the proportion of subjects with HbA1c ≤ 6.5%, changes in fasting blood glucose and seven-point fingerstick blood glucose from baseline, the proportion of subjects with body weight loss of ≥ 5% and ≥ 10%, absolute change in body weight from baseline, waist circumference, body mass index (BMI), systolic blood pressure (SBP), triglyceride (TG), serum uric acid (UA), alanine aminotransferase (ALT) and aspartate aminotransferase (AST), etc. Favorable safety and tolerability profile Gastrointestinal adverse reactions were the most common adverse events, most were mild to moderate in severity , transient, and mainly occurred during the first 12-week titration period. No severe hypoglycemia occurred; the incidence of moderate or severe hypoglycemia was comparable to that of dulaglutide; and the incidence of hypoglycemia was lower in indirect comparison to reported in registrational studies of other GLP-1 drugs. No signal of increased cardiovascular risk throughout the treatment period, similar to dulaglutide. The overall safety profile was consistent with that observed in previous clinical studies of mazdutide and no new safety signals observed. Mazdutide is the first GLP-1R/GCGR dual agonist in the regulatory review status, with the first new drug application (NDA) for chronic weight management under review by the Center for Drug Evaluation (CDE) of the National Medical Products Administration (NMPA). DREAMS-2, as one of the registrational clinical studies of mazdutide, will provide high-quality evidence of mazdutide for Chinese population with T2D. Innovent plans to read out the results of another DREAMS-1 Phase 3 clinical study in mid-2024 and submit to the CDE an NDA for the treatment of T2D with mazdutide. Detailed data from the DREAMS-1 and DREAMS-2 studies will be further analyzed and published at academic congresses or in clinical journals. Professor Lixin Guo, the principal investigator of the clinical study, Department of Endocrinology in Beijing Hospital, said: "In China, T2D patients often have a variety of chronic diseases as comorbidities, such as obesity, hyperlipidemia, coronary heart disease, hypertension and so on. Therefore, the management of T2D should take into consideration the improvements in blood glucose, blood lipid, blood pressure and other aspects. In endocrine and CVM areas, GLP-1-based drugs are the hotspot of research and development for the healthcare industry as well as for clinicians, especially multi-target drugs that are potentially more efficacious and can provide more metabolic benefits. DREAMS-2 is the first Phase 3 clinical study head-to-head with dulaglutide in China, which has high clinical significance and academic value. The results of this study showed that mazdutide, compared with dulaglutide, has a stronger glycaemic lowering effect and favorable safety profile. More importantly, mazdutide provided more comprehensive benefits in weight loss, blood lipid, blood pressure, blood uric acid, liver enzymes and other aspects. I look forward to the NDA submission of mazdutide in T2D, and wish it to benefit hundreds of millions of diabetic patients in China." Professor Yang Wenying, the principal investigator of the clinical study, Department of Endocrinology in China Japan Friendship Hospital, said: "China has the largest number of T2D patients in the world, and the prevalence of T2D among adults in China has reached 11.9%. Together with other investigators of the DREAMS-2 study, I am pleased to see that mazdutide, as a new generation of GLP-1R/GCGR dual target agonist, has met the primary endpoint and demonstrated superiority in change from baseline in HbA1c and multiple metabolic benefits compared with dulaglutide. DREAMS-2 is a landmark study as it is the first successful registrational study of a GLP-1R/GCGR dual target agonist in T2D. I believe that in the near future, mazdutide will provide a new and better choice for the treatment of type 2 diabetes in China." Dr. Lei Qian, Vice President of Clinical Development of Innovent, said: "There is a huge population of diabetes in China. Innovative drugs that are more effective, safer and more convenient are urgently needed. In the DREAMS-2 study, mazdutide showed comprehensive superiority to dulaglutide, one of the most-described glucose-lowering drugs in the world. We will further analyze the study data, and strive to submit an NDA for T2D as soon as possible this year, so as to help more Chinese T2D patients to achieve target blood glucose levels and acquire metabolic benefits. At the same time, we look forward to the performance of mazdutide in the DREAMS-3 study, a head-to-head study with semaglutide." About Diabetes According to the global overview of diabetes published by the International Diabetes Federation in 2021, China ranks first in the number of patients with diabetes globally, with an estimated number of more than 140 million in 2021 and 174 million in 2045 [1]. Poor glycemic control can lead to irreversible microvascular and macrovascular complications, such as decreased visual acuity, blindness, renal dysfunction, peripheral neuropathy, myocardial infarction, stroke and amputation [2]. The high incidence of diabetes, with serious complications, are of serious threat to human health. At present, there are many therapeutic regimens for diabetes. In addition to effectively controlling blood glucose, the development of new hypoglycemic drugs has begun to include the additional benefits of weight loss, cardiovascular risk reduction and kidney protection for patients with diabetes [3]. About Mazdutide (IBI362) Innovent entered into an exclusive license agreement with Eli Lilly and Company (Lilly) for the development and potential commercialization of OXM3 (also known as mazdutide), a GLP-1R and GCGR dual agonist, in China. As a mammalian oxyntomodulin (OXM) analogue, in addition to the effects of GLP-1 receptor agonists on promoting insulin secretion, lowering blood glucose and reducing body weight, mazdutide may also increase energy expenditure and improve hepatic fat metabolism through the activation of glucagon receptor. Mazdutide has demonstrated robust weight loss and glucose-lowering effects in clinical studies, as well as multiple cardio-metabolic benefits, including reducing waist circumference, blood lipids, blood pressure, blood uric acid, liver enzymes, liver fat content and improving insulin sensitivity. Currently, a total of five Phase 3 registrational studies are underway, including GLORY-1 (4 mg and 6 mg) in Chinese overweight or obese subjects, GLORY-2 (9 mg) in Chinese obese subjects, DREAMS-1, DREAMS-2, and DREAMS-3 (mazdutide in subjects with type 2 diabetes). Among them, GLORY-1 study and DREAMS-2 study have reached the endpoints. About Innovent Innovent is a leading biopharmaceutical company founded in 2011 with the mission to provide high-quality biologics that are affordable to all. The company discovers, develops, manufactures and commercializes innovative medicines that treat some of the most intractable diseases. Its pioneering therapies treat cancer, cardiovascular and metabolic, autoimmune and eye diseases. Innovent has 10 products in the market, 3 new drug applications under the NMPA review, 5 assets in Phase III or pivotal clinical trials and 18 more molecules in early clinical stage. Innovent partners with over 30 global healthcare leaders, including Eli Lilly, Roche, Sanofi, Adimab, Incyte and MD Anderson Cancer Center. Guided by the motto, "Start with Integrity, Succeed through Action," Innovent maintains the highest standard of industry practices and works collaboratively to advance the biopharmaceutical industry so that first-rate pharmaceutical drugs can become widely accessible. For more information, visit , or follow Innovent on Facebook and LinkedIn. Statement: Innovent does not recommend the use of any unapproved drug (s)/indication (s). * Note: This is based on efficacy estimand. The study used efficacy estimand and treatment-regimen estimand for statistical analysis, and they showed a high degree of concordance in the conclusions. Forward-looking statement This news release may contain certain forward-looking statements that are, by their nature, subject to significant risks and uncertainties. The words "anticipate", "believe", "estimate", "expect", "intend" and similar expressions, as they relate to Innovent Biologics ("Innovent"), are intended to identify certain of such forward-looking statements. The Company does not intend to update these forward-looking statements regularly. These forward-looking statements are based on the existing beliefs, assumptions, expectations, estimates, projections and understandings of the management of the Company with respect to future events at the time these statements are made. These statements are not a guarantee of future developments and are subject to risks, uncertainties and other factors, some of which are beyond the Company's control and are difficult to predict. Consequently, actual results may differ materially from information contained in the forward-looking statements as a result of future changes or developments in our business, the Company's competitive environment and political, economic, legal and social conditions. The Company, the Directors and the employees of the Company assume (a) no obligation to correct or update the forward-looking statements contained in this site; and (b) no liability in the event that any of the forward-looking statements does not materialise or turn out to be incorrect. References: [1]. Sun H, Saeedi P, Karuranga S, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projects for 2045 [published correction appeals in Diabetes Res Clin Pract. 2023 Oct; 204: 110945]. Diabetes Res Clin Pract. 2022; 183: 109119. doi: 10.1016/j.diabres.2021. 109119 [2]. Gregg EW, Sattar N, Ali MK. The changing face of diabetes complications. Lancet Diabetes Endocrinol. Published online 2016. doi: 10.1016/S2213-8587 (16) 30010-9 [3]. Nauck MA, Quast DR, Wefers J, Meier JJ. GLP-1 receptor agonists in the treatment of type 2 diabetes-state-of-the-art. Mol Metab. Published online 2020. doi: 10.1016/j.molmet.2020. 101102 SOURCE Innovent Biologics