Novel GLP-1R agonist beinaglutide exhibits favourable hypoglycemic effect in patients with type 2 diabetes

Beinaglutide was shown to reduce weight, blood glucose, and systolic blood pressure, and improve lipid metabolism. The fasting C-peptide levels of patients were linked to beinaglutide's hypoglycemic effect, and therefore, the researchers recommend evaluating when using or converting to beinaglutide.

Qiuhe Ji, Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, China, and colleagues aimed to compare glycemic control in Chinese patients with T2DM whose blood glucose levels were inadequately controlled with oral antidiabetic drugs after beinaglutide alone or combined with insulin glargine in a 16-week multicenter, randomized clinical trial.

The study included 68 participants with type 2 diabetes. They were randomly assigned to beinaglutide or IGlar for 8 weeks, then the two drugs when given in combination for eight weeks. The primary outcomes of the study were the change in glucose variability (as measured with a CGM system) and the proportion of individuals achieving their glycemic target from baseline to 8 and 16 weeks.

The researchers reported the following findings:

• Both the beinaglutide and IGlar groups showed increased proportions achieving their glycemic target at 8 weeks, and the combination augmented the proportion reaching the glycated haemoglobin target from 25.42% at 8 weeks to 40.68% at 16 weeks.
• The beinaglutide group showed a significant reduction in body weight, body mass index, waist circumference, and systolic blood pressure.
• Beinaglutide elevated high-density lipoprotein cholesterol by 0.08 mmol/L, and diminished low-density lipoprotein cholesterol by 0.21 mmol/L, whereas IGlar showed no effect.
• Though IGlar was more efficient in lowering fasting plasma glucose than beinaglutide at comparable efficacies (to −1.57 mmol/L), this difference was abolished in patients whose fasting C-peptide was ≥0.9 ng/mL.

"Beinaglutide reduces weight, blood glucose, and SBP, and improves lipid metabolism," the researchers wrote. "The fasting C-peptide levels of patients were related to the beinaglutide's hypoglycemic effect, and C-peptide should, therefore, be assessed when using or converting to beinaglutide.

"However, because beinaglutide is a new GLP-1RA, clinical reports on its use are relatively limited, and there is a need for more research data to verify our results," the researchers concluded.

The researchers add that authors of several guidelines recommend GLP-1RA as the first-line treatment of high risk for ASCVD, there is a need to evaluate the beta-cell function of patients to determine whether to use GLP-1RA as a hypoglycemic therapy.

Reference:

Liu, X., Yang, W., Liu, J., Huang, X., Fang, Y., Ming, J., Lai, J., Fu, J., Ji, Q., & Wang, L. The efficacy and safety of beinaglutide alone or in combination with insulin glargine in Chinese patients with type 2 diabetes mellitus who are inadequately controlled with oral antihyperglycemic therapy: A multicenter, open-label, randomized trial. Journal of Diabetes. https://doi.org/10.1111/1753-0407.13483