title: A Novel Allosteric Insulin Receptor-Activating Antibody Reduces Hyperglycemia without Hypoglycemia in Diabetic Cynomolgus Monkeys.
abstract: XMetA is a fully human, allosteric monoclonal antibody that binds the insulin receptor with high affinity and mimics the glucoregulatory, but not the mitogenic, actions of insulin. Here we evaluated the efficacy of both single and repeat s.c. administrations of XMetA in reducing hyperglycemia in obese cynomolgus monkeys with naturally developed type 2 diabetes, a model that shares many features of human diabetes. The data show that a single s.c. administration of XMetA at dose levels ranging from 1.5 to 10 mg/kg markedly reduced fasting hyperglycemia, with a peak effect occurring 1 to 2 days after administration, and sustained for up to 1 week. XMetA's effect on hyperglycemia was observed without elevations in serum insulin and was concomitant with reduced serum C-peptide levels, even at the lowest dose. Subchronic effects were evaluated via once weekly s.c. administration of XMetA, 10 mg/kg, for 6 weeks. XMetA treatment resulted in robust weekly decreases in fasting glucose levels averaging approximately 30% throughout the study, along with a significant absolute reduction from the vehicle control baseline of 1.2% in hemoglobin A1c, a marker of long-term glycemic status. XMetA treatment was well tolerated with no injection-site reactions, no body weight gain, and no episodes of clinical hypoglycemia. Thus, XMetA shows acute and subchronic improvements in glycemic control in spontaneously diabetic cynomolgus monkeys with a broad safety margin. This profile supports the development of XMetA as a novel glucose-lowering therapeutic agent for the management of type 2 diabetes.
authors.affiliation: Preclinical Development, XOMA Corporation, 2910 Seventh Street, Berkeley California bezwada@xoma.com.
authors.forename: Padma
authors.initials: P
authors.lastname: Bezwada
authors.affiliation: Preclinical Development, XOMA Corporation, 2910 Seventh Street, Berkeley California.
authors.forename: Jingsong
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Preclinical Development, XOMA Corporation, 2910 Seventh Street, Berkeley California.
authors.forename: Ken
authors.initials: K
authors.lastname: Der
authors.affiliation: Preclinical Development, XOMA Corporation, 2910 Seventh Street, Berkeley California.
authors.forename: Bob
authors.initials: B
authors.lastname: Shimizu
authors.affiliation: Preclinical Development, XOMA Corporation, 2910 Seventh Street, Berkeley California.
authors.forename: Liching
authors.initials: L
authors.lastname: Cao
authors.affiliation: Preclinical Development, XOMA Corporation, 2910 Seventh Street, Berkeley California.
authors.forename: Ago
authors.initials: A
authors.lastname: Ahene
authors.affiliation: Preclinical Development, XOMA Corporation, 2910 Seventh Street, Berkeley California.
authors.forename: Paul
authors.initials: P
authors.lastname: Rubin
authors.affiliation: Preclinical Development, XOMA Corporation, 2910 Seventh Street, Berkeley California.
authors.forename: Kirk
authors.initials: K
authors.lastname: Johnson
mesh_terms: D000818:Animals; D000906:Antibodies / Q000494:pharmacology / Q000627:therapeutic use; D015703:Antigens, CD / Q000378:metabolism*; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006943:Hyperglycemia / Q000097:blood* / Q000188:drug therapy; D007003:Hypoglycemia / Q000097:blood* / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D008252:Macaca fascicularis; D008297:Male; D011972:Receptor, Insulin / Q000819:agonists / Q000378:metabolism*
chemical_list: D000906:Antibodies; D015703:Antigens, CD; D001786:Blood Glucose; D007004:Hypoglycemic Agents; C435941:INSR protein, human; D011972:Receptor, Insulin