Lexicon Releases Initial Results on SGLT-1/SGLT-2 Inhibitor for Type 1 Diabetes
In May, Lexicon announced its results of LX4211, an SGLT-1/SGLT-2 inhibitor. The phase 2 trial finished its open-label, pioneer section, which showed a decrease in hypoglycemia and A1c. These positive results came from a very small group (three people were enrolled in the trial) and are mostly suggestive of potential effects; however, they allow researchers to expand the trial. Unlike many other antihyperglycemic drugs in development, Lexicon is exploring FDA approval for LX4211 for type 1 diabetes first.
LX4211 is a different sodium glucose linked transporter (SGLT) inhibitor than other drugs that are available or being developed. The drug inhibits both SGLT-1 and SGLT-2, while most other drugs only inhibit SGLT-2. SGLT-1 is located mostly in the gastrointestinal tract and SGLT-2 is mostly in the kidney. Both transporters bring glucose back to bloodstream from the GI tract and kidneys, respectively (to read more on SGLT-2 inhibitors, see our learning curve from diaTribe #51). LX4211 lowers blood sugar by preventing both of these proteins from working.
Inhibiting SGLT-1 could lower after meal blood glucose rises, similar to a GLP-1 agonist (such as Bydureon, Byetta, or Victoza). Since LX4211 can blunt the post-meal spike, there is potential for the drug to replace bolusing before meals, though the drug needs to be studied in a larger population before this becomes clear. Additionally, an SGLT-1 inhibitor could eliminate more glucose through the GI tract and less through the kidneys, which would allow patients with kidney impairment to take the drug too. We are very interested in LX4211 and will continue to follow its development – hopefully all the way to becoming available to patients. –MN