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Lexicon and JDRF Team Up to Test a Type 2 Diabetes Drug for Type 1

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Twitter summary: Using a #T2D therapy for #T1D, Lexicon & JDRF partner up for phase 2 trial of SGLT-2/SGLT-1 dual inhibitor drug

On July 9, Lexicon announced a collaboration with JDRF on a phase 2 trial of the SGLT-1/SGLT-2 dual inhibitor LX4211, focusing on young adults with type 1 diabetes. LX4211 blocks both SGLT-2 and SGLT-1 transporter proteins, which are found in the kidney and gut respectively, and work to keep glucose in the body by transporting glucose into the blood. By preventing both proteins from doing their job, the oral drug will prevent excess glucose from being absorbed and cause it to leave the body through urine. SGLT inhibitors work when blood glucose is high, which means the drugs are associated with low risk of hypoglycemia and makes them particularly useful after meals. By reducing insulin needs and getting rid of excess glucose in the urine – and thus excess calories – they can also contribute to weight loss. 

The trial will enroll up to 84 people between the ages of 18 and 30 years with type 1 diabetes and a high A1c level above 9%. The trial’s main goal is to reduce A1c, although researchers will also study “time in zone” using CGM (a more patient-friendly measure, in our view) and decreased insulin needs. A previous phase 2 trial in type 1 diabetes showed promising results; compared to a placebo, LX4211 reduced A1C, caused a 12% increase in time-in-zone, had weight loss benefits (~4 lbs. lost versus ~1 lb. gained on placebo), and reduced bolus insulin use by ~26% over just 4 weeks. There are many questions for future trials, especially safety in young patients, the risk of side effects in this drug class, and guidelines for reducing insulin. We are hopeful that many current type 2 therapies may come to market for type 1 diabetes in the next few years, including Victoza (liraglutide), Jardiance (empagliflozin), Invokana (canagliflozin), and Farxiga (dapagliflozin).  –AJW/NL

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