Company announcement
No. 39 / 2024
6
Obesity
Petrelintide (long-acting amylin analog)
Second quarter 2024 update:
• Announced positive topline results from MAD Part 2
(16-week trial).
Background:
Petrelintide (formerly ZP8396) is a long-acting amylin analog
that reduces food intake by restoring leptin sensitivity and
increasing satiety, in contrast to GLP-1RAs that reduce food
intake by suppressing appetite. The molecule is designed to
improve solubility, minimize fibrillation, and allow for co-
formulation with other peptides, including GLP-1RA-based
molecules. Petrelintide holds potential as a next-generation,
best-in-class alternative to GLP-1RA-based therapies for the
treatment of overweight and obesity, targeting weight loss
comparable with GLP-1RA-based therapies but with
significantly improved tolerability.
In the second half of 2024, Zealand expects to initiate a
large, comprehensive Phase 2b trial with petrelintide in
people with overweight or obesity.
Zealand conducted a Phase 1b, randomized, multiple
ascending dose (MAD) clinical trial of petrelintide in normal
weight and overweight healthy participants
(ClinicalTrials.gov ID: NCT05613387). The MAD trial
consisted of Part 1 and Part 2. Part 1 included 20 participants
(eligible BMI 21.0–29.9) receiving six once-weekly
subcutaneous doses of petrelintide or placebo. Part 2
included 48 participants (eligible BMI 27.0–39.9) receiving 16
once-weekly doses of petrelintide or placebo using a dose
up-titration scheme. Part 1 results were presented at the
Obesity Society Annual Meeting (ObesityWeek) in October
2023. Low doses of 0.6 mg and 1.2 mg petrelintide
administered once weekly for six weeks led to 5.3% and 5.1%
mean weight loss from baseline in enrolled participants
(mean body weight of 82 kg and BMI of 25.4). In the 6-week
trial, petrelintide was judged to be well tolerated, with no
serious or severe adverse events and no withdrawals. The
most common adverse events were related to the
gastrointestinal system, such as nausea. All gastrointestinal
side effects were mild, and most occurred within two days
of the first dose. Based on the mild adverse event profile,
Zealand initiated Part 2 of the MAD trial, exploring higher
doses of petrelintide over 16 weeks using a dose up-titration
scheme, with topline results reported in June 2024.
In Part 2 of the MAD trial, 48 participants were randomized
(3:1) within three dose cohorts using dose escalation to
reach different maintenance doses, administered for twelve,
eight and six weeks, respectively. After 16 weeks, mean body
weight reductions were 4.8%, 8.6% and 8.3% for the three
petrelintide-treated groups, respectively, versus 1.7% for the
pooled placebo group. Petrelintide was well tolerated, with
no serious or severe adverse events. All gastrointestinal
adverse events were mild, except for two moderate events
(nausea and vomiting) reported in one participant who
discontinued treatment. No other participants discontinued
treatment due to AEs. No other events of vomiting occurred,
and two events of diarrhea were reported, both of which
were mild. Detailed results from Part 2 of the MAD trial will
be presented at a scientific congress in the coming months.
The Phase 1a, first-in-human, randomized, single ascending
dose (SAD) trial to assess the safety, tolerability,
pharmacokinetics, and pharmacodynamics of petrelintide in
healthy volunteers (ClinicalTrials.gov ID: NCT05096598).
Healthy participants with a mean BMI of 25.8 were
randomized (6:2) within seven dose cohorts and treated
with either subcutaneous petrelintide or placebo. After one
week, participants treated with petrelintide had reductions
in mean body weight of 2.6%, 3.6% and 4.2% from baseline
following single doses of 0.7, 1.4 and 2.4 mg petrelintide.
Body weight reductions were well-sustained during the
additional five weeks of observation without further doses of
petrelintide. Placebo-treated participants had a mean body
weight increase of 0.6% after one week that continued to
increase in most participants during the follow-up period.
The plasma half-life of petrelintide was 230 hours, or
approximately 10 days, which supports once-weekly dose
administration. Petrelintide was well tolerated in this trial,
with no serious or severe adverse events and no
withdrawals. The detailed results were presented at the ADA
83
rd
Scientific Sessions in June 2023.
Dapiglutide (long-acting GLP-1R/GLP-2R dual agonist)
Second quarter 2024 update:
• Announced topline results from investigator-led trial
DREAM.
Background:
Dapiglutide is a long-acting, dual GLP-1R/GLP-2R agonist for
the potential treatment of obesity. This is a first-in-class
peptide designed to leverage the weight loss effects of a
potent GLP-1 agonist and address co-morbidities associated
with low-grade inflammation through improved intestinal
barrier function by GLP-2.
Zealand has to date reported results from two clinical trials
with low doses of dapiglutide, including a company-
sponsored 4-week Phase 1 trial and a 12-week mechanistic
investigator-led trial named DREAM. In the second half of
2024, Zealand expects to report topline data from a
company-sponsored 13-week Phase 1b dose titration trial,
evaluating significantly higher doses of dapiglutide
compared to the prior 4-week Phase 1 trial and the
investigator-led trial DREAM.
Zealand initiated the 13-week randomized, double-blind,
placebo-controlled, dose titration trial (ClinicalTrials.gov ID:
NCT06000891) to evaluate higher doses of dapiglutide in