 |
Diabetes, a disease with unsatisfied needs
In 2005 only, 1,5 millions new cases of diabetes were diagnosed in the US of which 90-95% are Type 2 Diabetes Mellitus (T2DM), bringing the prevalence of this disease to 20,8 M in the US only. This of course is secondary to the epidemic-like increase in obesity in this country as in all developed countries. Eighty (80) % of T2DM patients die from cardio-vascular complications, as diabetes is most frequently associated with visceral obesity and dyslipidemia, which are additional risk factors for cardiovascular disease, as parts of the metabolic syndrome.
The type 2 diabetes patient has long been treated under a well defined paradigm targeting only the glycemic control. This scheme involves the use of oral hypoglycaemic agents (OHA), initially as a monotherapy, then as combination therapy with complementary mechanisms of action, until the patient becomes resistant to its oral treatments and becomes insulin-dependent. The available treatments have two major drawbacks :
- a lack of long-term efficacy, all available treatments are only symptomatic treatments, that only delay the progression of diabetes and its complications;
- most of these treatments also do not manage obesity and dyslipidaemia; on the contrary, TZDs and insulin itself increase adiposity, thus creating a vicious circle, obesity being a major determinant of insulin resistance.
In this context, the focus of the industry is to develop new therapeutic classes that will offer new mechanisms of action for the control of glycemia, that would be complementary to the existing drugs, in order to delay onset of insulin injection; and also to develop new drugs with a broad spectrum of action, including effects on obesity and on dyslipidaemia, in order to decrease the risk of cardiovascular disease, the major cause of death in these patients.
The commercial success of injectable GLP-1 agonists shows that new drugs, notably peptides, with new mechanisms of actions are constantly needed in order to:
- Improve glucose control
- Reduce associated obesity
- Manage associated dyslipidemia
|
|
