Potential Therapeutic Levels of Glucagon-Like Peptide I Achieved in Humans by a Buccal Tablet

Author:

Gutniak Mark K1,Larsson Hillevi2,Heiber Sonia J3,Juneskans Olof T4,Holst Jens J5,Ahrén Bo2

Affiliation:

1. Vallingby Medical Center Stockholm

2. Department of Medicine, Lund University Malmö

3. Thera Tech, Inc. Salt Lake City, Utah

4. Karolinska Pharmacy Stockholm, Sweden

5. Department of Medical Physiology, PANUM Institute Copenhagen, Denmark

Abstract

OBJECTIVE Glucagon-like peptide I(7–36) (GLP-I) amide, an endogenous incretin, has been identified as a potential adjunct to the treatment of NIDDM and has been studied following intravenous and subcutaneous injection. A mucoadhesive buccal GLP-I tablet containing 119 nmol has been developed to provide transmucosal absorption as a possible alternative to injection treatment. RESEARCH DESIGN AND METHODS Eight healthy volunteers received a single tablet under fasting conditions in this randomized double-blind placebo-controlled study. A total GLP-I immunoreactivity was measured using COOH-terminal radioimmunoassay (RIA) (total peptide activity) and NH2-terminal RIA (active, nondegraded peptide). RESULTS The mean (± SE) peak GLP-I concentration was 117 ± 19 pmol/l and occurred 30 ± 4 min after application. The mean placebo-adjusted area under curve was 8,145 ± 873 pmol · min−1 · l−1, consistent with a relative bioavailability of 7% versus intravenous injection and 47% versus subcutaneous injection. The levels of active peptide increased in parallel with total GLP-I. Half-life of peptide activity after buccal administration was 27 and 24 min measured with COOH-terminal and NH2-terminal RIA, respectively. Placebo adjusted insulin concentrations increased to a peak of 252 ± 57 pmol/l, glucose decreased 1.4 ± 0.2 mmo/l, and glucagon decreased 17 ± 3 ng/l, consistent with the increase in plasma GLP-I concentrations. CONCLUSIONS Therapeutic plasma levels of GLP-I in humans were achieved after a single buccal tablet. No increased degradation of GLP-I was found in the buccal mucosa compared to subcutaneous tissue. This alternative treatment form may be feasible in in the future for NIDDM.

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

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