Source: GlobalData
GLP-1 receptor agonists hold potential to treat opioid use disorder, says GlobalData
Posted in Pharma
A three-week Phase I study conducted at the Caron Treatment Centers in Pennsylvania, enrolling 20 participants undergoing residential treatment for opioid use disorder (OUD), assessed Novo Nordisk’s Saxenda (liraglutide), a GLP-1 receptor agonist (GLP-1RA), as a monotherapy for OUD. The study displayed its potential to rival existing treatments and showed a 40% reduction in opioid cravings among those taking Saxenda. The results have opened a realm of new treatment possibilities for OUD patients, says GlobalData, a leading data and analytics company.
Jos Opdenakker, Pharma Analyst at GlobalData, comments: “Originally developed for treating diabetes, GLP-1RAs work by stimulating insulin secretion and suppressing glucagon release, thereby helping regulate blood sugar. However, there are GLP-1 receptors in the brain’s mesolimbic system, which is inextricably linked to motivation and reward. This has piqued the interest of drug developers looking to expand the label of their products to combat the opioid crisis. Early clinical work has shown that GLP-1RAs are a promising new avenue in the treatment of OUD, as the current treatment landscape is stifled by a lack of innovation and a heavy reliance upon opioid agonist therapies.”
According to GlobalData’s Drug Database, six out of the seven agents currently in late-stage development (Phase IIb–III) are non-opioids. Despite their non-opioid mechanisms, key opinion leaders (KOLs) interviewed by GlobalData are skeptical regarding the ability of these therapeutic candidates to replace first-line treatments. Currently, there is a lack of available efficacy data for many of the pipeline agents. Therefore, despite the presence of non-opioids in the pipeline, high-efficacy non-opioid OUD treatments remain an exploitable opportunity.
Opdenakker continues: “However, KOLs have cast doubt over the use of a reduction in cravings as an outcome measure in clinical trials and have questioned how transferrable the measure is to the real world. This is because OUD is a relapsing-remitting disorder in which the natural tendency of an OUD patient is to use opioids. Furthermore, the use of addictive substances is inextricably tied to social context and environment, which are not easily replicated in a study. Thus, a reduction in cravings in a laboratory may not necessarily translate to the real world, meaning that expectations of GLP-1RAs must be managed until further data is obtained.”
In addition to OUD, according to GlobalData’s Drug Database, GLP-1RAs are also being investigated in other neurology indications, such as to treat Alzheimer’s disease and associated cognitive impairment, Parkinson’s disease, alcohol dependence, peripheral neuropathy, and intracranial hypertension. Developers have recognized the potential of GLP-1RAs, and a new class of neurological agents is developing.
Opdenakker concludes: “The entry of GLP-1RAs into an array of CNS indications is underway. As the understanding of the role of the GLP-1 receptors in the brain is developing, the treatment of OUD is the latest frontier to be tackled by this drug class. However, GLP-1RAs will have to demonstrate significantly improved efficacy in order to displace the gold standards of treatment, methadone and buprenorphine.”