Review of pramlintide as adjunctive therapy in treatment of type 1 and type 2 diabetes - PubMed (original) (raw)

Review of pramlintide as adjunctive therapy in treatment of type 1 and type 2 diabetes

Gina Ryan et al. Drug Des Devel Ther. 2009.

Abstract

Pramlintide (Symlin), a synthetic analog of a neurohormone amylin, was approved by the US Food and Drug Administration for use along with premeal insulin in patients with type 1. In patients with type 2 diabetes, pramlintide is approved for addition to pre-meal insulin in those patients who are either only on pre-meal insulin or those receiving the combination of insulin and metformin and/or a sulfonylurea. This article reviews the pharmacology, pharmacokinetics, dosing, clinical trials, safety, contraindications, and drug interactions of pramlintide therapy. A search for published clinical trials and therapeutic reviews in the English language was done in the following databases: Iowa Drug Information Service (1966 to July 2008), MEDLINE (1966 to July 2008), and International Pharmaceutical Abstracts (1970 to July 2008). Pramlintide and amylin were used as keywords and title words. References of key articles were also reviewed to identify additional publications. Amylin is a 37 amino acid peptide neurohormone co-secreted from the beta cells of the pancreas, along with insulin, in response to meals. Amylin lowers serum glucose by decreasing glucagon release, slowing gastric emptying and decreasing food intake. Pramlintide, a synthetic analog of amylin, reduces 2-hour postprandial blood glucose between 3.4 and 5 mmol/L, reduces A1C by 0.2% to 0.7% and has no effect on fasting glucose levels. The use of pramlintide was associated with up to a 1.6 kg weight loss. Nausea was the most commonly reported adverse event. Pramlintide is an amylin analog that was FDA approved for the treatment of type 1 and type 2 diabetes. Its use results in modest reduction of A1C and the most frequent side effects are hypoglycemia and nausea.

Keywords: amylin; pramlintide; type 1 diabetes; type 2 diabetes.

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Figures

Figure 1

Figure 1

Amylin actions. The figure illustrates the three primary mechanisms by which amylin lowers serum glucose. Amylin activates receptors in the brain which sends signals via the vagus nerve to slow gastric emptying and decrease food intake. Amylin’s neuronal stimulation decreases glucagon production from the pancreas alpha cells.

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References

    1. American Diabetes Association. Economic costs of diabetes in the US in 2007. Diabetes Care. 2008;31:596–615. - PubMed
    1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2005;27:S37. - PubMed
    1. Beaumont K, Kenney MA, Young AA, et al. High affinity amylin binding sites in rat brain. Mol pharmacol. 1993;44:493–7. - PubMed
    1. Boyle J, Honeycutt A, Narayan K, et al. Projection of diabets burdent through 2050; the impact of changing demography and disease prevalence in the US. Diabetes Care. 2001;24:936–1940. - PubMed
    1. Centers for Disease Control and Prevention. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2005. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2005.

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