Title: Solving the challenges of engineering an ultra-long acting insulin-Fc conjugate
Abstract:
Millions of people with diabetes suffer from the burden of daily subcutaneous insulin injections. Engineering a basal insulin for once weekly injection will result in fewer injections and likely improved acceptance of and compliance to the treatment, thereby improving glucose control and long-term outcomes for the patients. To improve the pharmacokinetics of insulin we developed conjugation chemistry to be able to chemically link one insulin molecule to the heterodimeric Fc. Ultra-long pharmacokinetic profile of the insulin Fc conjugates was the result of concertedly slowing insulin receptor mediated clearance by 1) introduction of amino acid substitutions that lowered the insulin receptor affinity and 2) conjugating insulin to the Fc element. Fc-conjugation leads to recycling by the neonatal Fc-receptor and increase of the molecular size both contributing to the ultra-long pharmacokinetic and pharmacodynamic profiles of the insulin-conjugates.