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Clinical proof-of-concept study with MSDC-0160, a prototype mTOT-modulating insulin sensitizer.

J R Colca¹, J T VanderLugt, W J Adams

¹Metabolic Solutions Development Company, Kalamazoo, Michigan, USA. jcolca@msdrx.com

Clinical Pharmacology and Therapeutics

|March 7, 2013

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New mTOT modulators, like MSDC-0160, effectively lower blood glucose in type 2 diabetes patients. These drugs offer similar glucose-lowering benefits to pioglitazone but with fewer side effects, such as fluid retention.

Area of Science:

Metabolic Diseases
Pharmacology
Mitochondrial Biology

Background:

Thiazolidinediones (TZDs) improve insulin sensitivity but have side effects linked to peroxisome proliferator-activated receptor-γ (PPAR-γ) activation.
The mitochondrial target of thiazolidinediones (mTOT) is a novel target for improving insulin sensitivity, potentially avoiding PPAR-γ-related adverse effects.

Purpose of the Study:

To evaluate the efficacy and safety of MSDC-0160, an mTOT modulator, in patients with type 2 diabetes.
To compare the effects of MSDC-0160 with pioglitazone (a PPAR-γ agonist) and placebo regarding glucose-lowering and side effect profiles.

Main Methods:

A phase IIb, 12-week clinical trial involving 258 patients with type 2 diabetes.
Patients received varying doses of MSDC-0160 (50, 100, or 150 mg), pioglitazone HCl (45 mg), or placebo.

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Key outcomes measured included fasting glucose, glycated hemoglobin (HbA1c), and indicators of fluid retention and adiponectin levels.

Main Results:

Both MSDC-0160 and pioglitazone significantly lowered fasting glucose levels to a similar extent.
The reduction in HbA1c with higher doses of MSDC-0160 was comparable to that of pioglitazone.
MSDC-0160 treatment resulted in 50% less fluid retention (hematocrit, red blood cells, hemoglobin) compared to pioglitazone.
A smaller increase in high-molecular-weight adiponectin was observed with MSDC-0160, suggesting less white adipose tissue expansion.

Conclusions:

MSDC-0160, an mTOT modulator, demonstrates comparable glucose-lowering efficacy to pioglitazone in type 2 diabetes.
MSDC-0160 offers a potentially improved safety profile by significantly reducing fluid retention and white adipose tissue expansion associated with PPAR-γ agonists.