American Diabetes Association
Cotadutide_Ph2b_supplementary_only_Diab_Care_12March2021.pdf (493.85 kB)

Effects of Cotadutide on Metabolic and Hepatic Parameters in Adults with Overweight or Obesity and Type 2 Diabetes Mellitus: A 54-Week Randomized Phase 2b Study

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posted on 2021-05-20, 00:33 authored by Rajaa Nahra, Tao Wang, Kishore M. Gadde, Jan Oscarsson, Michael Stumvoll, Lutz Jermutus, Boaz Hirshberg, Philip Ambery
Objective: Cotadutide, a dual GLP-1 and glucagon receptor agonist, is under development for nonalcoholic steatohepatitis (NASH) and type 2 diabetes. The effects of cotadutide on hepatic and metabolic parameters were evaluated in participants with overweight/obesity and type 2 diabetes.

Research Design and Methods: In this phase 2b study, 834 adults with BMI ≥25kg/m2 and type 2 diabetes inadequately controlled with metformin (glycated hemoglobin A1c [HbA1c] of 7.0%─10.5% [53─91 mmol/mol]) were randomized to double-blind cotadutide 100µg (n=100), 200µg (n=256), or 300µg (n=256), placebo (n=110), or open-label liraglutide 1.8mg (n=110), all administered subcutaneously (NCT03235050). Coprimary endpoints were changes in HbA1c and body weight at week 14. The originally randomized interventions were continued to week 54. Liver damage biomarkers and liver fibrosis algorithms were assessed.

Results: Cotadutide significantly decreased HbA1c and body weight at weeks 14 and 54 versus placebo (all P<0.001). Improvements in lipid profile, aspartate aminotransferase and alanine aminotransferase levels, PRO-C3 level, fibrosis-4 index, and nonalcoholic fatty liver disease fibrosis score were observed with cotadutide 300µg versus placebo, but not with liraglutide. Weight loss with cotadutide 200µg was similar to liraglutide 1.8mg, and greater with cotadutide 300µg versus liraglutide 1.8mg. The most common adverse events with cotadutide (nausea, 35%; vomiting, 17%) decreased over time.

Conclusions: Cotadutide treatment for 54 weeks improved glycemic control and weight loss in participants with overweight/obesity and type 2 diabetes. Ad hoc analyses demonstrated improvements in hepatic parameters and support further evaluation of cotadutide in NASH.


This study was funded by AstraZeneca. The sponsor had a role in the study design; in the collection, analysis, and interpretation of data; in the development of the manuscript; and in the decision to submit the manuscript for publication. Medical writing support was provided by Oxford PharmaGenesis Inc., and was funded by AstraZeneca.