Cotadutide Dual glucagon-like peptide 1 receptor (GLP-1R)/glucagon receptor (GCGR) agonist Treatment of diabetes Treatment of nonalcoholic steatohepatitis Treatment of obesity

Cotadutide (MEDI-0382) is new synthetic oxyntomodulin-like peptide with balanced dual glucagon-like peptide 1 receptor (GLP-1R) and glucagon receptor (GCGR) agonist activity whose pharmacokinetics support a once-daily subcutaneous dosing. Cotadutide in early phase studies has shown clinically meaningful reductions in glycemic parameters in individuals with type 2 diabetes. The placebo-corrected decrease in body weight was up to 3.3 kg and there was a significant decrease in liver fat (39%), liver volume and diameter with cotadutide in approximately 6 weeks. This indicates that it may have the potential to be a disease-modifying therapy for nonalcoholic steatohepatitis in addition to type 2 diabetes. However, phase 111 randomized head-to-head controlled studies with larger study populations and longer duration comparing cotadutide to available GLP-1 analogues are needed to assess the additional benefit of GCGR agonism for long-term efficacy, safety and cardiovascular outcome.