Enlicitide (Lipfendra – Merck), an oral proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitor, has been approved by the FDA to reduce low-density lipoprotein cholesterol (LDL-C) in adults with hypercholesterolemia, including heterozygous familial hypercholesterolemia (HeFH). It is the first oral PCSK9 inhibitor to be approved in the US; the other FDA-approved PCSK9 inhibitors (alirocumab [Praluent], evolocumab [Repatha], and lerodalcibep [Lerochol]) and the PCSK9-directed small interfering RNA inclisiran (Leqvio) are injected subcutaneously.1 Lipfendra was...
RELEASE
Insulin icodec (Awiqli – Novo Nordisk), an ultra-longacting basal human insulin analog, has been approved by the FDA for once weekly treatment of type 2 diabetes. Two once-daily, long-acting insulin analogs are available in the US: glargine U300 (Toujeo) and degludec U100 and U200 (Tresiba). Insulin icodec has been available in Canada since 2024.
INSULIN FOR TYPE 2 DIABETES — Many patients with type 2 diabetes eventually require insulin for glycemic control. When adding insulin to other glucose-lowering drugs, a basal insulin is usually the first choice (see Table 1).1,2
PHARMACOLOGY — Like other long-acting human insulin analogs, insulin icodec is synthesized using recombinant DNA technology. It forms multihexamers in subcutaneous tissue, which delays its absorption, and binds to circulating albumin, which delays its elimination (see Table …