Metreleptin

Metreleptin, sold under the brand name Myalept among others, is a synthetic analog of the hormone leptin used to treat diabetes and various forms of dyslipidemia. It has been approved in Japan for metabolic disorders including lipodystrophy and in the United States as replacement therapy to treat the complications of leptin deficiency, in addition to diet, in patients with congenital generalized or acquired generalized lipodystrophy.[2] In Europe based on EMA, metreleptin should be used in addition to diet to treat lipodystrophy, where patients have loss of fatty tissue under the skin and build-up of fat elsewhere in the body such as in the liver and muscles. The medicine is used in: adults and children above the age of 2 years with generalised lipodystrophy (Berardinelli-Seip syndrome and Lawrence syndrome) and in adults and children above the age of 12 years with partial lipodystrophy (including Barraquer-Simons syndrome), when standard treatments have failed.[3]

Metreleptin
Clinical data
Trade namesMylept, Myalepta
Other namesN-Methionylleptin; r-metHuLeptin
AHFS/Drugs.comMonograph
License data
Pregnancy
category
  • US: C (Risk not ruled out) [1]
    Routes of
    administration    		Subcutaneous injection
    ATC code
    Legal status
    Legal status
    • US: ℞-only
    • In general: ℞ (Prescription only)
    Identifiers
    CAS Number
    DrugBank
    ChemSpider
    • none
    UNII
    KEGG
    ChEMBL
    Chemical and physical data
    FormulaC714H1167N19O221S6
    Molar mass16,156 g·mol−1

    Metreleptin is currently being investigated for the treatment of diabetes and/or hypertriglyceridemia, in patients with rare forms of lipodystrophy, syndromes characterized by abnormalities in adipose tissue distribution, and severe metabolic abnormalities.[4] The FDA approved Metreleptin injection for treating complications of leptin deficiency in February 2014.

    In a three-year study of metreleptin in patients with lipodystrophy organized by the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health, metreleptin treatment was associated with a significant decrease in blood glucose (A1c decreased from 9.4% at baseline to 7.0% at study end) and triglyceride concentration (from 500 mg/dl at baseline to 200 mg/dl at study end).[5]

    NHS England will commission metreleptin treatment for patients (all ages) with congenital leptin deficiency from April 1, 2019. [6]

    References
    1. "Metreleptin (Myalept) Use During Pregnancy". Drugs.com. 4 May 2020. Retrieved 28 May 2020.
    2. Chou K, Perry CM (June 2013). "Metreleptin: first global approval". Drugs. 73 (9): 989–97. doi:10.1007/s40265-013-0074-7. PMID 23740412.
    3. "Myalepta | European Medicines Agency". www.ema.europa.eu. Retrieved 2019-01-09.
    4. "Amylin Seeks FDA Approval for Metreleptin". diabetesincontrol.com. 11 April 2012.
    5. "Amylin to Present Data Showing Investigational Metreleptin Treatment Led to Long-Term Improvements in Diabetes and Lipid Control in Patients with Lipodystrophy". Press Release. Amylin Pharmaceuticals. 2011-04-15. Retrieved 2011-10-27.
    6. "NHS England » Metreleptin for congenital leptin deficiency (all ages)". www.england.nhs.uk. Retrieved 2019-01-18.
    • "Metreleptin". Drug Information Portal. U.S. National Library of Medicine.
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