Title of Invention

FORMULATION FOR ORAL ADMINISTRATION FOR THE TREATMENT OF TYPE 2 DIABETES

Abstract The invention encompasses formulations that demonstrate the feasibility of oral absorption comprising GLP - 1 Compounds and specified delivery agents
Full Text METHOD FOR ADMINISTERING GLP-1 MOLECULES
FIELD OF THE INVENTION
The present invention relates to a formulation useful for the oral administration
comprising a glucagon-like peptide-1 (GLP-1) compound and a specified delivery agent.
Oral administration of the formulations can be used to treat type 2 diabetes as well as a
variety of other conditions.
BACKGROUND OF THE INVENTION
Over the past several decades, continuous strides have been made to improve the
treatment of diabetes mellitus. Approximately 90% of people with diabetes have type 2
diabetes, also known as non-insulin dependent diabetes mellitus (NDDDM). Type 2
diabetics generally still make insulin, but the insulin cannot be used effectively by the
body's cells. This is primarily because the amount of insulin produced in response to
rising blood sugar levels is not sufficient to allow cells to efficiently take up glucose and
thus, reduce blood sugar levels.
A large body of pre-clinical and clinical research data suggests that glucagon-like
peptide-1 (GLP-1) compounds show great promise as a treatment for type 2 diabetes and
other conditions. GLP-1 induces numerous biological effects such as stimulating insulin
secretion, inhibiting glucagon secretion, inhibiting gastric emptying, enhancing glucose
utilization, and inducing weight loss. Further, pre-clinical studies suggest that GLP-1
may also act to prevent the 6 cell deterioration that occurs as the disease progresses.
Perhaps the most salient characteristic of GLP-1 is its ability to stimulate insulin secretion
without the associated risk of hypoglycemia that is seen when using insulin therapy or
some types of oral therapies that act by increasing insulin expression.
However, development of a GLP-1 therapeutic has been extremely difficult. This
is primarily due to the instability of the peptide during manufacturing processes, in
solution formulations, and in vivo. The only published clinical studies employing GLP-1
compounds to treat hyperglycemia or other conditions involve formulating GLP-1
compounds such that they can be delivered by subcutaneous injection or through
continuous subcutaneous infusion or continuous intravenous administration. Many type 2

diabetics or obese patients desiring to lose weight will not be willing to undertake a
treatment regimen that may involve several injections per day. Thus, there is a need to
develop GLP-1 compound therapeutics that can be delivered by an alternative non-
invasive means such as by oral delivery.
Unfortunately, there are numerous barriers to effective oral delivery of peptides.
The high acid content and ubiquitous digestive enzymes of the digestive tract will often
degrade proteins and peptides before they reach the site of absorption. Further, many
peptides cannot effectively traverse the cells of the epithelial membrane in the small
intestine to reach the bloodstream. Finally, many drugs become insoluble at the low pH
levels encountered in the digestive tract and, thus, are not absorbed effectively.
The fact that GLP-1 compounds are relatively unstable in solution formulations,
only remain in solution under a fairly narrow set of conditions, and have a relatively short
in vivo half-life when administered as a solution formulation, suggested that these
compounds could not be effectively delivered through the oral route. Thus, it was
surprising that GLP-1 compounds could be formulated such that biologically active
molecules were absorbed into the blood stream after oral administration.
The present invention involves the use of specific delivery agent molecules that
interact with GLP-1 compounds in a non-covalent fashion to allow the compounds to
cross gut membranes and yet remain therapeutically active. Although the delivery agents
employed in the present invention have been disclosed in a series of U.S. Patents (see
U.S. Patent Nos. 5,541,155; 5,693,338; 5,976,569; 5,643,957; 5,955,503; 6,100,298;
5,650,386; 5,866,536; 5,965,121; 5,989,539; 6,001,347; 6,071,510; 5,820,881; and
6,242,495; see also WO 02/02509; WO 01/51454; WO 01/44199; WO 01/32130;
WO 00/59863; WO 00/50386; WO 00/47188; and WO 00/40203), oral administration of
formulations comprising GLP-1 compounds with these delivery agents has not been
disclosed or suggested. Further, numerous parameters impact whether a particular class
of compounds can be effectively delivered in combination with one or more classes of
delivery agents. For example, the conformation of the peptide, the surface charges on the
molecule under certain formulation conditions, the solubility profile, the stability as a
formulated component, as well as susceptibility to protease digestion and in vivo stability
all influence the ability to deliver a compound orally.

SUMMARY OF THE INVENTION
The present invention encompasses the development of novel formulations
comprising GLP-1 compounds and delivery agents that can be administered orally. The
present invention provides a formulation which can be administered orally comprising a
GLP-1 compound and a specified delivery agent. The GLP-1 compound can be native
GLP-1; GLP-1 fragments; GLP-1 analogs; GLP-1 derivatives of native, fragments, or
analogs of GLP-1; and Exendin-3 and Exendin-4. The delivery agent is selected from
delivery agents described in U.S. Patents 5,541,155; 5,693,338; 5,976,569; 5,643,957;
5,955,503; 6,100,298; 5,650,386; 5,866,536; 5,965,121; 5,989,539, 6,001,347;
6,071,510; 5,820,881; and 6,242,495; and WO 02/02509; WO 01/51454;
WO 01/44199; WO 01/32130; WO 00/59863; WO 00/50386; WO 00/47188; and
WO 00/40203.
Preferred GLP-1 compounds are analogs or derivatives of analogs having
modifications at one or more of the following positions: 8,12,16, 18, 19, 20,22,25,27,
30, 33, and 37 and show increased potency compared with Val8-GLP-l(7-37)OH.
Preferred GLP-1 compounds are also described in SEQ ID NO:l, SEQ ID NO:2, SEQ ID
NO:3, SEQ ID NO:4, SEQ ID NO:5, SEQ ID NO:6, SEQ ID NO:7, SEQ ID NO:8, SEQ
ID NO:9, SEQ ID NO:10, SEQ ID NO:l 1, SEQ ID NO:12, SEQ ED NO:13, or SEQ ID
NO:14. More preferred GLP-1 compounds are described in compounds of SEQ ID NO:2,
SEQ ID NO:12, SEQ ID NO:13, and SEQ ID NO:14.
Preferred delivery agents are described in Table 1. More preferred delivery agents
are delivery agents corresponding to numbers of Table 1 selected from the group
consisting of 1, 2,4, 5, 6, 9, 10, 11, 13, 14, 15, 20, 21, 22, 23, 24, 26, 28, 30, 31, 35, 36,
38,39,40,41,42,43,44,46, 51, 52, and 54.
The present invention also encompasses a method of stimulating the GLP-1
receptor in a subject in need of such stimulation, said method comprising the step of
administering to the subject an effective amount of the oral formulation described herein.
Subjects in need of GLP-1 receptor stimulation include those with non-insulin dependent
diabetes and obesity.

DETAILED DESCRIPTION OF THE INVENTION
The three-letter abbreviation code for amino acids used in this specification
conforms with the list contained in Table 3 of Annex C, Appendix 2 of the PCT
Administrative Instructions and with 37 C.F.R. § 1.822(d)(l)(2000).
For purposes of the present invention as disclosed and described herein, the
following terms and abbreviations are defined as follows.
The term "formulation" as used herein refers to a GLP-1 compound and a
specified delivery agent combined together which can be administered orally such that
GLP-1 compound passes through the gut into the systemic circulation and has the ability
to bind to the GLP-1 receptor and initiate a signal transduction pathway resulting in
insulinotropic activity. The formulation can optionally comprise other agents so long as
the GLP-1 retains the ability to bind the GLP-1 receptor.
The term "oral" as used herein refers to delivery of a compound by mouth such
that the compound passes through the stomach, small intestine, or large intestine into the
systemic circulation.
The term "GLP-1 compound" as used herein refers to polypeptides that include
naturally occurring GLP-1 polypeptides (GLP-1 (7-3 7)OH and GLP-1 (7-3 6)NH2), GLP-1
fragments, GLP-1 analogs, GLP-1 derivatives of naturally occurring GLP-1 polypeptides,
GLP-1 fragments, or GLP-1 analogs, and Exendin-3 and Exendin-4 that have the ability
to bind to the GLP-1 receptor and initiate a signal transduction pathway resulting in
insulinotropic activity.
The term "insulinotropic activity" refers to the ability to stimulate insulin secretion
in response to elevated glucose levels, thereby causing glucose uptake by cells and
decreased plasma glucose levels. For example, insulinotropic activity can be determined
using the method described in Example 1. A GLP-1 molecule has insulinotropic activity
if islet cells secrete insulin levels in the presence of the GLP-1 molecule above
background levels.
The term "DPP IV resistant" refers to GLP-1 molecules that have extended
metabolic stability and improved biological activity. For example, DPP IV resistance can
be determined using the method described in Example 2. A GLP-1 molecule is DPP IV
resistant if in the presence of DPP IV the GLP-1 molecule has extended metabolic

stability above that of native GLP-1. DPP IV resistant GLP-1 molecules can have an
amino acid change at the DPP IV recognition site (position 8), or DPP IV resistant
peptides can have an attached group that restricts the accessibility of the DPP IV to the
recognition site, or both.
A "GLP-1 fragment" is a polypeptide obtained after truncation of one or more
amino acids from the TV-terminus and/or C-terminus of GLP-1 (7-3 7)OH or an analog or
derivative thereof. The nomenclature used to describe GLP-1 (7-37)OH is also applicable
to GLP-1 fragments. For example, GLP-l(9-36)OH denotes a GLP-1 fragment obtained
by truncating two amino acids from the TV-terminus and one amino acid from the C-
terminus. The amino acids in the fragment are denoted by the same number as the
corresponding.amino acid in GLP-1 (7-37)OH. For example, the N-terminal glutamic acid
in GLP-1 (9-36)OH is at position 9; position 12 is occupied by phenylalanine; and position
22 is occupied by glycine, as in GLP-1 (7-3 7)OH. For GLP-1 (7-36)OH, the glycine at
position 37 of GLP-1 (7-37)OH is deleted.
A "GLP-1 analog" has sufficient homology to GLP-1 (7-37)OH or a fragment of
GLP-1 (7-3 7)OH such that the analog has insulinotropic activity. Preferably, a GLP-1
analog has the amino acid sequence of GLP-1 (7-37)OH or a fragment thereof, modified
so that from one, two, three, four or five amino acids differ from the amino acid in
corresponding position of GLP-1 (7-37)OH or a fragment of GLP-l(7-37)OH. In the
nomenclature used herein to designate GLP-1 compounds, the substituting amino acid and
its position is indicated prior to the parent structure. For example, Glu22-GLP-l(7-37)OH
designates a GLP-1 compound in which the glycine normally found at position 22 of
GLP-1 (7-37)OH has been replaced with glutamic acid; Val8-Glu22-GLP-l(7-37)OH
designates a GLP-1 compound in which alanine normally found at position 8 and glycine
normally found at position 22 of GLP-1 (7-37)OH have been replaced with valine and
glutamic acid, respectively.
GLP-1 molecules also include polypeptides in which one or more amino acids
have been added to the N-terminus and/or C-terminus of GLP-1 (7-37)OH, or fragments or
analogs thereof. It is preferred that GLP-1 molecules of this type have up to about thirty-
nine amino acids. The amino acids in the "extended" GLP-1 molecule are denoted by the
same number as the corresponding amino acid in GLP-1 (7-37)OH. For example, for a

GLP-1 molecule obtained by adding two amino acids to the TV-terminus of
GLP-1 (7-3 7)OH, the N-terminal amino acid is located at position 5; and for a GLP-1
molecule obtained by adding one amino acid to the C-terminus of GLP-1 (7-37)OH, the C-
terminal amino acid is located at position 38. Thus, position 12 is occupied by
phenylalanine and position 22 is occupied by glycine in both of these "extended" GLP-1
compounds, as in GLP-1 (7-37)OH. Amino acids 1-6 of an extended GLP-1 molecule are
preferably the same as or a conservative substitution of the amino acid at the
corresponding position of GLP-l(l-37)OH. Amino acids 38-45 of an extended GLP-1
molecule are preferably the same as or a conservative substitution of the amino acid at the
corresponding position of glucagon or Exendin-4.
A "GLP-1 derivative" refers to a molecule having the amino acid sequence of
GLP-1, a GLP-1 fragment, or a GLP-1 analog, but additionally having chemical
modification of one or more of its amino acid side groups, a-carbon atoms, terminal
amino group, or terminal carboxylic acid group. A chemical modification includes, but is
not limited to, adding chemical moieties, creating new bonds, and removing chemical
moieties. Modifications at amino acid side groups include, without limitation, acylation
of lysine e-amino groups, N-alkylation of arginine, histidine, or lysine, alkylation of
glutamic or aspartic carboxylic acid groups, and deamidation of glutamine or asparagine.
Modifications of the terminal amino group include, without limitation, the des-amino,
N-lower alkyl, N-di-lower alkyl, and N-acyl modifications. Modifications of the terminal
carboxy group include, without limitation, the amide, lower alkyl amide, dialkyl amide,
and lower alkyl ester modifications. Lower alkyl is C1-C4 alkyl. Furthermore, one or
more side groups, or terminal groups, may be protected by protective groups known to the
ordinarily-skilled protein chemist. The a-carbon of an amino acid may be mono- or
dimethylated.
For the purposes of the present invention, an in vitro GLP-1 receptor-signaling
assay is used to determine whether a particular extended GLP-1 peptide will exhibit
insulinotropic activity in vivo. Extended GLP-1 peptides encompassed by the present
invention have an in vitro potency that is not less than one-tenth the in vitro potency of
the DPP IV resistant GLP-1 analog known as Valδ-GLP-l(7-37)OH. More preferably, the

extended GLP-1 peptides of the present invention are as potent or more potent than
Valδ-GLP-l(7-37)OH.
"In vitro potency" as used herein is the measure of the ability of a peptide to
activate the GLP-1 receptor in a cell-based assay. In vitro potency is expressed as the
"EC50" which is the effective concentration of compound that results in 50% activity in a
single dose-response experiment. For the purposes of the present invention, in vitro
potency is determined using a fluorescence assay that employs HEK-293 Aurora CRE-
BLAM cells that stably express the human GLP-1 receptor. These HEK-293 cells have
stably integrated a DNA vector having a cAMP response element (CRE) driving
expression of the β-lactamase (BLAM) gene. The interaction of a GLP-1 agonist with the
receptor initiates a signal that results in activation of the cAMP response element and
subsequent expression of β-lactamase. The β-lactamase CCF2/AM substrate that emits
fluorescence when it is cleaved by β-lactamase (Aurora Biosciences Corp.) can then be
added to cells that have been exposed to a specific amount of GLP-1 agonist to provide a
measure of GLP-1 agonist potency. The assay is further described in Zlokarnik, et al.
(1998) Science 279:84-88 (See also Example 1). The EC50 values for the compounds
listed in example 1 were determined using the BLAM assay described above by
generating a dose response curve using dilutions ranging from 0.00003 nanomolar to 30
nanomolar. Relative in vitro potency values are established by running
Valδ-GLP-l(7-37)OH as a control and assigning the control a reference value of 1.
The term "delivery agent" refers to molecules in U.S. Patents 5,541,155;
5,693,338; 5,976,569; 5,643,957; 5,955,503; 6,100,298; 5,650,386; 5,866,536;
5,965,121; 5,989,539; 6,001,347; 6,071,510; 5,820,881; and 6,242,495; and
WO 02/02509; WO 01/51454; WO 01/44199; WO 01/32130; WO 00/59863;
WO 00/50386; WO 00/47188; and WO 00/40203. The delivery agents are generally
derived from amino acids and are useful in the oral formulations of the present invention.
The derived amino acids can also be in the form of poly amino acids, and peptides. An
amino acid is any carboxylic acid having at least one free amine group and includes
naturally occurring and synthetic amino acids. Poly amino acids are either peptides or
two or more amino acids linked by a bond formed by other groups which can be linked,
e.g., an ester, anhydride, or an anhydride linkage. Peptides are two or more amino acids

joined by a peptide bond. Peptides can vary in length from dipeptides with two amino
acids to polypeptides with several hundred amino acids. Preferred peptides include di-
peptides, tri-peptides, tetra-peptides, and penta-peptides.
Furthermore, the delivery agents of the present invention are optionally in a salt
form. Examples of salts include sodium, hydrochloric acid, sulfuric acid, phosphoric
acid, citric acid, acetic acid, sulfate, phosphate, chloride, bromide, iodide, acetate,
propionate, hydrobromic acid, sodium hydroxide, potassium hydroxide, ammonium
hydroxide, and potassium carbonate.
The various oral formulations of the present invention may optionally encompass
a pharmaceutically acceptable buffer. Examples of pharmaceutically acceptable buffers
include phosphate buffers such as dibasic sodium phosphate, TRIS, glycylglycine,
maleate, sodium acetate, sodium citrate, sodium tartrate, or an amino acid such as glycine,
histidine, lysine or arginine. Other pharmaceutically acceptable buffers are known in the
art. Preferably, the buffer is selected from the group consisting of phosphate, TRIS,
maleate, and glycine. Even more preferably the buffer is TRIS.
Preferably, the TRIS concentration is between about 1 raM and 100 mM. Even
more preferably, the concentration is between about 10 mM and about 50 mM, most
preferably the buffer is about 20 mM.
The pH of the oral formulations is adjusted to provide stability and to be
acceptable for oral administration. Preferably, the pH is adjusted to between about 7.0
and about 9.0, more preferably the pH is between about 7.4 and 8.4. Even more
preferably the pH is between about 7.8 and 8.4. Most preferably, the pH is between about
7.8 and 8.1.
The various oral formulations of the present invention may optionally encompass
a suspending agent. Some delivery agents require a suspending agent due to their
solubility characteristics. An example of a suspending agent is hydroxypropyl-
methylcellulose. Preferably, the final concentration of hydroxypropylmethylcellulose is
between about 2% and about 10% (weight/volume). Even more preferably, the
concentration is between about 2% and about 5% (w/v). Most preferably the
concentration is about 3.9% (w/v).

The oral formulations of the present invention may optionally comprise a
cosolvent. Some delivery agents require cosolvents due to their solubility characteristics.
Examples of cosolvents include ethanol, N-methylpyrrolidone, N,N-dimethylacetamide,
N,N-dimethylformamide, glycofurol, ethoxydiol, propylene glycol, polyethylene glycol
300 and polyvinylpyrrolidone. Preferably, the final concentration of the cosolvents is
between about 5% and about 30% (volume/volume). Even more preferably, the
concentration is between about 10% and about 25% (v/v). Most preferably the
concentration is about 20% (v/v).
The oral formulations of the present invention may optionally comprise a
preservative. Preservative refers to a compound that is added to the formulation to act as
an antimicrobial agent. Among preservatives known in the art as being effective and
acceptable in parenteral formulations are phenolic preservatives, alkylparabens, benzyl
alcohol, chlorobutanol, resorcinol, and other similar preservatives, and various mixtures
thereof. Examples of phenolic derivatives include cresols and phenol or a mixture of
cresols and phenol. Examples of cresols include meta-cresol, ortho-cresol, para-cresol,
chlorocresol, or mixtures thereof. Alkylparaben refers to a C1 to C4 alkylparaben, or
mixtures thereof. Examples of alkylparabens include methylparaben, ethylparaben,
propylparaben, or butylparaben. The concentrations must be sufficient to maintain
preservative effectiveness by retarding microbial growth. Preferably, the preservative is a
phenol derivative. More preferably the preservative is a cresol. Even more preferably the
preservative is meta-cresol.
A preferred concentration of a preservative in the final mixture is about
1.0 mg/mL to about 20.0 mg/mL. More preferred ranges of concentration of preservative
in the final mixture are about 2.0 mg/mL to about 8.0 mg/mL, about 2.5 mg/mL to about
4.5 mg/mL and about 2.0 mg/mL to about 4.0 mg/mL. A most preferred concentration of
preservative in the final mixture is about 3.0 mg/mL.
The oral formulations of the present invention may optionally comprise an
isotonicity agent. Isotonicity agents refer to compounds that are tolerated physiologically
and impart a suitable tonicity to the formulation to prevent the net flow of water across
cell membranes. Examples of such compounds include glycerin, salts, e.g., NaCl, and
sugars, e.g., dextrose, mannitol, and sucrose. These compounds are commonly used for

such purposes at known concentrations. One or more isotonicity agents may be added to
adjust the ionic strength or tonicity. The preferred isotonicity agent is NaCl. The
concentration of the NaCl is preferably between about 10 mM and 200 mM, more
preferred is between about 50 mM and 150 mM, and most preferred is about 100 mM.
The administration compositions may alternatively be in the form of a solid, such
as a tablet, capsule or particle, such as a powder. Solid dosage forms may be prepared by
mixing the solid form of the compound with the solid form of the active agent.
Alternatively, a solid may be obtained from a solution of compound and active agent by
methods known in the art, such as freeze drying, precipitation, crystallization ad solid
dispersion.
GLP-1 compounds appropriate for use in the present invention:
The GLP-1 compounds of the present invention can be made by a variety of
methods known in the art such as solid-phase synthetic chemistry, purification of GLP-1
molecules from natural sources, recombinant DNA technology, or a combination of these
methods. For example, methods for preparing GLP-1 peptides are described in United
States Patent Nos. 5,118,666; 5,120,712; 5,512,549; 5,977,071; and 6,191,102.
By custom in the art, the amino terminus of GLP-1 (7-3 7)OH has been assigned
number residue 7, and the carboxy-terminus has been assigned number 37. The other
amino acids in the polypeptide are numbered consecutively, as shown in SEQ ID NO:l.
For example, position 12 is phenylalanine and position 22 is glycine.
The two naturally occurring truncated GLP-1 peptides are represented in
Formula I, SEQ ID NO: 1.
His7-Ala-Glu-Gly10-Thr-Phe-Thr-Ser-Asp-Val-Ser-Ser-Tyr-Leu20-Glu-
Gly-Gln-Ala-Ala25-Lys-Glu-Phe-Ile-Ala30-Trp-Leu-Val-Lys-Gly35-
Arg-Xaa37
Formula I, SEQ ID NO: 1
wherein:
Xaa37 is Gly, or -NH2.

Preferably, a GLP-1 compound has the amino acid sequence of SEQ ID NO: 1 or is
modified so that from one, two, three, four or five amino acids differ from SEQ ID NO: 1.
A preferred group of GLP-1 compounds is composed of GLP-1 analogs of
Formula I (SEQ ID NO:2).
His-Xaa8-Xaa9-Gly-Xaa11-Phe Thr-Xaa14-Asp-Xaal6-Xaa17-Xaa18-Xaa19-
Xaa20-Xaa21-Xaa22-Xaa23-Xaa24-Xaa25-Xaa26-Xaa27-Phe-ne-Xaa30-Xaa31-
Xaa32-Xaa33-Xaa34-Xaa35-Xaa36-Xaa37-Xaa38-Xaa39-Xaa40-Xaa41-Xaa42-
Xaa43-Xaa44-Xaa45
Formula I (SEQ ID NO.2)
wherein:
Xaaδ is Ala, Gly, Ser, Thr, Leu, Ile, Val, Glu, Asp, or Lys;
Xaa9 is Glu, Asp, or Lys;
Xaa11 is Thr, Ala, Gly, Ser, Leu, Ile, Val, Glu, Asp, or Lys;
Xaa14 is Ser, Ala, Gly, Thr, Leu, De, Val, Glu, Asp, or Lys;
Xaa16 is Val, Ala, Gly, Ser, Thr, Leu, IIe, Tyr, Glu, Asp, Trp, or Lys;
Xaa17 is Ser, Ala, Gly, Thr, Leu, Ile, Val, Glu, Asp, or Lys;
Xaa18 is Ser, Ala, Gly, Thr, Leu, Ile, Val, Glu, Asp, Trp, Tyr, or Lys;
Xaa19 is Tyr, Phe, Trp, Glu, Asp, Gln, or Lys;
Xaa20 is Leu, Ala, Gly, Ser, Thr, Ile, Val, Glu, Asp, Met, Trp, Tyr, or Lys;
Xaa21 is Glu, Asp, or Lys;
Xaa22 is Gly, Ala, Ser, Thr, Leu, Ile, Val, Glu, Asp, or Lys;
Xaa23 is Gin, Asn, Arg, Glu, Asp, or Lys;
Xaa24 is Ala, Gly, Ser, Thr, Leu, Ile, Val, Arg, Glu, Asp, or Lys;
Xaa25 is Ala, Gly, Ser, Thr, Leu, Ile, Val, Glu, Asp, or Lys;
Xaa26 is Lys, Arg, Gln, Glu, Asp, or His;
Xaa27 is Leu, Glu, Asp, or Lys;
Xaa30 is Ala, Gly, Ser, Thr, Leu, De, Val, Glu, Asp, or Lys;
Xaa31 is Trp, Phe, Tyr, Glu, Asp, or Lys;

Xaa32 is Leu, Gly, Ala, Ser, Thr,Ile, Val, Glu, Asp, or Lys;
Xaa33 is Val, Gly, Ala, Ser, Thr, Leu, Ile, Glu, Asp, or Lys;
Xaa34 is Asn, Lys, Arg, Glu, Asp, or His;
Xaa35 is Gly, Ala, Ser, Thr, Leu, De, Val, Glu, Asp, or Lys;
Xaa36 is Gly, Arg, Lys, Glu, Asp, or His;
Xaa37 is Pro, Gly, Ala, Ser, Thr, Leu, Ile, Val, Glu, Asp, or Lys, or is deleted;
Xaa38 is Ser, Arg, Lys, Glu, Asp, or His, or is deleted;
Xaa39 is Ser, Arg, Lys, Glu, Asp, or His, or is deleted;
Xaa40 is Gly, Asp, Glu, or Lys, or is deleted;
Xaa41 is Ala, Phe, Trp, Tyr, Glu, Asp, or Lys, or is deleted;
Xaa42 is Ser, Pro, Lys, Glu, or Asp, or is deleted;
Xaa43 is Ser, Pro, Glu, Asp, or Lys, or is deleted;
Xaa44 is Gly, Pro, Glu, Asp, or Lys, or is deleted; and
Xaa45 is Ala, Ser, Val, Glu, Asp, or Lys, Ala-NH2, Ser-NH2, Val-NH2, Glu-NH2,
Asp-NH2, or Lys-NH2, or is deleted;
provided that when the amino acid at position 37, 38, 39, 40,41, 42, 43, or 44 is deleted,
then each amino acid downstream of that amino acid is also deleted.
It is preferred that the GLP-1 compound of formula I contain less than six amino
acids that differ from the corresponding amino acid in GLP-1 (7-37)OH or Exendin-4. It
is more preferred that less than five amino acids differ from the corresponding amino acid
in GLP-1 (7-37)OH or Exendin-4. It is even more preferred that less than four amino
acids differ from the corresponding amino acid in GLP-1 (7-37)OH or Exendin-4.
GLP-1 compounds of the present invention include derivatives of formula I such
as a C-l-6-ester, or amide, or C-l-6-alkylamide, or C-l-6-dialkylamide thereof.
WO99/43706 describes derivatives of GLP-1 compounds of formula I and is incorporated
by reference herein in its entirety. The compounds of formula I derivatized as described
in WO 99/43706 and underivatized are encompassed by the present invention.
Another preferred group of GLP-1 compounds is composed of GLP-1 analogs of
formula II (SEQ ID NO:3):

Xaa7-Xaaδ-Xaa9-Gly-Xaa11-Xaal2-Thr-Ser-Asp-Xaal6-Ser-Xaa18-
Xaa19-Leu-Glu-Gly-Xaa23-Xaa24-Ala-Xaa26-Xaa27-Phe-Ile-Xaa30-
Xaa3,-Leu-Xaa33-Xaa34-Xaa35-Xaa36-R37
Formula II (SEQ ID NO:3)
wherein:
Xaa7 is: L-histidine, D-histidine, desamino-histidine, 2-amino-histidine, B-hydxoxy-
histidine. homohistidine, α-fluoromcthyl-histidine or a-methyl-histidine:
Xaa8 is: Gly, Ala, Val, Leu, De, Ser, or Thr;
Xaa9 is: Thr, Ser, Arg, Lys, Trp, Phe, Tyr, Glu, or His;
Xaa11 is: Asp, Glu, Arg, Thr, Ala, Lys, or His;
Xaa12 is: His, Trp, Phe, or Tyr;
Xaa16 is: Leu, Ser, Thr, Trp, His, Phe, Asp, Val, Tyr, Glu, or Ala;
Xaa18 is: His, Pro, Asp, Glu, Arg, Ser, Ala, or Lys;
Xaa" is: Gly, Asp, Glu, Gln, Asn, Lys, Arg, or Cys;
Xaa23 is: His, Asp, Lys, Glu, Gln, or Arg;
Xaa24 is: Glu, Arg, Ala, or Lys;
Xaa26 is: Trp, Tyr, Phe, Asp, Lys, Glu, or His;
Xaa27 is: Ala, Glu, His, Phe, Tyr, Trp, Arg, or Lys;
Xaa30 is: Ala, Glu, Asp, Ser, or His;
Xaa31 is: Asp, Glu, Ser, Thr, Arg, Trp, or Lys;
Xaa33 is: Asp, Arg, Val, Lys, Ala, Gly, or Glu;
Xaa34 is: Glu, Lys, or Asp;
Xaa35 is: Thr, Ser, Lys, Arg, Trp, Tyr, Phe, Asp, Gly, Pro, His, or Glu;
Xaa36 is: Thr, Ser, Asp, Trp, Tyr, Phe, Arg, Glu, or His;
R37 is: Lys, Arg, Thr, Ser, Glu, Asp, Trp, Tyr, Phe, His, Gly, Gly-Pro, or is deleted.
Another preferred group of GLP-1 compounds is composed of GLP-1 analogs of
Formula m (SEQ ID NO:4):

Xaa7-Xaa8-GIu-GIy-Xaa11-Xaa12--Thr-Ser-Asp-Xaal6-Scr-Ser-Tyr-Leu-
Glu-Xaa22-Xaa23-Xaa24-Xaa25-Lys-Xaa27-Phe-ne-Xaa30-Trp-Leu-
Xaa33-Xaa34-Xaa35-Xaa36-R37
Formula III (SEQ ED NO:4)
wherein:
Xaa7 is: L-histidine, D-histidine, desamino-histidine, 2-amino-histidine, B-hydroxy-
histidine. hornohistidine, α-fluoromethvlhistidine or α-methylhistidine:
Xaa8 is: Gly, Ala, Val, Leu, lie, Ser, or Thr;
Xaa11 is: Asp, Glu, Arg, Thr, Ala, Lys, or His;
Xaa12 is: His, Trp, Phe, or Tyr;
Xaa16 is: Leu, Ser, Thr, Trp, His, Phe, Asp, Val, Glu, or Ala;
Xaa22 is: Gly, Asp, Glu, Gln, Asn, Lys, Arg, or Cys;
Xaa23 is: His, Asp, Lys, Glu, or Gln;
Xaa24 is: Glu, His, Ala, or Lys;
Xaa25 is: Asp, Lys, Glu, or His;
Xaa27 is: Ala, Glu, His, Phe, Tyr, Trp, Arg, or Lys;
Xaa30 is: Ala, Glu, Asp, Ser, or His;
Xaa33 is: Asp, Arg, Val, Lys, Ala, Gly, or Glu;
Xaa34 is: Glu, Lys, or Asp;
Xaa35 is: Thr, Ser, Lys, Arg, Trp, Tyr, Phe, Asp, Gly, Pro, His, or Glu;
Xaa36 is: Arg, Glu, or His;
R37 is: Lys, Arg, Thr, Ser, Glu, Asp, Trp, Tyr, Phe, His, Gly, Gly-Pro, or is deleted.
Another preferred group of GLP-1 compounds is composed of GLP-1 analogs of
Formula IV (SEQ ID NO:5):
Xaa7-Xaa8-Glu-Gly-Thr-Xaa12-Thr-Ser-Asp-Xaal6-Ser-Ser-Tyr-Leu-
Glu-Xaa22-Xaa23-Ala-Ala-Xaa26-Glu-Phe-Ile-Xaa30-Trp-Leu-Val-Lys-
Xaa35-Arg-R37
Formula IV (SEQ ED NO:5)

wherein:
Xaa7is: I histidine, D-histidine, desamino-histidine, 2-amino-histidine, β-hydroxy-
histidine, homohistidine, α-fluoromethyl-histidine, or α-methyl-histidinc;
Xaaδ is: Gly, Ala, Val, Leu, Ile, Ser, Met, or Thr;
Xaa12 is: His, Trp, Phe, or Tyr;
Xaa16 is: Leu, Ser, Thr, Trp, His, Phe, Asp, Val, Glu, or Ala;
Xaa22 is: Gly, Asp, Glu, Gln, Asn, Lys, Ary, or Cys;
Xaa23 is: His, Asp, Lys, Glu, or Gln;
Xaa26 is: Asp, Lys, Glu, or His;
Xaa30 is: Ala, Glu, Asp, Ser, or His;
Xaa35 is: Thr, Ser, Lys, Arg, Trp, Tyr, Phe, Asp, Gly, Pro, His, or Glu;
R37 is: Lys, Arg, Thr, Ser, Glu, Asp, Trp, Tyr, Phe, His, Gly, Gly-Pro, or is deleted.
Another preferred group of GLP-1 compounds is composed of GLP-1 analogs of
formula V (SEQ ID NO:6):
Xaa7-Xaa8-Glu-Gly-Thr-Phe-Thr-Scr-Asp-Val-Ser-Ser-Tyr-Leu-GIu-
Xaa22-Xaa23-Xaa24-Ala-Lys-Glu-Phe-De-Xaa30-Trp-Leu-Val-Lys-Gly-
Arg-R37
Formula V (SEQ ID NO:6)
wherein:
Xaa7 is: L-histidine, D-histidine, desamino-histidine, 2-amino-histidine, β-hydroxy-
histidine, homohistidine, α-fluoromethyl-histidine, or α-methyl-histidinc;
Xaa8 is: Gly, Ala, Val, Leu, De, Ser, or Thr,
Xaa22 is: Gly, Asp, Glu, Gln, Asn, Lys, Arg, or Cys;
Xaa23 is: His, Asp, Lys, Glu, or Gln;
Xaa24 is: Ala, Glu, His, Phe, Tyr, Trp, Arg, or Lys;
Xaa30 is: Ala, Glu, Asp, Ser, or His;
R37 is: Lys, Arg, Thr, Ser, Glu, Asp, Trp, Tyr, Phe, His, Gly, Gly-Pro, or is deleted.
Preferred GLP-1 compounds of formula I, II, HI, TV, and V comprise GLP-1
analogs or fragments of GLP-1 analogs wherein the analogs or fragments contain an

amino acid other than alanine at position 8 (position 8 analogs). It is preferable that these
position 8 analogs contain one or more additional changes at positions 9, 11,12, 16, 18,
22, 23, 24, 26, 27, 30, 31, 33, 34, 35, 36, and 37 compared to the corresponding amino
acid of native GLP-l(7-37)OH. It is also preferable that these analogs have 6 or fewer
changes compared to the corresponding amino acids in native GLP-l(7-37)OH or
GLP-l(7-36)OH. More preferred analogs have 5 or fewer changes compared to the
corresponding amino acids in native GLP-l(7-37)OH or GLP-l(7-36)OH or have 4 or
fewer changes compared to the corresponding amino acids in native GLP-1 (7-37)OH or
GLP-l(7-36)OH. It is even more preferable that these analogs have 3 or fewer changes
compared to the corresponding amino acids in native GLP-l(7-37)OH or
GLP-1 (7-36)OH. It is most preferable that these analogs have 2 or fewer changes
compared to the corresponding amino acids in native GLP-l(7-37)OH.
Preferred GLP-1 compounds of formula II, III, IV, and V comprise GLP-1 analogs
or fragments of GLP-1 analogs in which glycine at position 22 and preferably alanine at
position 8 have been replaced with another amino acid.
When position 22 is aspartic acid, glutamic acid, arginine or lysine, position 8 is
preferably glycine, valine, leucine, isoleucine, serine, threonine or methionine and more
preferably valine or glycine. When position 22 is a sulfonic acid such as cysteic acid,
position 8 is preferably glycine, valine, leucine, isoleucine, serine, threonine or
methionine and more preferably valine or glycine.
Other preferred GLP-1 compounds include GLP-1 analogs of formula IV (SEQ ID
NO:5) wherein the analogs have the sequence of GLP-1 (7-37)OH except that the amino
acid at position 8 is preferably glycine, valine, leucine, isoleucine, serine, threonine, or
methionine and more preferably valine or glycine and position 30 is glutamic acid,
aspartic acid, serine, or histidine and more preferably glutamic acid.
Other preferred GLP-1 compounds include GLP-1 analogs of formula IV (SEQ ID
NO:5) wherein the analogs have the sequence of GLP-1 (7-37)OH except that the amino
acid at position 8 is preferably glycine, valine, leucine, isoleucine, serine, threonine, or
methionine and more preferably valihe or glycine and position 37 is histidine, lysine,
arginine, threonine, serine, glutamic acid, aspartic acid, tryptophan, tyrosine,
phenylalanine and more preferably histidine.

Other preferred GLP-1 compounds include GLP-1 analogs of formula IV (SEQ ID
NO:5) wherein the analogs have the sequence of GLP-1 (7-37)OH, except that the amino
acid at position 8 is preferably glycine, valine, leucine, isoleucine, serine, threonine, or
methionine and more preferably valine or glycine and position 22 is glutamic acid, lysine,
aspartic acid, or arginine and more preferably glutamic acid or lysine and position 23 is
lysine, arginine, glutamic acid, aspartic acid, and histidine and more preferably lysine or
glutamic acid.
Other preferred GLP-1 compounds include GLP-1 analogs of formula V (SEQ ID
NO:6) wherein the analogs have the sequence of GLP-1 (7-37)OH except that the amino
acid at position 8 is preferably glycine, valine, leucine, isoleucine, serine, threonine, or
methionine and more preferably valine or glycine and position 22 is glutamic acid, lysine,
aspartic acid, or arginine and more preferably glutamine acid or lysine and position 27 is
alanine, lysine, arginine, tryptophan, tyrosine, phenylalanine, or histidine and more
preferably alanine.
Other preferred GLP-1 compounds include GLP-1 analogs of formula II wherein
the analogs have the sequence of GLP-1 (7-37)OH except that the amino acid at position 8
and one, two, or three amino acids selected from the group consisting of position 9,
position 11, position 12, position 16, position 18, position 22, position 23, position 24,
position 26, position 27, position 30, position 31, position 33, position 34, position 35,
position 36, and position 37, differ from the amino acid at the corresponding position of
native GLP-1 (7-37)OH.
Other preferred GLP-1 compounds of formula II include: Valδ-GLP-l(7-37)OH,
Gly8-GLP-l(7-37)OH, Glu22-GLP-l(7-37)OH, Asp22-GLP-l(7-37)OH,
Arg22-GLP-l(7-37)OH, Lys22-GLP-l(7-37)OH, Cys22-GLP-l(7-37)OH,
Val8-Glu22-GLP-1 (7-37)OH, Valδ-Asp22-GLP-1 (7-37)OH, Val8-Arg22-GLP-l(7-37)OH,
Val8-Lys22-GLP-l(7-37)OH,Val8-Cys22-GLP-l(7-37)OH,Glyδ-Glu22-GLP-l(7-37)OH,
Gly8-Asp22-GLP-l(7-37)OH,Gly8-Arg22-GLP-l(7-37)OH,Gly8-Lys22-GLP-l(7-37)OH,
Gly8-Cys22-GLP-l(7-37)OH,Glu22-GLP-l(7-36)OH,Asp22-GLP-l(7-36)OH,
Arg22-GLP-l(7-36)OH, Lys22-GLP-l(7-36)OH, Cys22-GLP-l(7-36)OH,
Val8-Glu22-GLP-1 (7-36)OH, Val8-Asp22-GLP-1 (7-36)OH, Val8-Arg22-GLP-l(7-36)OH,
Val8Lys22-GLP-1 (7-36)OH, Val8-Cys22-GLP-1 (7-36)OH, Gly8-Glu22-GLP-1 (7-36)OH,



wherein:
R1 is selected from the group consisting of L-histidine, D-histidine, desaraino-
histidine, 2-amino-histidine, β-hydroxy-histidine, homohistidine, α-fluoromethyl-
histidine, and α-methylhistidine;
X is selected from the group consisting of Ala, Gly, Val, Thr, Ile, and alpha-methyl-
Ala;
Y is selected from the group consisting of Glu, Gln, Ala, Thr, Ser, and Gly;
Z is selected from the group consisting of Glu, Gln, Ala, Thr, Ser, and Gly; and
R2 is Gly-OH.
Another preferred group of GLP-1 compounds for use in the present invention is
disclosed in WO 91/11457, and consists essentially of GLP-1 (7-34), GLP-l(7-35),
GLP-1 (7-36), or GLP-1 (7-37), or the amide form thereof, and pharmaceutically-
acceptable salts thereof, having at least one modification selected from the group
consisting of:
(a) substitution of glycine, serine, cysteine, threonine, asparagine,
glutamine, tyrosine, alanine, valine, isoleucine, leucine, methionine, phenylalanine,
arginine, or D-lysine for lysine at position 26 and/or position 34; or substitution of
glycine, serine, cysteine, threonine, asparagine, glutamine, tyrosine, alanine, valine,
isoleucine, leucine, methionine, phenylalanine, lysine, or a D-arginine for arginine at
position 36;
(b) substitution of an oxidation-resistant amino acid for tryptophan at
position 31;
(c) substitution of at least one of: tyrosine for valine at position 16; lysine
for serine at position 18; aspartic acid for glutamic acid at position 21; serine for glycine
at position 22; arginine for glutamine at position 23; arginine for alanine at position 24;
and glutamine for lysine at position 26; and
(d) substitution of at least one of: glycine, serine, or cysteine for alanine at
position 8; aspartic acid, glycine, serine, cysteine, threonine, asparagine, glutamine,
tyrosine, alanine, valine, isoleucine, leucine, methionine, or phenylalanine for glutamic
acid at position 9; serine, cysteine, threonine, asparagine, glutamine, tyrosine, alanine,

valine, isoleucine, leucine, methionine, or phenylalanine for glycine at position 10; and
glutamic acid for aspartic acid at position 15; and
(e) substitution of glycine, serine, cysteine, threonine, asparagine,
glutamine, tyrosine, alanine, valine, isoleucine, leucine, methionine, or phenylalanine, or
the D- or N-acylated or alkylated form of histidine for histidine at position 7; wherein, in
the substitutions is (a), (b), (d), and (e), the substituted amino acids can optionally be in
the D-form and the amino acids substituted at position 7 can optionally be in the N-
acylated or N-alkylated form. Because the enzyme, dipeptidyl-peptidase IV (DPP IV),
may be responsible for the observed rapid in vivo inactivation of administered GLP-1,
[See, e.g., Mentlein, R., et al., Eur. J. Biochem., 214:829-835 (1993)], GLP-1 analogs and
derivatives that are protected from the activity of DPP IV in the context of a fusion
protein are preferred, and fusion proteins wherein the GLP-1 compound is
Gly8-GLP-l(7-37)OH, Val8-GLP-l(7-37)OH, a-methyl-Ala8-GLP-l(7-37)OH, or Gly8-
Gln21-GLP-l(7-37)OH are more preferred. Another preferred group of GLP-1
compounds for use in the present invention consists of the compounds of formula VII
(SEQ ID NO:8) claimed in U.S. Patent No. 5,512,549, which is expressly incorporated
herein by reference.
R1AJa-Glu-Gly10-Thr-Phe-Thr-Ser-Asp15-Val-Ser-Ser-Tyr-Leu20-Glu-Gly-
Gln-Ala-Ala25-Xaa-Glu-Phe-nc-Ala30-Trp-Leu-Val-Lys-Gly35-Arg-R3
I
R2
Formula VII (SEQ ID NO:8)
wherein:
R1 is selected from the group consisting of 4-imidazopropionyl, 4-imidazoacetyl, or 4-
imidazo-α, α-dimethyl-acetyl;
R2 is selected from the group consisting of C6-C10 unbranched acyl, or is absent;
R3 is selected from the group consisting of Gly-OH or NH2; and
Xaa is Lys or Arg.
More preferred compounds of formula VU for use in the present invention are
those in which Xaa is Arg and R2 is C6-C10 unbranched acyl. Even more preferred

compounds of formula IV for use in the present invention are those in which Xaa is Arg,
R2 is C6-C10 unbranched acyl, and R3 is Gly-OH. Other highly preferred compounds of
formula IV for use in the present invention are those in which Xaa is Arg, is C6-C10
unbranched acyl, R3 is Gly-OH, and R1 is 4-imidazopropionyl. An especially preferred
compound of formula IV for use in the present invention is that in which Xaa is Arg, R2 is
Cδ unbranched acyl, R3 is Gly-OH, and R1 is 4-imidazopropionyl.
Other preferred GLP-1 derivatives are described in U.S. Patent No. 6,268,343 Bl.
A more preferred GLP-1 derivative is Arg34Lys26-(N-ε-(γ-Glu(N-α-hexadecanoyl)))-
GLP-l(7-37).
Preferably, the GLP-1 compounds comprise GLP-1 analogs wherein the backbone
for such analogs or fragments contains an amino acid other than alanine at position 8
(position 8 analogs). The backbone may also include L-histidine, D-histidine, or modified
forms of histidine such as desamino-histidine, 2-amino-histidine, β-hydroxy-histidine,
homohistidine, α-fluoromethyl-histidine, or α-methyl-histidine at position 7. It is
preferable that these position 8 analogs contain one or more additional changes at
positions 12,16, 18, 19, 20, 22, 25, 27, 30, 33, and 37 compared to the corresponding
amino acid of native GLP-1 (7-37)OH. It is more preferable that these position 8 analogs
contain one or more additional changes at positions 16,18, 22, 25 and 33 compared to the
corresponding amino acid of native GLP-1 (7-37)OH.
In a preferred embodiment, the GLP-1 analog is GLP-l(7-37)OH wherein the
amino acid at position 12 is selected from the group consisting of tryptophan or tyrosine.
It is more preferred that in addition to the substitution at position 12, the amino acid at
position 8 is substituted with glycine, valine, leucine, isoleucine, serine, threonine, or
methionine and more preferably valine or glycine. It is even more preferred that in
addition to the substitutions at position 12 and 8, the amino acid at position 22 is
substituted with glutamic acid.
In another preferred embodiment, the GLP-1 analog is GLP-1 (7-37)OH wherein
the amino acid at position 16 is selected from the group consisting of tryptophan,
isoleucine, leucine, phenylalanine, or tyrosine. It is more preferred that in addition to the
substitution at position 16, the amino acid at position 8 is substituted with glycine, valine,
leucine, isoleucine, serine, threonine, or methionine and more preferably valine or

glycine. It is even more preferred that in addition to the substitutions at position 16 and 8,
the amino acid at position 22 is substituted with glutamic acid. It is also preferred that in
addition to the substitutions at positions 16 and 8, the amino acid at position 30 is
substituted with glutamic acid. It is also preferred that in addition to the substitutions at
positions 16 and 8, the amino acid at position 37 is substituted with histidine.
In another preferred embodiment, the GLP-1 analog is GLP-l(7-37)OH wherein
the amino acid at position 18 is selected from the group consisting of tryptophan, tyrosine,
phenylalanine, lysine, leucine, or isoleucine, preferably tryptophan, tyrosine, and
isoleucine. It is more preferred that in addition to the substitution at position 18, the
amino acid at position 8 is substituted with glycine, valine, leucine, isoleucine, serine,
threonine, or methionine and more preferably valine or glycine. It is even more preferred
that in addition to the substitutions at position 18 and 8, the amino acid at position 22 is
substituted with glutamic acid. It is also preferred that in addition to the substitutions at
positions 18 and 8, the amino acid at position 30 is substituted with glutamic acid. It is
also preferred that in addition to the substitutions at positions 18 and 8, the amino acid at
position 37 is substituted with histidine
In another preferred embodiment, the GLP-1 analog is GLP-1 (7-37)OH wherein
the amino acid at position 19 is selected from the group consisting of tryptophan or
phenylalanine, preferably tryptophan. It is more preferred that in addition to the
substitution at position 19, the amino acid at position 8 is substituted with glycine, valine,
leucine, isoleucine, serine, threonine, or methionine and more preferably valine or
glycine. It is even more preferred mat in addition to the substitutions at position 19 and 8,
the amino acid at position 22 is substituted with glutamic acid. It is also preferred that in
addition to the substitutions at positions 19 and 8, the amino acid at position 30 is
substituted with glutamic acid. It is also preferred that in addition to the substitutions at
positions 19 and 8, the amino acid at position 37 is substituted with histidine
In another preferred embodiment, the GLP-1 analog is GLP-l(7-37)OH wherein
the amino acid at position 20 is phenylalanine, tyrosine, or tryptophan. It is more
preferred that in addition to the substitution at position 20, the amino acid at position 8 is
substituted with glycine, valine, leucine, isoleucine, serine, threonine, or methionine and
more preferably valine or glycine. It is even more preferred that in addition to the

substitutions at position 20 and 8, the amino acid at position 22 is substituted with
glutamic acid. It is also preferred that in addition to the substitutions at positions 20 and
8, the amino acid at position 30 is substituted with glutamic acid. It is also preferred that
in addition to the substitutions at positions 20 and 8, the amino acid at position 37 is
substituted with histidine
In another preferred embodiment, the GLP-1 analog is GLP-l(7-37)OH wherein
the amino acid at position 25 is selected from the group consisting of valine, isoleucine,
and leucine, preferably valine. It is more preferred that in addition to the substitution at
position 25, the amino acid at position 8 is substituted with glycine, valine, leucine,
isoleucine, serine, threonine, or methionine and more preferably valine or glycine. It is
even more preferred that in addition to the substitutions at position 25 and 8, the amino
acid at position 22 is substituted with glutamic acid. It is also preferred that in addition to
the substitutions at positions 25 and 8, the amino acid at position 30 is substituted with
glutamic acid. It is also preferred that in addition to the substitutions at positions 25 and
8, the ammo acid at position 37 is substituted with histidine.
In another preferred embodiment, the GLP-1 analog is GLP-1(7-37)OH wherein
the amino acid at position 27 is selected from the group consisting of isoleucine or
alanine. It is more preferred that in addition to the substitution at position 27, the amino
acid at position 8 is substituted with glycine, valine, leucine, isoleucine, serine, threonine,
or methionine and more preferably valine or glycine. It is even more preferred that in
addition to the substitutions at position 27 and 8, the amino acid at position 22 is
substituted with glutamic acid. It is also preferred that in addition to the substitutions at
positions 27 and 8, the amino acid at position 30 is substituted with glutamic acid. It is
also preferred that in addition to the substitutions at positions 27 and 8, the amino acid at
position 37 is substituted with histidine
In another preferred embodiment, the GLP-1 analog is GLP-1 (7-37)OH wherein
the amino acid at position 33 is isoleucine. It is more preferred that in addition to the
substitution at position 33, the amino acid at position 8 is substituted with glycine, valine,
leucine, isoleucine, serine, threonine, or methionine and more preferably valine or
glycine. It is even more preferred that in addition to the substitutions at position 33 and 8,
the amino acid at position 22 is substituted with glutamic acid. It is also preferred that in

addition to the substitutions at positions 33 and 8, the amino acid at position 30 is
substituted with glutamic acid. It is also preferred that in addition to the substitutions at
positions 33 and 8, the amino acid at position 37 is substituted with histidine.
The GLP-1 compounds have modifications at one or more of the following
positions: 8,12, 16, 18, 19,20,22, 25, 27, 30, 33, and 37. These GLP-1 compounds
show increased potency compared with GLP-1 (7-37)OH and comprise the amino acid
sequence of formula Vffl (SEQ ID NO:9)
Xaa7-Xaa8-Glu-Gly-Thr-Xaa12-Thr-Ser-Asp-Xaa16-Ser-Xaa18-Xaa19-
Xaa20-Glu-Xaa22-Gm-Ala-Xaa25-Lys-Xaa27-Phe-He-Xaa30-Trp-Leu-
Xaa33-Lys-Gly-Arg-Xaa37
Formula VIE (SEQ ID NO:9)
wherein:
Xaa7 is: L-histidine, D-histidine, desamino-histidine, 2-amino-histidine, β-hydroxy-
histidine, homohistidine, α-fluoromethyl-histidine, or α-methyl-histidine;
Xaa8 is: Ala, Gly, Val, Leu, Ile, Ser, or Thr;
Xaa12 is: Phe, Trp, or Tyr;
Xaa16 is: Val, Trp, Ile, Leu, Phe, or Tyr;
Xaa18 is: Ser, Trp, Tyr, Phe, Lys, Ile, Leu, Val;
Xaa19 is: Tyr, Trp, or Phe;
Xaa20 is: Leu, Phe, Tyr, or Trp;
Xaa22 is: Gly, Glu, Asp, or Lys;
Xaa25 is: Ala, Val, Ile, or Leu;
Xaa27 is: Glu, Ile, or Ala;
Xaa30 is: Ala or Glu;
Xaa33 is: Val or He; and
Xaa37 is: Gly, His, NH2, or is absent.
Some preferred GLP-1 compounds of formula VIE include GLP-1 (7-37)OH,
GLP-1 (7-36)NH2, Gly8-GLP-l(7-37)OH, Glyδ-GLP-1(7-36)NH2, Valδ-GLP-l(7-37)OH,
Val8-GLP-1(7-36)NH2, Leu8-GLP-l(7-37)OH, Leu8-GLP-1(7-36)NH2,
Ile8-GLP-l(7-37)OH, He8-GLP-1(7-36)NH2, Ser8-GLP-l(7-37)OH,


Some preferred GLP-1 compounds of formula VIII having multiple substitutions
include GLP-1 (7-37)OH wherein position 8 is valine or glycine, position 22 is glutamic
acid, position 16 is tyrosine, leucine or tryptophan, position 18 is tyrosine, tryptophan, or
isolcucinc, position 25 is valine and position 33 is isoleucine. Other preferred GLP-1
compounds include the following: Val8-Tyrl6-GLP-l(7-37)OH,




The GLP-1 compounds of the present invention also encompass Exendin
compounds. Exendin-3 and Exendin-4 are biologically active peptides first isolated from
Helodermatidae lizard venoms and have been shown to bind the GLP-1 receptor and
stimulate cAMP-depcndent H production in mammalian parietal cells. Exendin-3 and
Exendin-4 are both 39 amino acid peptides which are approximately 53% homologous to
GLP-1. They act as potent agonists of GLP-1 activity. Notably, an N-terminally
truncated derivative of Exendin, known as Exendin(9-39 amino acids), is an inhibitor of
Exendin-3, Exendin-4 and GLP-1.
An Exendin compound typically comprises a polypeptide having the amino acid
sequence of Exendin-3, Exendin-4, or an analog or fragment thereof. Exendin-3 and
Exendin-4 are disclosed in U.S. Patent No. 5,424,286.


GLP-1 compounds also include Exendin fragments which are polypeptides
obtained after truncation of one or more amino acids from the N-terminus and/or C-
terminus of Exendin or an Exendin analog. Furthermore, GLP-1 compounds include
Exendin polypeptides in which one or more amino acids have been added to the TV-
terminus and/or C-terminus of Exendin or fragments thereof. Exendin compounds of this
type have up to about forty-five amino acids.
GLP-1 compounds also include "Exendin analogs." An Exendin analog has
sufficient homology to Exendin-4, Exendin-3, or a fragment thereof such that the analog
has insulinotropic activity. The activity of Exendin fragments and/or analogs can be
assessed using in vitro assays such as those described in Example 1.
Preferably, an Exendin analog has the amino acid sequence of Exendin-4 or a
fragment thereof, modified so that from one, two, three, four or five amino acids differ
from the amino acid in corresponding position of Exendin-4 or the fragment of
Exendin-4. In the nomenclature used herein to designate Exendin compounds, the
substituting amino acid and its position is indicated prior to the parent structure. For
example, Val8-Exendin-4 designates an Exendin compound in which the glycine normally
found at position 8 of Exendin-4 has been replaced with valine.
Another preferred group of GLP-1 compounds is composed of GLP-l/Exendin-4
analogs of formula DC (SEQ ID NO: 12).




R37 is: Gly, Pro, Pro-Ser-Ser-Gly-Ala-Pro-Pro-Pro-Ser, or is absent.
Further Exendin-analogs that are useful for the present invention are described in
PCT patent publications WO 99/25728 (Beeley, et al.); WO 99/25727 Beeley, et ai);
WO 98/05351 (Young, et al); WO 99/40788 (Young, et al); WO 99/07404 (Beeley, et
al); and WO 99/43708 (Knudsen, et al).
Another preferred group of GLP-1 compounds has the amino acid sequence of
formula X (SEQ ID NO: 13)

Formula X (SEQ ID NO:13)
wherein:
Xaa7 is: L-histidine, D-histidine, desamino-histidine, 2-amino-histidine, β-hydroxy-
histidine, homohistidine, α-fluoromethyl-histidine, or α-methyl-histidine;



provided that if Xaa42 , Xaa43 , Xaa44 , Xaa45 , Xaa46 , or Xaa47 is absent each amino acid
downstream is absent and further provided that the GLP-1 peptide does not have the
following C-terminal amino acid extension beginning at Xaa36: Gly-Pro-Ser-Ser-Gly-Ala-
Pro-Pro-Pro-Ser-NH2.
Another preferred group of GLP-1 compounds has the amino acid sequence of
formula XI (SEQ ID NO: 14)
Xaa7-Xaa8-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Xaa16-Ser-Ser-Tyr-Lys-Glu-
Xaa22-Gln-AJa-Xaa25-Lys-Glu-Phe-Ile-Ala-Trp-Leu-Xaa33-Xaa34-Gly-
Xaa36-Xaa37-Xaa38-Xaa39-Xaa40-Xaa4I-Xaa42-Xaa43-Xaa44-Xaa45-
Xaa46-Xaa47
Formula XI (SEQ ID NO: 14)
wherein:


provided that if Xaa , Xaa , Xaa , or Xaa is absent each amino acid downstream is
absent and further provided that the GLP-1 peptide does not have the following C-
terminal amino acid extension beginning at Xaa36: Gly-Pro-Ser-Ser-Gly-Ala-Pro-Pro-Pro-
Ser-NH2.
Preferred embodiments of formula X and formula XI include GLP-1 compounds
that have valine or glycine at position 8 and glutamic acid at position 22.
Delivery agents appropriate for use in the present invention:
The delivery agents of the present invention can be made by organic chemistry
methods known in the art and as described in WO 90/36480; WO 96/30036; U.S. Pat.

No. 5,643,957; U.S. Pat. No. 6,242,495; all of which are herein incorporated by
reference.
Many of the delivery agents of the present invention can be readily prepared from
amino acids including, but not limited to, aminocaprylic acid, butyrylhydroxaminic acid,
aminophenylbutyric acid, aminophenylhexanoic acid, aminophenylpropionic acid,
aminosalicylic acid, aminophenylsuccinic acid, aminononanic acid, aminonicotinic acid,
aminovalenic acid, aminophenylacetic acid, aminocaproic acid, aminoundecanoic acid,
aminoheptanoic acid, aminohydroxybenzoic acid, and aminodecanoic acid.
For example, these delivery agents may be prepared by reacting the single acid
with the appropriate agent which reacts with free amino moiety present in the amino acids
to form amides. Protecting groups may be used to avoid unwanted side reactions as
would be known to those skilled in the art.
The delivery agents may be purified by rccrystallization or by fractionation on
solid column supports. Suitable rccrystallization solvent systems include acetonitrile,
methanol and tetrahydrofuran. Fractionation may be performed on a suitable solid
column supports such as alumina, using mcthanol/n-propanol mixtures as the mobile
phase; reverse phase column supports using trifluoroacetic acid/acetonitrile mixtures as
the mobile phase; and ion exchange chromatography using water as the mobile phase.
When anion exchange chromatography is performed, preferably a subsequent 0-500 mM
sodium chloride gradient is employed.
Useful delivery agents in the present invention are described in U.S. Patents
5,541,155; 5,693,338; 5,976,569; 5,643,957; 5,955,503; 6,100,298; 5,650,386;
5,866,536; 5,965,121; 5,989,539; 6,001,347; 6,071,510; 5,820,881; and 6,242,495; and

WO 02/02509; WO 01/51454; WO 01/44199; WO 01/32130; WO 00/59863;
WO 00/50386; WO 00/47188; and WO 00/40203; and arc all herein incorporated by
reference. A skilled artisan will also recognize that variations of the delivery agents can
be made and used in the present invention.
Examples of delivery agents are described in Table 1. Preferred delivery agents of
Table 1 are delivery agent numbers 1, 2, 4, 5, 6, 9, 10, 11, 13, 14, 15,20,21,22,23,24,
26, 28, 30, 31, 35, 36, 38, 39, 40, 41, 42, 43, 44, 46, 51, 52, and 54.














The oral formulations comprising a GLP-1 compound and a delivery agent can be
used to treat a wide variety of diseases and conditions. The GLP-1 compounds primarily
exert their biological effects by acting at a GLP-1 receptor. Subjects with diseases and/or
conditions that respond favorably to GLP-1 receptor stimulation or to the administration
of GLP-1 compounds can therefore be treated with the oral formulations of the present
invention. These subjects are said to "be in need of treatment with GLP-1 compounds" or
"in need of GLP-1 receptor stimulation". Included are subjects with non-insulin
dependent diabetes, insulin dependent diabetes, stroke (see WO 00/16797), myocardial
infarction (see WO 98/08531), obesity (see WO 98/19698), catabolic changes after
surgery (see U.S. Patent No. 6,006,753), functional dyspepsia and irritable bowel
syndrome (see WO 99/64060). Also included are subjects requiring prophylactic
treatment with a GLP-1 compound, e.g., subjects at risk for developing non-insulin
dependent diabetes (see WO 00/07617). Subjects with impaired glucose tolerance or
impaired fasting glucose, subjects whose body weight is about 25% above normal body
weight for the subject's height and body build, subjects with a partial pancreatectomy,
subjects having one or more parents with non-insulin dependent diabetes, subjects who
have had gestational diabetes and subjects who have had acute or chronic pancreatitis are
at risk for developing non-insulin dependent diabetes.

The present invention may be better understood with reference to the following
examples. These examples are intended to be representative of specific embodiments of
the invention, and are not intended as limiting the scope of the invention.
EXAMPLES
Example 1
Insulinotropic activity determination
A collagenase digest of pancreatic tissue is separated on a Ficoll gradient (27%,
23%, 20.5%, and 11% in Hank's balanced salt solution, pH 7.4). The islets arc collected
from the 20.5%/l 1% interface, washed and handpicked free of exocrine and other tissue
under a stereomicroscope. The islets are incubated overnight in RPMI 1640 medium
supplemented with 10% fetal bovine plasma and containing 11 mM glucose at 37°C and
95% air/5% CO:. The GLP-1 compound to be studied is prepared at a range of
concentrations, preferably 3 nanomolar to 30 nanomolar in RPMI medium containing
10% fetal bovine plasma and 16.7 mM glucose. About 8 to 10 isolated islets are then
transferred by pipette to a total volume of 250 μl. of the GLP-1 compound containing
medium in 96-well microtitcr dishes. The islets arc incubated in the presence of the
GLP-1 compound at 37°C, 95% air, 5% CO2 for 90 minutes. Then aliquots of islet-free
medium are collected and 100 μl thereof are assayed for the amount of insulin present by
radioimmunoassay using an Equate Insulin RIA Kit (Binax, Inc., Portland, ME).
Example 2
GLP-1 stability in the presence of DPP IV
The stability of each GLP-1 molecule can be determined by incubation of the
GLP-1 molecule in human plasma. Plasma (800 μL), obtainable from healthy human
volunteers, is incubated at 37°C with 300 pmol/L of a GLP-1 molecule for up to six
hours. This is followed by reversed phase HPLC and RIA according to Deacon, et al, in
J. Clin. Endocrinol. Metab. 80:952-957 (1995).

Example 3
Formulation of delivery agent number 15
Approximately 600 mg of delivery agent number 15 was weighed into Type I glass
vials to which 3 mL of base (0.1 N NaOH, pH 12.7) was added to achieve a final
concentration of 200 mg/mL. The pH was adjusted to 7.1 and the concentration was
estimated to be 171 mg/mL. Delivery agent number 15 was then diluted to 150 mg/mL
with Milli-Q® water.
Example 4
Formulation of delivery agent number 40
Delivery agents number 40 and 9 were insoluble at the desired concentration of
150 mg/mL when followed example 1. Further dilution with base to pH 11.5 also did not
achieve the desired concentration of 150 mg/mL. Addition of cosolvents also failed to
solubilize either delivery agent to the desired concentration of 150 mg/mL. Cosolvents
tested included ethanol, N-methylpyrrolidone, N,N-dimethylacetamide, N,N-
dimethylformamide, glycofurol, ethoxydiol, propylene glycol, polyethyleneglycol 300,
and polyvinylpyrrolidone.
However, for delivery agent number 40, 150 mg was weighed into a Type I vial, to
which 1 mL of Milli-Q® water was added, and the pH adjusted with 10 N NaOH. Using
this approach, a 150 mg/mL solution was achieved for delivery agent number 40
(pH 8.22).
Example 5
Formulation of delivery agent number 9
Due to the aqueous insolubility of delivery agent number 9, a suspension
formulation was prepared in 4% weight/volume (aqueous) of suspending agent
hydroxypropylmethylcellulose (Klucel®). Approximately 1.7 mL of suspending agent
was added to a Type I glass vial containing 300 mg of delivery agent number 9. The
preparation was cooled on ice for 3 minutes, followed by probe sonication on ice for
30 minutes using a Misonix Sonicator® Ultrasonic Processor XL (3/16th inch microtip).
Sonication resulted in a reduction of the mean particle size of delivery agent number 9

from 48 μm to 8 μm (Coulter® LS Particle Size Analyzer) at pH 7.98. The formulation
was then diluted to 150 mg/mL with the suspending agent.
Example 6
Other delivery agents:
All other delivery agents were prepared as described in examples 3 and 4 above,
except delivery agent numbers 10, 11, 12, 16, 18, 22, 25, 27, 33, and 52, which were
prepared as described in example 5 above. Delivery agents 46 and 54 were prepared in
two separate formulations: one according to either example 3 or 4 and another according
to example 5.
Example 7
Stability studies:
Stability studies were conducted for delivery agent numbers 9, 15, and 40. The
delivery agents were freshly prepared as described above respectively to achieve the
desired concentration of 150 mg/mL. The samples were divided into three 2 raL aliquots
and stored at -20°C, 4°C, and ambient for three days. HPLC assay development and
analyses were performed at the end of the storage period. The results are shown in Table
2.

Example 8
Formulation of the GLP-1 compound:
A solution of Val8-Glu22-GLP-1 was prepared by dissolving the GLP-1 compound
in distilled water to yield a concentration of 7 mg/mL. The pH was slowly raised to 10.5

with 2 N NaOH, followed by incubation at room temperature for 30 minutes. A volume
of 1 M Tris buffer, pH 8.0 was added to give a final buffer concentration 20 mM Tris, and
the pH adjusted to pH 7.8 with 1 N or 5 N HC1. The solution was then filtered through a
low protein binding 0.22 uM syringe filter (Millex GV, Millipore) and the concentration
of the GLP-1 compound was determined by UV spectroscopy. The solution was diluted to
a final concentration of 5.5 mg/mL using 20 mM Tris buffer, pH 7.8. The peptide
solution was then stored in 1 0 mL aliquots at -70°C until used.
Example9
Final formulations:
Final formulations were freshly prepared approximately 30 minutes to 1 hour prior
to in vivo dosing by combining 4.5 mL of the delivery agent with 0.5 mL of the GLP-1
compound. The final formulations were dosed by oral gavage at 2 mL/kg (1.1 mg/kg
GLP-1 compound, 300 mg/kg delivery agent) with to Male Sprague Dawley rats that were
fasted for 12 hours prior to dosing. A subcutaneous dose of the GLP-1 compound alone
was used as a control (0.011 mg/kg). The mean pharmacokinetic parameters are shown in
the following table.
Table 3. Mean Pharmacokinetic Parameters and Bioavailability for Delivery agents 9,
15, and 40.

a Bioavailability relative to subcutaneous dosing.
b NC = not calculated due below detection level
From the above data, the percent bioavailability for the oral administration of
Val8Glu22-GLP-l in a formulation with delivery agent number 15 is calculated to be
2.72%, Val8-Glu22-GLP-l in a formulation with delivery agent number 40 is calculated to

be 1.01%, and Val8-Glu22-GLP-1 in a formulation with delivery agent number 9 is
calculated to be 0.3%.
Pharmacokinetic data for all delivery agents are shown in Table 4, below.
Table 4. Tmax, Cmax, and AUC Pharmacokinetic Data for Delivery agents 1 through 56.









a Peptide used: HVEGTFTSDVSSYLEEQAAKEFIAWLVKGRG
b Peptide used: HVEGTFTSDVSSYLEEQAAKEFIAWLIKGGPSSGDPPPS
C NC not calculated due to insufficient data.
d Formulation dosed as a solution with a few undissolved/fibrous particles.
e Formulation dosed as a hazy solution.
f Formulation dosed as a solution with a few undissolved particles.
g Formulation dosed as a hazy viscous solution.
h Formulation dosed as a solution with a few translucent particles.
i Formulatipn dosed as a non-homogeneous, somewhat clumpy suspension.

WE CLAIM:
1. A formulation for oral administration for the treatment of type 2 diabetes
which comprises:
a GLP-1 compound of SEQ ID No. 1; and
as delivery agent, delivery agent No. 54 identified in Table 1 herein,
the GLP-1 compound and the delivery agent being present substantially in the
ratio of 11 : 3000 to 1 : 9
2. A formulation as claimed in claim 1 which includes one or more excipients
selected from the group consisting of a pharmaceutically acceptable buffer, a
suspending agent, a co-solvent, a preservative and an isotonicity agent.
3. A formulation as claimed in claim 2 wherein the excipient is a
pharmaceutically acceptable buffer which is present in a concentration of from
1 mM to 100 mM.
4. A formulation as claimed in claim 2 wherein the excipient is a suspending
agent which is present in a concentration of from 2% to 10 % w/v.
5. A formulation as claimed in claim 2 wherein the excipient is a co-solvent
which is present in a concentration of from 5% to 30 % v/v.
6. A formulation as claimed in claim 2 wherein the excipient is a preservative
which is present in a concentration of from 1.0 mg/mL to 20.0 mg/mL.
7. A formulation as claimed in claim 2 wherein the excipient is an isotonicity
agent which is present in a concentration of from 10 mM to 200 mM.

8. A formulation as claimed in any one of claims 1 to 7 which is in the form of
a solid such as a tablet, capsule, particle or powder.

The invention encompasses formulations that demonstrate the feasibility of oral
absorption comprising GLP - 1 Compounds and specified delivery agents

Documents:

1148-KOLNP-2004-FOR ALTERATION OF ENTRY.pdf

1148-kolnp-2004-granted-abstract.pdf

1148-kolnp-2004-granted-assignment.pdf

1148-kolnp-2004-granted-claims.pdf

1148-kolnp-2004-granted-correspondence.pdf

1148-kolnp-2004-granted-description (complete).pdf

1148-kolnp-2004-granted-examination report.pdf

1148-kolnp-2004-granted-form 1.pdf

1148-kolnp-2004-granted-form 13.pdf

1148-kolnp-2004-granted-form 18.pdf

1148-kolnp-2004-granted-form 2.pdf

1148-kolnp-2004-granted-form 3.pdf

1148-kolnp-2004-granted-form 5.pdf

1148-kolnp-2004-granted-form 6.pdf

1148-kolnp-2004-granted-gpa.pdf

1148-kolnp-2004-granted-reply to examination report.pdf

1148-kolnp-2004-granted-specification.pdf


Patent Number 230111
Indian Patent Application Number 1148/KOLNP/2004
PG Journal Number 09/2009
Publication Date 27-Feb-2009
Grant Date 25-Feb-2009
Date of Filing 10-Aug-2004
Name of Patentee EMISPHERE TECHNOLOGIES, INC.
Applicant Address 765 OLD SAW MILL RIVER ROAD, TARRYTOWN, NEW YORK
Inventors:
# Inventor's Name Inventor's Address
1 KHAN, MOHAMMED AMIN 5163 SUE DRIVE, CARMEL, INDIANA 46033
2 JONES, BRYAN EDWARD 14772 BEACON PARK DRIVE, CARMEL, INDIANA 46032
3 MCGILL, JOHN MCNEILL 2254 ARDEN PLACE, GREENWOOD, INDIANA 46143
PCT International Classification Number A01N 37/18
PCT International Application Number PCT/US2003/03111
PCT International Filing date 2003-02-07
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 60/358,184 2002-02-20 U.S.A.