Blood Glucose May be Improved with Repurposed Asthma Drug

Amlexanox, an inhibitor of the enzymes IKKε and TBK1 used for the treatment of asthma, was found to effectively reduce HbA1c level in patients with obesity and diabetes, according to a recent clinical trial.¹ However, only certain patients experienced the beneficial effects of the asthma drug.

Following the success of a safety trial that included 6 patients, the researchers randomly assigned 42 obese patients with type 2 diabetes and nonalcoholic fatty liver disease to receive amlexanox or placebo for 12 weeks. Insulin sensitivity, blood sugar, weight, and liver fat were measured, and a biopsy of subcutaneous fat was performed at baseline and after 12 weeks.
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Overall, one-third of participants responded to treatment with amlexanox. Patients who responded to amlexanox experienced a statistically significant reduction in HbA1c and fructosamine levels, and a subset of those who responded also had improvements in insulin sensitivity and hepatic steatosis.

Among patients who responded to amlexanox, the researchers found a distinct inflammatory gene expression signature that were consistent with higher levels of inflammation within biopsied subcutaneous fat obtained at baseline, and a unique pattern of gene expression changes that were consistent with increased energy expenditure after amlexanox treatment.

“Together, these data suggest that dual-specificity inhibitors of IKKɛ and TBK1 may be effective therapies for metabolic disease in an identifiable subset of patients,” the researchers concluded.

“The most exciting part of this is that we have a new drug that has never been studied before. It’s a new mechanism for a diabetes and fatty liver drug. It’s promising, but there are a lot of questions that need to be answered still.”²

—Melissa Weiss

Reference:

1) Oral EA, Reilly SM, Gomez, AV, et al. Inhibition of IKKɛ and TBK1 improves glucose control in a subset of patients with type 2 diabetes [published online July 5, 2017]. Cell Metab. http://dx.doi.org/10.1016/j.cmet.2017.06.006

2) Galindo Y, LaFee S. Repurposed asthma drug shows blood sugar improvement among some diabetics [press release]. San Diego, CA; UC San Diego News; July 5, 2017. https://health.ucsd.edu/news/releases/Pages/2017-07-05-repurposed-asthma-drug-shows-blood-sugar-improvement-among-some-diabetics.aspx.Accessed July 6, 2017.