AUTHOR=Klotsman Michael , Adin Christopher A. , Anderson Wayne H. , Gilor Chen 

TITLE=Safety, Tolerability, and Proof-Of-Concept Study of OKV-119, a Novel Exenatide Long-Term Drug Delivery System, in Healthy Cats

JOURNAL=Frontiers in Veterinary Science

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2021.661546

DOI=10.3389/fvets.2021.661546

ISSN=2297-1769

ABSTRACT=<p><bold>Background:</bold> Glucagon-like peptide-1 (GLP-1) is an incretin hormone that plays an important role in glucose homeostasis and food intake. In people, GLP-1 receptor agonists (GLP-1RAs) are commonly used for the treatment of type 2 diabetes mellitus (DM) and obesity; however, non-adherence to injectable medications is common. OKV-119 is an investigational drug delivery system intended for subdermal implantation and delivery of the GLP-1RA exenatide for up to 6 months.</p><p><bold>Hypothesis/Objectives:</bold> Develop protocols for the subcutaneous (SC) insertion and removal of OKV-119 and to evaluate its tolerability, <italic>in vivo</italic> drug-releasing characteristics, and weight-loss effects in cats.</p><p><bold>Animals:</bold> Two cadaveric and 19 purpose-bred cats.</p><p><bold>Methods:</bold> In cadavers, OKV-119 insertion protocol and imaging were performed at three SC locations. The safety and tolerability of OKV-119 implants were assessed in a small (<italic>n</italic> = 4 cats) 62-day study. Weekly plasma exenatide concentrations and body weight were measured in a 42-day proof-of-concept study designed to evaluate OKV-119 prototypes implanted in cats (<italic>n</italic> = 15).</p><p><bold>Results:</bold> In anesthetized cats, the duration of insertion and removal procedures was 1–2 min. OKV-119 was easily identified on radiographs, and well-tolerated without any apparent implant site reactions. Following implantation, exanatide plasma concentrations were observed for up to 35 days. Plasma exenatide concentrations were correlated to weight loss.</p><p><bold>Conclusion and clinical importance:</bold> Our findings suggest that OKV-119 could be easily inserted and removed during a routine clinic visit and can be used to safely and effectively deliver exenatide. Future studies of OKV-119, configured to release exenatide for a longer extended months-long duration, are warranted to determine whether the combination of metabolic improvements and beneficial weight-loss, coupled with minimal impact on pet-owner's lifestyle, lead to improved outcomes for obese cats and feline DM patients.</p>