Everyone has heard of Novo Nordisk. Europe’s largest company by market capitalisation and famed for Ozempic, WeGovy, Insulin and other diabetes related products.
Far fewer know about Zealand. But if you’re involved with Diabetes, you probably should. They’ve had a partnership with BetaBionics since 2016 to produce Dasiglucagon, the stable version of Glucagon that’s intended to work in a dual hormone Automated delivery system.
Note: all images in this article taken from December 2023 Company Presentation.
But they do so much more.
As the image above shows, while Zealand have done a lot of work with Dasiglucagon, they’re also heavily focused on peptides.
There’s a large block focused on some very interesting molecules, and if these are half as successful as the Lily and Novo GLP1 Receptor Agonists, they’re potentially on to something big. The phase 2 clinical trials for Servodutide suggested a 19% weight loss, for example…
From a type 1 perspective, however, I’m very interested in ZP8396. An Amylin analogue called Petrelintide.
Why are amylin analogues interesting? In type 1 they are one of the hormones missing when we lose beta cells and are responsible for slowing stomach emptying. They also appear to help in weight loss.
There is currently only one available, Pramlinatide, which has a license in the US, and pretty much nowhere else. It was approved in 2005, and is known as Symlin.
Clinical trials in type 1 suggest that its use reduced Hba1C by between 0.3 and 0.7 percentage points, and also reduced weight in both type 1 and type 2 diabetes.
One of the main benefits of use in type 1 is that by slowing stomach emptying, the rate of glucose increase can be mitigated, as most people with type 1 who don’t have complications have faster stomach emptying than non-t1ds.
Having an additional Amylin analogue with wider availability could be an interesting adjunct treatment for many people outside the US. It would also depend on the price, but just having it available outside the US would be a good start.
Will it be with us anytime soon?
I’m going to guess the answer to that is no. As the chart shows, it’s still in phase 1 trials, and is focused on Obesity, so whether Zealand will ever seek a license for Type 1 use is unclear.
Their website suggests that they see wider use options than just obesity, but gives nothing away, and their recent investor presentation focuses only on Glucagon for their type 1 portfolio, and not Petrelintide.
This is what they say about type 1:
But this appears to be how they intend to do it….
In summary, this looks like another potentially useful drug in type 1 that might never be licensed for it. And that would be a very sad state of affairs.