Old Asthma Drug Shows Potential Benefit For Type 2 Diabetics
According to a small clinical trial released Wednesday, symptoms of Type 2 diabetes and nonalcoholic fatty liver disease improved in some patients who were given an asthma drug amlexanox. Its an anti-inflammatory drug which was invented in Japan in the 1980s to treat asthma but was quickly eclipsed by more effective treatments.
Drug resulted in reduced blood-sugar levels and liver fat in one-third of patients in the placebo-controlled study. Also, the researchers found gene signatures that correlated with the positive responses.
The UCSD team, working with scientists at the Salk Institute and the University of Michigan, discovered that two enzymes called IKKε and TBK1 are ratcheted up in obese mice, making it difficult for them to burn calories and expend energy.
Saltiel and colleagues then searched through a database of chemicals to find inhibitors of these enzymes. They came up with amlexanox, which is approved for asthma in Japan, but not in the United States. They’ve now shown that some people with Type 2 diabetes experience a significant drop in glucose after taking the drug.
The researchers tested amlexanox in 21 people with obesity and Type 2 diabetes, and compared them to a control group given a placebo. A third of people taking the drug responded to it, according to the release. Patients who had nonalcoholic fatty liver disease also responded well to it.
The researchers wanted to understand what separated the responders from the non-responders, so they took biopsies of fat cells from the patients at the beginning and end of the study. They discovered more than 1,100 genetic changes that occurred in people who responded to amlexanox, but that were absent in patients who didn’t respond.
Inhibiting inflammatory enzymes is an entirely new approach, UCSD’s Saltiel acknowledges, and it raises several challenges that still need to be addressed. More studies with larger number of patients are needed to validate the effectiveness of amlexanox, the study’s authors said. Questions to be answered include the amount of drug to give, its frequency and how it works in combination with other drugs.