New data show that pre-diabetes and impaired beta cell function were associated with a dysfunctional gut barrier, a potential precursor to metabolic diseases
Additional analysis of the company’s pivotal GLOW study suggests fasting plasma glucose levels and insulin resistance could be strong predictors of weight loss with Plenity®
New in-vitro beverage interaction study finds that Plenity’s hydrogel maintained its properties in the presence of alcoholic or acidic drinks
Boston, November 3, 2020 – Gelesis, a biotechnology company developing a novel hydrogel platform technology to treat overweight, obesity and other chronic metabolic diseases, announces the release of three poster presentations at ObesityWeek® 2020, the annual congress of The Obesity Society, including:
“This work presented at ObesityWeek highlights the interplay between the loss of intestinal barrier integrity and early beta-cell function, adding to the increased focus of the gut-pancreatic axis and its critical role on metabolic health,” said Paresh Dandona, MD, PhD, Distinguished Professor in the Department of Medicine, Jacobs School of Medicine and Biomedical Sciences at SUNY Buffalo. “Gelesis is leading the field of research for intestinal barrier health with its hydrogel technology, with the goal of becoming a frontline treatment approach that targets the complex gut-host interaction.”
The details of the presentations are as follows.
Poster Presentation (EP-234): Impaired Beta Cell Function is Associated with Evidence of Dysfunctional Gut Barrier; Husam Ghanim, PhD; State University of New York, Buffalo, NY
Impaired small intestinal permeability has been linked to metabolic diseases, including obesity, diabetes, and fatty liver disease. Intestinal permeability can be measured by drinking a solution containing various sugars that are typically too large to be absorbed through the gut barrier. The presence of these sugars (e.g. cellobiose) in the urine suggest an impairment in gut barrier function. This analysis is the first, to the authors’ knowledge, to describe an association between increased small intestine permeability and a reduction in insulin-secreting pancreatic beta-cell function, as indicated by a reduced insulin response to a glucose stimulus. Diabetes is already known to have an association with impaired gut barrier. This new research also suggested a correlation between fasting plasma glucose (FPG) and gut permeability, proposing that pre-diabetes is potentially associated with impaired gut barrier as well. These data also suggest that intestinal barrier integrity may play an important role in the treatment of metabolic diseases.
Poster Presentation (EP-174): Evaluating Glucose and Insulin as Predictors of Weight Loss in GLOW: A Novel Statistical Approach; Mads Fiil Hjorth, PhD; University of Copenhagen, Frederiksberg, Denmark
In this post-hoc analysis of the Gelesis Loss of Weight (GLOW) study, researchers evaluated fasting plasma glucose (FPG) and fasting plasma insulin (FPI) levels as biomarker predictors for weight loss with Plenity. The results of this analysis suggest that for each 1mg/dL increase in FPG, people using Plenity lost 0.10kg more weight than those on placebo. Similar associations to weight loss were observed for fasting FPI and HOMA-IR for those individuals with elevated FPG. The authors conclude that FPG may be a predictor of weight loss with Plenity treatment, and FPI may also be an effective predictor, particularly in patients with an elevated FPG. The results of this analysis are consistent with the previously reported analysis of the FLOW pilot study, as well as studies that have demonstrated that patients with impaired FPG lost more weight than those with normal glycemia when exposed to diets higher in vegetables, fruits, and whole grains.
Poster Presentation (EP-175): Evaluating the Interaction of an Oral Superabsorbent Hydrogel with Alcohol and Acidic Beverages; Damian Bialonczyk, PharmD; Gelesis, Inc., Boston, MA
This presentation details the interaction of Plenity and the consumption of alcohol and acidic beverages during meals. Plenity is intended to be taken with 16 ounces of water 20-30 minutes prior to lunch and dinner. However, some patients may elect to consume beverages other than water with their meals (after consuming the recommended 16 oz of water with their Plenity capsules before the meal). The results of this in-vitro analysis suggest that the Plenity hydrogel maintains its firmness and water absorption capacity in the presence of a meal and various alcoholic and acidic beverages.
The Gelesis Loss Of Weight (GLOW) Study was a randomized, double-blind, placebo-controlled, parallel-group study enrolling 436 adults with a body mass index (BMI) ≥ 27 and ≤ 40 kg/m2, including those with prediabetes or type 2 diabetes. The 6-month study compared a 2.25 g dose of Plenity, administered twice daily, to placebo and was conducted at 33 sites across the United States and several European countries. Both the active and placebo arms also included a reduced calorie diet and daily physical activity. The study had two predefined co-primary endpoints: at least 35% of patients taking Plenity achieving ≥ 5% weight loss (categorical endpoint) and placebo-adjusted weight loss with a super-superiority margin of 3%. In addition, a prespecified analysis of simple superiority was also performed. The study met and exceeded the predefined categorical endpoint, with 59% of adults in the treatment group achieving weight loss of 5% or greater. The study did not meet the 3% super-superiority endpoint but demonstrated superiority of the Plenity treatment over the placebo group (–6.4% vs. –4.4%, P=0.0007). Plenity-treated individuals had twice the odds of achieving at least 5% weight loss vs. placebo (adjusted odds ratio [OR]: 2.0,P=0.0008). In addition, 26% of the adults who completed the treatment with Plenity were “super-responders,” defined as achieving at least 10% weight loss. These super-responders achieved an average of about 14% weight loss or approximately 30 pounds. The overall incidence of adverse events (AEs) in the Plenity treatment group was no different from placebo. The most common treatment-related adverse events (TRAEs) were gastrointestinal disorders (158 TRAEs in 84 [38%] subjects in the Plenity arm, compared to 105 events in 58 [28%] subjects receiving placebo), infections and infestations (2 events in 2 [1%] subjects with Plenity and 1 events in 1 [1%] subjects with placebo), and musculoskeletal and connective tissue disorders (3 events in 2 [1%] subjects with Plenity and 0 in 0 [0%] subjects with placebo). There were no serious adverse events (SAE) in the Plenity treatment group, whereas there was one (1) SAE in the placebo treatment group.
Plenity is an oral, non-systemic, superabsorbent hydrogel which has received FDA clearance as an aid in weight management in overweight and obese adults with a BMI of 25–40 kg/m2, when used in conjunction with diet and exercise. Gelesis has also received approval to market Plenity in the European Economic Area. Plenity is made by cross-linking two naturally derived building blocks, modified cellulose and citric acid, that create a three-dimensional matrix. Plenity particles rapidly absorb water in the stomach and homogenously mix with ingested foods. Rather than forming one large mass, it creates thousands of small individual gel pieces with the elasticity and firmness of solid plant-based foods (e.g., vegetables) without caloric value. The Plenity hydrogel increases the volume and elasticity of the stomach and small intestine contents and induces a feeling of fullness and satiety. Once it arrives in the large intestine, the hydrogel is partially broken down by enzymes and loses its three-dimensional structure along with most of its absorption capacity. The released water is reabsorbed in the large intestine, and the remaining cellulosic material is eliminated through the body’s natural digestive processes. Plenity is considered a medical device because it achieves its primary intended purpose through mechanical modes of action consistent with mechanobiology constructs. For more information, visit myplenity.com.
Gelesis is developing a novel hydrogel platform technology to treat overweight and obesity and chronic diseases related to the GI pathway. Gelesis’ proprietary approach is designed to act mechanically in the GI pathway to potentially alter the course of certain chronic diseases. In April 2019, Gelesis received FDA clearance for its lead product candidate, Plenity®, as an aid for weight management in overweight and obese adults with a Body Mass Index (BMI) of 25-40 kg/m2, when used in conjunction with diet and exercise. It was also granted a CE Mark, which allows Gelesis to market Plenity in the European Economic Area. Plenity is currently available in limited release in the U.S. Additionally, Gelesis is developing additional investigational candidates such as Gelesis200, a hydrogel optimized for weight loss and glycemic control in patients with type 2 diabetes and prediabetes. Novel hydrogel mechanotherapeutics based on the Gelesis platform technology are also being advanced in other GI inflammatory conditions, such as non-alcoholic steatohepatitis (NASH) and functional constipation. For more information, visit gelesis.com or connect with us on Twitter @GelesisInc.
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