Insulin icodec

Insulin icodec, sold under the brand name Awiqli, is a medication used for the treatment of diabetes to improve glycemic control.^[3] It is an ultralong-acting basal insulin analogue that is developed by Novo Nordisk.^[3]

Insulin icodec

Clinical data
Trade names	Awiqli
Pregnancy category	AU: B3[1]
Routes of administration	Subcutaneous
ATC code	A10AE07 (WHO)
Legal status
Legal status	AU: S4 (Prescription only)[1] CA: ℞-only / Schedule D[2][3][4] EU: Rx-only[5][6]
Identifiers
IUPAC name (1a-21a),(1b-29b)-Insulin (human), 14a-L-glutamic acid-16b-L-histidine-25b-L-histidine-29b-(N6-(N-(19-carboxy-1-oxononadecyl)-L-gamma-glutamyl-2-(2-(2-aminoethoxy)ethoxy)acetyl-2-(2-(2-aminoethoxy)ethoxy)acetyl)-L-lysine)-
CAS Number	1188379-43-2
DrugBank	DB16693
UNII	P7YU3ED05N
KEGG	D12358
Chemical and physical data
Formula	C280H435N71O87S6
Molar mass	6380.33 g·mol−1

It has a plasma half-life more than eight days^[7] (compared to 25 hours of the previous longest-acting insulin analogue insulin degludec), making it a once-weekly basal insulin.^[7]

Like insulin, icodec is composed of two peptide chains linked by a disulfide bridge. However, a C20 fatty diacid-containing side chain has been added for strong, reversible albumin binding; and three amino acid substitutions provide molecular stability and attenuate insulin receptor binding and clearance. Together, these modifications prolong the half-life.^[8]

Society and culture

Legal status

Insulin icodec was approved for medical use in Canada in March 2024.^[3]

In March 2024, the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Awiqli, intended for the treatment of diabetes.^[5] The applicant for this medicinal product is Novo Nordisk A/S.^[5] Insulin icodec was approved for medical use in the European Union in May 2024.^[6]

Names

Insulin icodec is the international nonproprietary name.^[9]

Research

Based on a clinical trial, glycemic control was found to be non-inferior with once-weekly insulin icodec compared with once-daily insulin glargine U100.^[10]