Pramlintide
Pramlintide (amylin analogue)
Also known as: Symlin
An FDA-approved synthetic amylin analogue used with insulin to improve post-meal glucose control and reduce appetite.
Overview
Pramlintide is a synthetic analogue of amylin, a hormone co-secreted with insulin. It is FDA-approved as Symlin as an add-on to mealtime insulin in type 1 and type 2 diabetes, where it slows gastric emptying, suppresses glucagon, and reduces appetite. It set the pharmacological groundwork for the newer long-acting amylin agonist cagrilintide.
Mechanism of action
Agonizes amylin receptors to delay gastric emptying, suppress post-meal glucagon, and promote satiety, complementing insulin.
Key studies & citations
- Human2002
A randomized study and open-label extension evaluating the long-term efficacy of pramlintide as an adjunct to insulin therapy in type 1 diabetes
52-week trial in 480 patients with type 1 diabetes: pramlintide lowered HbA1c by 0.67% versus 0.16% for placebo at week 13, with weight loss rather than gain and no rise in severe hypoglycemia.
Diabetes Care - Human2004
Effect of pramlintide on weight in overweight and obese insulin-treated type 2 diabetes patients
Pooled analysis of two long-term trials: placebo-corrected reductions of 0.41% in HbA1c and 1.8 kg in weight at 26 weeks, with lower insulin use.
Obesity Research - Human2007
Progressive reduction in body weight after treatment with the amylin analog pramlintide in obese subjects: a phase 2, randomized, placebo-controlled, dose-escalation study
16 weeks in 204 obese subjects without insulin: placebo-corrected weight loss of 3.7% (3.6 kg), showing the amylin pathway's appetite effect that later informed cagrilintide.
Journal of Clinical Endocrinology and Metabolism - Human2015
Symlin (pramlintide acetate) injection: prescribing information
FDA-approved label: adjunct to mealtime insulin in type 1 and type 2 diabetes; boxed warning for severe insulin-induced hypoglycemia and a 50% mealtime insulin reduction at initiation.
U.S. FDA (Drugs@FDA label)
Frequently asked questions
How does pramlintide relate to cagrilintide?
Both act on amylin receptors. Pramlintide is a short-acting approved insulin adjunct, while cagrilintide is a long-acting, once-weekly amylin agonist still in development for obesity.