COMBINATION OF ACYLATED GLUCAGON ANALOGUES WITH INSULIN ANALOGUES

• US 20160000883A1
• Filed: 09/17/2015
• Published: 01/07/2016
• Est. Priority Date: 01/20/2011
• Status: Abandoned Application

• Current Assignee: Zealand Pharma A/S
• Original Assignee: Zealand Pharma A/S
• Inventors: RIBER, Ditte, FOSGERAU, Keld
• Application Number:
  US14/857,067
• Publication Number:
  US 20160000883A1
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61K 2300/00 Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00
• CPC Class Codes: A61K 38/26 Glucagons
• CPC Class Codes: A61K 38/28 Insulins
• CPC Class Codes: A61P 3/04 Anorexiants; Antiobesity agents
• CPC Class Codes: A61P 3/06 Antihyperlipidemics
• CPC Class Codes: A61P 3/08 for glucose homeostasis pancreatic hormones A61P5/48
• CPC Class Codes: A61P 3/10 for hyperglycaemia, e.g. antidiabetics
• CPC Class Codes: A61P 5/48 of the pancreatic hormones
• CPC Class Codes: A61P 9/00 Drugs for disorders of the cardiovascular system
• CPC Class Codes: A61P 9/10 for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis
• CPC Class Codes: C07K 14/605 Glucagons

Abstract

The invention relates to methods for treating metabolic disorders, including diabetes by using a combination of an acylated glucagon analogue and an insulin analogue. The invention also features a kit that includes an acylated glucagon analogue and an insuline analogue.

Claims

1. A combination of compounds for use in a method for preventing or reducing weight gain;

promoting weight loss;

improving circulating glucose levels, glucose tolerance or circulating cholesterol levels;

lowering circulating LDL levels;

increasing HDL/LDL ratio;

or treating a condition caused or characterized by excess body weight, wherein said method comprises administering to a mammalian subject a combination of compounds comprising;

(a) a compound having the formula;

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula I;

6. The combination of compounds for use in a method of treatment, the use, or the method of claims 1-5, wherein said insulin analogue is selected from the group consisting of insulin glulisine, insulin lispro, Degludec, Actraphane HM, LY2963016, LY2605541, pegylated insulin Lispro, insulin glargine, insulin detemir, insulin isophane, insulin aspen, insulin buccal, hyaluronidase insulin, and insulin protamine.

7. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-6, wherein (a) and (b) are administered in amounts that together are effective.

8. The combination of compounds for use in a method of treatment, the use, or the method of any one of claim 1-7, wherein (a) and (b) are administered within one month of each other.

9. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-8, wherein said condition caused or characterized by excess body weight is selected from the group consisting of obesity, morbid obesity, obesity-linked inflammation, obesity-linked gallbladder disease, obesity-induced sleep apnea, metabolic syndrome, pre-diabetes, insulin resistance, glucose intolerance, type 2 diabetes, type I diabetes, hypertension, atherogenic dyslipidaemia, atherosclerosis, arteriosclerosis, coronary heart disease, peripheral artery disease, stroke, and microvascular disease.

10. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-9, wherein said method prevents or reduces weight gain or promotes weight loss.

11. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-9, wherein said method improves circulating glucose levels.

12. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-11, wherein said subject has type 1 or type 2 diabetes.

13. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-12, wherein one or more of said residues X is independently selected from Lys, Glu and Cys.

14. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-13, wherein:

X16 is selected from Glu, Lys, and Ser;

X17 is selected from Lys and Cys;

X20 is selected from His, Lys, Arg, and Cys;

X24 is selected from Lys, Glu, and Ala;

X27 is selected from Leu and Lys; and

/or

X28 is selected from Ser, Arg, and Lys.

15. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-14, wherein the peptide of formula I includes one or more of the following combinations of residues:

X2 is Aib and X17 is Lys;

X2 is Aib and X17 is Cys;

X2 is Aib and X20 is Cys;

X2 is Aib and X28 is Lys;

X12 is Arg and X17 is Lys;

X12 is Leu and X17 is Lys;

X12 is Lys and X20 is Lys;

X12 is Lys and X17 is Lys;

X16 is Lys and X17 is Lys;

X16 is Ser and X17 is Lys;

X17 is Lys and X20 is Lys;

X17 is Lys and X21 is Asp;

X17 is Lys and X24 is Glu;

X17 is Lys and X27 is Leu;

X17 is Lys and X27 is Lys;

X17 is Lys and X28 is Ser;

X17 is Lys and X28 is Arg;

X20 is Lys and X27 is Leu;

X21 is Asp and X27 is Leu;

X2 is Aib, X12 is Lys, and X16 is Ser;

X12 is Lys, X17 is Lys, and X16 is Ser;

X12 is Arg, X17 is Lys, and X16 is Glu;

X16 is Glu, X17 is Lys, and X20 is Lys;

X16 is Ser, X21 is Asp, and X24 is Glu;

X17 is Lys, X24 is Glu, and X28 is Arg;

X17 is Lys, X24 is Glu, and X28 is Lys;

X17 is Lys, X27 is Leu, and X28 is Ser;

X17 is Lys, X27 is Leu, and X28 is Arg;

X20 is Lys, X24 is Glu, and X27 is Leu;

X20 is Lys, X27 is Leu, and X28 is Ser;

X20 is Lys, X27 is Leu, and X28 is Arg;

X16 is Ser, X20 is His, X24 is Glu, and X27 is Leu;

X17 is Lys, X20 is His, X24 is Glu, and X28 is Ser;

X17 is Lys, X20 is Lys, X24 is Glu, and X27 is Leu;

or

X17 is Cys, X20 is Lys, X24 is Glu, and X27 is Leu.

16. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-15, wherein the peptide of formula I contains only one amino acid of the type conjugated to the lipophilic substituent.

17. The combination of compounds for use in a method of treatment, the use, or the method of claim 16, wherein the peptide of formula I contains only one Lys residue, only one Cys residue, or only one Glu residue, and wherein the lipophilic substituent is conjugated to that residue.

18. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-17, wherein the peptide sequence of formula I comprises one or more intramolecular bridges.

19. The combination of compounds for use in a method of treatment, the use, or the method of claim 18, wherein the intramolecular bridge is formed between the side chains of two amino acid residues which are separated by three amino acids in the linear amino acid sequence of formula I.

20. The combination of compounds for use in a method of treatment, the use, or the method of claim 19, wherein the intramolecular bridge is formed between the side chains of residue pairs 16 and 20, 17 and 21, 20 and 24, or 24 and 28.

21. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 18-20, wherein the intramolecular bridge is a salt bridge or a lactam ring.

22. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 18-21, wherein the intramolecular bridge involves a pair of residues selected from the group consisting of:

X16 is Glu and X20 is Lys;

X16 is Glu and X20 is Arg;

X16 is Lys and X20 is Glu;

X16 is Arg and X20 is Glu;

X17 is Arg and X21 is Glu;

X17 is Lys and X21 is Glu;

X17 is Arg and X21 is Asp;

X17 is Lys and X21 is Asp;

X20 is Glu and X24 is Lys;

X20 is Glu and X24 is Arg;

X20 is Lys and X24 is Glu;

X20 is Arg and X24 is Glu;

X24 is Glu and X28 is Lys;

X24 is Glu and X28 is Arg;

X24 is Lys and X28 is Glu; and

X24 is Arg and X28 is Glu.

23. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-22, wherein at least one of X16, X17, X20, and X28 is conjugated to a lipophilic substituent.

24. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-23, wherein X30 is absent.

25. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-23, wherein X30 is present and is conjugated to a lipophilic substituent.

26. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-25, wherein the compound has just one lipophilic substituent, at position 16, 17, 20, 24, 27, 28 or 30, preferably at position 16, 17 or 20, particularly at position 17.

27. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-25, wherein the compound has precisely two lipophilic substituents, each at one of positions 16, 17, 20, 24, 27, 28, and 30.

28. The combination of compounds for use in a method of treatment, the use, or the method of claim 27, wherein the compound has lipophilic substituents at positions 16 and 17, 16 and 20, 16 and 24, 16 and 27, 16 and 28, 16 and 30, 17 and 20, 17 and 24, 17 and 27, 17 and 28, 17 and 30, 20 and 24, 20 and 27, 20 and 28, 20 and 30, 24 and 27, 24 and 28, 24 and 30, 27 and 28, 27 and 30, or 28 and 30.

29. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-12, wherein said compound has the formula:

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula IIa

30. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-12, wherein said compound has the formula,

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula IIb;

31. The combination of compounds for use in a method of treatment, the use, or the method of claim 29, wherein said compound has the formula:

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula IIIa;

32. The combination of compounds for use in a method of treatment, the use, or the method of claim 30, wherein said compound has the formula:

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula IIIb;

33. The combination of compounds for use in a method of treatment, the use, or the method of claim 31, wherein said compound has the formula:

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula IVa;

34. The combination of compounds for use in a method of treatment, the use, or the method of claim 32, wherein said compound has the formula:

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula IVb;

35. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-34, wherein said peptide Z has the sequence:

36. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-35, wherein said peptide Z has the sequence:

37. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-36, wherein Z¹ comprises a hydrocarbon chain having 10 to 24 C atoms, 10 to 22 C atoms, or 10 to 20 C atoms.

38. The combination of compounds for use in a method of treatment, the use, or the method of claim 37, wherein Z¹ is a dodecanoyl, 2-butyloctanoyl, tetradecanoyl, hexadecanoyl, heptadecanoyl, octadecanoyl, or eicosanoyl moiety.

39. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 1-38, wherein Z² is or comprises one or more amino acid residues.

40. The combination of compounds for use in a method of treatment, the use, or the method of claim 39, wherein Z² is a γ

-Glu, Glu, β

-Ala or ε

-Lys residue, or a 3-aminopropanoyl, 4-aminobutanoyl, 8-aminooctanoyl, or 8-amino-3,6-dioxaoctanoyl moiety.

41. The combination of compounds for use in a method of treatment, the use, or the method of claim 40, wherein the lipophilic substituent is selected from the group consisting of dodecanoyl-γ

-Glu, hexadecanoly-γ

-Glu, hexadecanoyl-Glu, hexadecanoyl-[3-aminopropanoyl], hexadecanoyl-[8-aminooctanoyl], hexadecanoyl-ε

-Lys, 2-butyloctanoyl-γ

-Glu, octadecanoyl-γ

-Glu, and hexadecanoyl-[4-aminobutanoyl].

42. The combination of compounds for use in a method of treatment, the use, or the method of claim 41, wherein Z has the formula:

43. The combination of compounds for use in a method of treatment, the use, or the method of claim 41, wherein Z has the formula:

71. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-5, wherein said combination of compounds includes H-H-Aib-QGTFTSDYSKYLDS-K(Hexadecanoyl-isoGlu)-AAHDFVEVVLLSA-NH₂ and insulin glargine.

72. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-5, wherein said combination of compounds includes H-H-Aib-QGTFTSDYSKYLDS-K(Hexadecanoyl-isoGlu)-AAHDFVEWLLSA-NH₂ and insulin detemir.

73. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-5, wherein said combination of compounds includes H-H-Aib-QGTFTSDYSKYLDS-K(Hexadecanoyl-isoGlu)-AAHDFVEWLLSA-NH₂ and glulisine.

74. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-5, wherein said combination of compounds includes H-H-Aib-QGTFTSDYSKYLDS-K(Hexadecanoyl-isoGlu)-AAHDFVEWLLSA-NH₂ and insulin lispro.

75. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-5, wherein said combination of compounds includes H-H-Aib-QGTFTSDYSKYLDS-K(Hexadecanoyl-isoGlu)-AAHDFVEWLLSA-NH₂ and degludec.

76. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-5, wherein said combination of compounds includes H-H-Aib-QGTFTSDYSKYLDS-K(Hexadecanoyl-isoGlu)-AAHDFVEWLLSA-NH₂ and Actraphane.

77. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-5, wherein said combination of compounds includes H-H-Aib-QGTFTSDYSKYLDS-K(Hexadecanoyl-isoGlu)-AAHDFVEWLLSA-NH₂ and LY2963016.

78. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-5, wherein said combination of compounds includes H-H-Aib-QGTFTSDYSKYLDS-K(Hexadecanoyl-isoGlu)-AAHDFVEWLLSA-NH₂ and LY2605541.

79. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-5, wherein said combination of compounds includes H-H-Aib-QGTFTSDYSKYLDS-K(Hexadecanoyl-isoGu)-AAHDFVEWLLSA-NH₂ and pegylated insulin Lispro.

80. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-5, wherein said combination of compounds includes H-H-Aib-QGTFTSDYSKYLDS-K(Hexadecanoyl-isoGlu)-AAHDFVEWLLSA-NH₂ and NN-1953, IN-105, BIOD-620 and Analog-PH20.

81. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-80, wherein (a) and (b) are administered within one week, three days, or two days of each other.

82. The combination of compounds for use in a method of treatment, the use, or the method of claim 81, wherein (a) and (b) are administered within one day, 12 hours, or six hours of each other.

83. A compound for use in a method for preventing or reducing weight gain;

promoting weight loss;

improving circulating glucose levels, glucose tolerance or circulating cholesterol levels;

lowering circulating LDL levels;

increasing HDL/LDL ratio;

or treating a condition caused or characterized by excess body weight in a mammalian subject that is receiving an insulin analogue, said method comprising administering to said subject the compound recited in any one of claims 1-80 in an effective amount.

84. Use of the compound recited in any one of claims 1-80, in the manufacture of a medicament for preventing or reducing weight gain;

promoting weight loss;

improving circulating glucose levels, glucose tolerance or circulating cholesterol levels;

lowering circulating LDL levels;

increasing HDL/LDL ratio;

or treating a condition caused or characterized by excess body weight in a mammalian subject that is receiving an insulin analogue.

85. A method for preventing or reducing weight gain;

promoting weight loss;

improving circulating glucose levels, glucose tolerance or circulating cholesterol levels;

lowering circulating LDL levels;

increasing HDL/LDL ratio;

lowering circulating triacylglycerol levels, lowering circulating free fatty acids or treating a condition caused or characterized by excess body weight in a mammalian subject that is receiving an insulin analogue, said method comprising administering to said subject the compound recited in any one of claims 1-80 in an effective amount.

86. The compound for use in a method of treatment, the use, or the method of any one of claims 1-85, wherein said insulin analogue is selected from the group consisting of insulin glulisine (Apidra), insulin lispro (Humalog), Degludec, Actraphane HM, LY2963016, LY2605541, pegylated insulin Lispro, insulin glargine (Lantus), insulin detemir (Levemir), NN-1953, IN-105, BIOD-620 and Analog-PH20.

87. The compound for use in a method of treatment, the use, or the method of any one of claims 83-86, wherein said condition caused or characterized by excess body weight is selected from the group consisting of obesity, morbid obesity, obesity-linked inflammation, obesity-linked gallbladder disease, obesity-induced sleep apnea, metabolic syndrome, pre-diabetes, insulin resistance, glucose intolerance, type 2 diabetes, type I diabetes, hypertension, atherogenic dyslipidaemia, hypertriglyceridemia, hypercholesterolemia, atherosclerosis, arteriosclerosis, coronary heart disease, peripheral artery disease, stroke, and microvascular disease.

88. The compound for use in a method of treatment, the use, or the method of any one of claims 83-87, wherein said method prevents or reduces weight gain or promotes weight loss.

89. The compound for use in a method of treatment, the use, or the method of any one of claims 83-87, wherein said method improves circulating glucose levels.

90. The compound for use in a method of treatment, the use, or the method of any one of claims 83-89, wherein said subject has type 1 or type 2 diabetes.

91. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-91, wherein said compound is part of a composition comprising said compound, or a salt or derivative thereof, in admixture with a carrier.

92. The compound or combination of compounds for use in a method of treatment, the use, or the method of claim 91, wherein said composition is a pharmaceutically acceptable composition, and the carrier is a pharmaceutically acceptable carrier.

93. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-93, wherein said compound is administered in a dosage of 0.1 nmol/kg to 1 μ

mol/kg.

94. The compound or combination of compounds for use in a method of treatment, the use, or the method of claim 93, wherein said compound is administered in a dosage of 3 nmol/kg to 30 nmol/kg.

95. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-94, wherein said insulin analogue is administered in a dosage of 0.02 U/kg to 20 U/kg.

96. The compound or combination of compounds for use in a method of treatment, the use, or the method of claim 95, wherein said insulin analogue is administered in a dosage of 0.1 U/kg to 0.3 U/kg or in a dosage of about 0.2 U/kg.

97. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-96, wherein said compound is administered every other week, weekly, every other day, daily, twice daily, or three times daily.

98. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-97, wherein said insulin analogue is administered every other week, weekly, every other day, daily, twice daily, or three times daily.

99. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-98, wherein said compound or combination of compounds is administered in an amount sufficient to reduce food intake in said subject by at least 5%, 10%, 15%, 20%, 25%, 30%, or 50%.

100. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-98, wherein said combination of compounds is administered in an amount sufficient to reduce the subject'"'"'s fasting blood glucose level by at least 1, 2, 3, 4, 5, 6, 8, 10, 11, 12, 15, or 20 mM.

101. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-98, wherein said compound or combination of compounds is administered in an amount sufficient to reduce the subject'"'"'s HbA1c level by at least 0.1%, 0.2%, 0.3%, 0.4%, 0.5%, 0.6%, 0.8%, 1.0%, 1.5%, or 2.0%.

102. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-98, wherein administration of said compound or combination of compounds results in a body weight reduction of at least 3%, 5%, 8%, 10%, 12%, 15% or 20% within 1 year of starting administration.

103. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-98, wherein administration of said compound or combination of compounds results in a body weight reduction of at least 1%, 2%, 3%, 4%, 5%, 6%, 8%, or 10%, 15% within six months of starting administration.

104. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-98, wherein administration of said compound or combination of compounds results in a body weight reduction of at least 0.5%, 1%, 2%, 3%, 4%, 5%, 6%, 8%, 10% or 15% within three months of starting administration.

105. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-104, wherein said compound is administered subcutaneously, intravenously, intramuscularly, by inhalation, rectally, buccally, intraperitoneally, intraarticularly, or orally.

107. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-105, where said insulin analogue is administered subcutaneously, intravenously, intramuscularly, by inhalation, rectally, buccally, intraperitoneally, intraarticularly, or orally.

108. The compound or combination of compounds for use in a method of treatment, the use, or the method of any one of claims 1-107, wherein said subject is a human.

109. A kit comprising:

(a) a compound as recited in any of claims 1-80; and

(b) an insulin analogue.

110. The kit of claim 109 further comprising:

(c) instructions for administering (a) and (b) to a mammalian subject in need of preventing or reducing weight gain;

promoting weight loss;

improving circulating glucose levels, glucose tolerance or circulating cholesterol levels;

lowering circulating LDL levels;

increasing HDL/LDL ratio;

or treatment for a condition caused or characterized by excess body weight.

111. The kit of claim 109 or 110, wherein said insulin analogue is selected from the group consisting of insulin glulisine, insulin lispro, Degludec, Actraphane HM, LY2963016, LY2605541, pegylated insulin Lispro, insulin glargine (Lantus) insulin detemir (Levemir), NN-1953, IN-105, BIOD-620 and Analog-PH20.

2. Use of (a) a compound having the formula:

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula I;

3. The use of claim 2, wherein the compound (a) and insulin analogue (b) are formulated for simultaneous or sequential administration.

4. The use of claim 2 or claim 3, wherein the compound (a) and insulin analogue (b) are formulated as separate medicaments.

5. A method for preventing or reducing weight gain;

promoting weight loss;

improving circulating glucose levels, glucose tolerance or circulating cholesterol levels;

lowering circulating LDL levels;

increasing HDL/LDL ratio;

or treating a condition caused or characterized by excess body weight, said method comprising administering to a mammalian subject a combination of compounds comprising;

(a) a compound having the formula;

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula I;

44. A combination of compounds for use in a method for preventing or reducing weight gain;

promoting weight loss;

improving circulating glucose levels, glucose tolerance or circulating cholesterol levels;

lowering circulating LDL levels;

increasing HDL/LDL ratio;

or treating a condition caused or characterized by excess body weight, said method comprising administering to a mammalian subject a combination of compounds comprising;

(a) a compound having the formula;

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula V;

49. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 44-48, wherein said insulin analogue is selected from the group consisting of insulin glulisine (Apidra), insulin lispro (Humalog), Degludec, Actraphane HM, LY2963016, LY2605541, pegylated insulin Lispro, insulin glargine (Lantus), insulin detemir (Levemir), insulin isophane, insulin aspart, insulin buccal, hyalurinidase, and insulin protamine

50. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 44-49, wherein (a) and (b) are administered in amounts that together are effective.

51. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 44-50, wherein (a) and (b) are administered within one month of each other.

52. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 44-51, wherein said condition caused or characterized by excess body weight is selected from the group consisting of obesity, morbid obesity, obesity-linked inflammation, obesity-linked gallbladder disease, obesity-induced sleep apnea, metabolic syndrome, pre-diabetes, insulin resistance, glucose intolerance, type 2 diabetes, type I diabetes, hypertension, atherogenic dyslipidaemia, atherosclerosis, arteriosclerosis, coronary heart disease, peripheral artery disease, stroke, and microvascular disease.

53. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 44-52, wherein said method prevents or reduces weight gain or promotes weight loss.

54. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 44-52, wherein said method improves circulating glucose levels.

55. The combination of compounds in a method of treatment, the use, or the method of any one claims 44-54, wherein said subject has type 1 or type 2 diabetes.

56. The combination of compounds for use in a method of treatment, the use, or the method of claim 55, wherein said subject has type 2 diabetes.

57. The combination of compounds for use in a method of treatment, the use, or the method of any one claims 44-56, wherein Z has the formula:

45. Use of (a) a compound having the formula:

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula V;

46. The use of claim 45, wherein the compound (a) and insulin analogue (b) are formulated for simultaneous or sequential administration.

47. The use of claim 45 or claim 46, wherein the compound (a) and insulin analogue (b) are formulated as separate medicaments.

48. A method for preventing or reducing weight gain;

promoting weight loss;

improving circulating glucose levels, glucose tolerance or circulating cholesterol levels;

lowering circulating LDL levels;

increasing HDL/LDL ratio;

or treating a condition caused or characterized by excess body weight, said method comprising administering to a mammalian subject a combination of compounds comprising;

(a) a compound having the formula;

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula V;

58. A combination of compounds for use in a method for preventing or reducing weight gain;

promoting weight loss;

improving circulating glucose levels, glucose tolerance or circulating cholesterol levels;

lowering circulating LDL levels;

increasing HDL/LDL ratio;

or treating a condition caused or characterized by excess body weight, said method comprising administering to a mammalian subject a combination of compounds comprising;

(a) a compound having the formula;

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula VI;

63. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 58-62, wherein said insulin analogue is selected from the group consisting of insulin glulisine, insulin lispro, Degludec, Actraphane HM, LY2963016, LY2605541, pegylated insulin lispro, insulin glargine, insulin detemir, NN-1953, IN-105, BIOD-620 and Analog-PH20.

64. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 58-63, wherein (a) and (b) are administered in amounts that together are effective.

65. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 58-64, wherein (a) and (b) are administered within one month of each other.

66. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 58-65, wherein said condition caused or characterized by excess body weight is selected from the group consisting of obesity, morbid obesity, obesity-linked inflammation, obesity-linked gallbladder disease, obesity-induced sleep apnea, metabolic syndrome, pre-diabetes, insulin resistance, glucose intolerance, type 2 diabetes, type I diabetes, hypertension, atherogenic dyslipidaemia, atherosclerosis, arteriosclerosis, coronary heart disease, peripheral artery disease, stroke, and microvascular disease.

67. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 58-66, wherein said method prevents or reduces weight gain or promotes weight loss.

68. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 58-66, wherein said method improves circulating glucose levels.

69. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 58-68, wherein said subject has type 1 or type 2 diabetes.

70. The combination of compounds for use in a method of treatment, the use, or the method of any one of claims 58-69, wherein Z has the formula:

H-Aib-EGTFTSDYSKYLDS-K(Hexadecanoyl-isoGlu)-AAHDFVEINLLSA.

59. Use of (a) a compound having the formula:

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula VI;

60. The use of claim 59, wherein the compound (a) and insulin analogue (b) are formulated for simultaneous or sequential administration.

61. The use of claim 59 or claim 60, wherein the compound (a) and insulin analogue (b) are formulated as separate medicaments.

62. A method for preventing or reducing weight gain;

promoting weight loss;

improving circulating glucose levels, glucose tolerance or circulating cholesterol levels;

lowering circulating LDL levels;

increasing HDL/LDL ratio;

or treating a condition caused or characterized by excess body weight, said method comprising administering to a mammalian subject a combination of compounds comprising;

(a) a compound having the formula;

R¹—

Z—

R²

wherein R¹ is H, C_1-4 alkyl, acetyl, formyl, benzoyl, or trifluoroacetyl;

R² is OH or NH₂;

and Z is a peptide having the formula VI;