Hydrocarbon stapling also enhances the pharmacological performance of peptide drugs by dramatically improving target affinity, resistance to proteolysis, cell permeability, and in vivo pharmacokinetics 33,34
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Finally, some clinical case studies and short series suggest their benefits also in patients with CKD stage 5D, although it should be recalled that this indication is not included in the labeling of arGLP-1 s.114,115 The Effect of semaglutide versus placebo on the progression of renal impairment in subjects with type 2 diabetes and chronic kidney disease (FLOW), a phase 3 clinical trial involving more than 3,000 patients with type 2 DM and moderate-severe CKD (eGFR 2575 ml/min/1.73 m2 and Urine Alb/Cr ratio of 3005,000 mg/g) is currently underway (NCT03819153)
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