Insulin icodec

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

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

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.

Legal status
Insulin icodec was approved for medical use in Canada in March 2024.

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. The applicant for this medicinal product is Novo Nordisk A/S. Insulin icodec was approved for medical use in the European Union in May 2024.

Names
Insulin icodec is the international nonproprietary name.

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.