Physico-chemical properties of co-formulation of insulin with pramlintide

Since the discovery of amylin its use has been discouraged by the inadequacy of the protocol involving multiple injections in addition to insulin. While a combined fixed-dose formulation is thus highly desirable, it has long been limited due to incompatibility as historically documented. We have investigated the compatibility of regular and fast-acting insulin analogues (Aspart, AspB28, and LisPro, LysB28ProB29) with the amylin analogue pramlintide. Insulin interacts with pramlintide, forming heterodimers as probed by electrospray ionization - ion mobility spectrometry-mass spectrometry. While their interaction is likely to delay the amyloid aggregation of pramlintide in phosphate-buffered solution pH 7.0, they do not prevent aggregation at this condition. At acidic sodium acetate solution pH 5.0, combination of pramlintide and the fast-acting insulin analogues become stable against amyloid aggregation. The co-formulated product at high concentration of both pramlintide (600 g/mL,150 M) and LisPro insulin (50 IU/mL, 300 M) showed also stability against amyloid aggregation. These data indicate a potential for the development of a co-formulation of fast-acting LisPro insulin with pramlintide, which could bring benefits for the combined therapy.\n\nAbbreviations