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Peptide

Pramlintide (Symlin)

Pramlintide is a synthetic analog of human amylin, a peptide hormone co-secreted with insulin from pancreatic beta cells. FDA-approved in 2005, it is used as adjunctive therapy to mealtime insulin in type 1 and type 2 diabetes. Clinical trials showed HbA1c reductions of 0.3-0.62% plus weight loss, with 48% achieving dual improvement in HbA1c and weight (vs 16% placebo).

Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.

Best evidence
Grade A
Conditions studied
2
Outcomes
10
Graded outcomes
5221

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

2 conditions, plus general outcomes

Type 1 Diabetes

Type 1 Diabetes: outcomes studied for Pramlintide (Symlin)
GradeOutcomeEffectSizeStudiesPeopleStudies list
HbA1c Reduction (Type 1)

FDA-approved for type 1 diabetes. Long-term studies show HbA1c and weight reduction without increased severe hypoglycemia.

Improves (the measure goes down)Moderate effect28 studies

Studies that measured hba1c reduction (type 1)

and 18 more in the citations list

Type 2 Diabetes

Type 2 Diabetes: outcomes studied for Pramlintide (Symlin)
GradeOutcomeEffectSizeStudiesPeopleStudies list
HbA1c Reduction

52-week RCT: 0.3-0.62% HbA1c reduction vs placebo. Improvement achieved without increase in insulin dose or severe hypoglycemia.

Improves (the measure goes down)Moderate effect26 studies

Studies that measured hba1c reduction

and 16 more in the citations list

Postprandial Glucose

1-hour PPG reduced by 4.8 mmol/L, 2-hour PPG reduced by 3.4 mmol/L in clinical trials.

Improves (the measure goes down)Large effect26 studies

Studies that measured postprandial glucose

and 16 more in the citations list

Body Weight

Significant weight reduction in all dose groups vs placebo. 48% achieved combined HbA1c + weight reduction (vs 16% placebo).

Improves (the measure goes down)Moderate effect25 studies

Studies that measured body weight

and 15 more in the citations list

Postprandial Glucagon

Significant suppression of postprandial glucagon secretion, reducing inappropriate hepatic glucose output after meals.

Improves (the measure goes down)Moderate effect23 studies

Studies that measured postprandial glucagon

and 13 more in the citations list

Lipid Profile

Reductions in plasma total and LDL cholesterol observed in 4-week trial supporting improved metabolic control.

Improves (the measure goes down)Small effect23 studies

Studies that measured lipid profile

and 13 more in the citations list

General

General: outcomes studied for Pramlintide (Symlin)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Blood Glucose Control

52 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes down)Moderate effect12 studies

Studies that measured blood glucose control

and 2 more in the citations list

Liver Protection

4 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect5 studies

Studies that measured liver protection

Neuroprotection

3 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect4 studies

Studies that measured neuroprotection

Oxidative Stress

2 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes down)Small effect3 studies

Studies that measured oxidative stress

Key findings

  • HbA1c Reduction (Type 1)Type 1 DiabetesImproves (the measure goes down)
  • HbA1c ReductionType 2 DiabetesImproves (the measure goes down)
  • Postprandial GlucoseType 2 DiabetesImproves (the measure goes down)

Studies cited

34 studies from PubMed

  1. Pramlintide an Adjunct to Insulin Therapy: Challenges and Recent Progress in Delivery.The Journal of pharmacology and experimental therapeutics, 2024 · PMID 37863489
  2. Simple meal announcements and pramlintide delivery versus carbohydrate counting in type 1 diabetes with automated fast-acting insulin aspart delivery: a randomised crossover trial in Montreal, Canada.The Lancet. Digital health, 2024 · PMID 38906614
  3. Liraglutide versus pramlintide in protecting against cognitive function impairment through affecting PI3K/AKT/GSK-3β/TTBK1 pathway and decreasing Tau hyperphosphorylation in high-fat diet- streptozocin rat model.Pflugers Archiv : European journal of physiology, 2024 · PMID 38536493
  4. Treating obesity in type 1 diabetes mellitus - review of efficacy and safety.Current opinion in endocrinology, diabetes, and obesity, 2024 · PMID 37820077
  5. Pramlintide: An Amylin Analogue Protects Endothelial Cells against Oxidative Stress through Regulating Oxidative Markers and NF-κb Expression.International journal of preventive medicine, 2022 · PMID 35392304
  6. Alleviating carbohydrate counting with a FiASP-plus-pramlintide closed-loop delivery system (artificial pancreas): Feasibility and pilot studies.Diabetes, obesity & metabolism, 2021 · PMID 34047449
  7. Neuroprotective Effects of the Amylin Analog, Pramlintide, on Alzheimer's Disease Are Associated with Oxidative Stress Regulation Mechanisms.Journal of Alzheimer's disease : JAD, 2019 · PMID 30958347
  8. Pramlintide: The Effects of a Single Drug Injection on Blood Phosphatidylcholine Profile for Alzheimer's Disease.Journal of Alzheimer's disease : JAD, 2018 · PMID 29480193
  9. Clinical review: Drugs commonly associated with weight change: a systematic review and meta-analysis.The Journal of clinical endocrinology and metabolism, 2015 · PMID 25590213
  10. The effect of pramlintide acetate on glycemic control and weight in patients with type 2 diabetes mellitus and in obese patients without diabetes: a systematic review and meta-analysis.Diabetes, obesity & metabolism, 2011 · PMID 21199269
  11. Pramlintide and the treatment of diabetes: a review of the data since its introduction.Expert opinion on pharmacotherapy, 2011 · PMID 21564002
  12. Pramlintide in the treatment of diabetes mellitusDrugs, 2007 · PMID 18998755
  13. Diabetes: assessing the pipeline.Atherosclerosis. Supplements, 2006 · PMID 16504599
  14. Exenatide and pramlintide: new glucose-lowering agents for treating diabetes mellitus.Cleveland Clinic journal of medicine, 2006 · PMID 16708716
  15. Adjunctive therapy with pramlintide in patients with type 1 or type 2 diabetes mellitus.Pharmacotherapy, 2006 · PMID 17064208
  16. Pramlintide in the treatment of type 1 and type 2 diabetes mellitusClin Ther, 2005 · PMID 16330288
  17. Properties of pramlintide and insulin upon mixing.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2005 · PMID 15821274
  18. Pramlintide (symlin) for diabetes.The Medical letter on drugs and therapeutics, 2005 · PMID 15912124
  19. Effects in liver.Advances in pharmacology (San Diego, Calif.), 2005 · PMID 16492549
  20. Pramlintide as an adjunct to insulin therapy in type 2 diabetesDiabetes Care, 2004 · PMID 15855578
  21. Pramlintide for the treatment of insulin-requiring diabetes mellitus: rationale and review of clinical data.Drugs, 2004 · PMID 15212559
  22. Pramlintide as an adjunct to insulin therapy improves long-term glycemic and weight control in patients with type 2 diabetes: a 1-year randomized controlled trialDiabetes Care, 2003 · PMID 12610038
  23. Effect of pramlintide on A1C and body weight in insulin-treated African Americans and Hispanics with type 2 diabetes: a pooled post hoc analysisMetabolism, 2003 · PMID 14669170
  24. Pramlintide for the treatment of diabetes mellitus.The Annals of pharmacotherapy, 2003 · PMID 12841822
  25. Addition of pramlintide to insulin therapy lowers HbA1c in conjunction with weight loss in patients with type 2 diabetes approaching glycaemic targets.Diabetes, obesity & metabolism, 2003 · PMID 14617226
  26. Adjunctive therapy with the amylin analogue pramlintide leads to a combined improvement in glycemic and weight control in insulin-treated subjects with type 2 diabetesDiabetes Technol Ther, 2002 · PMID 12017421
  27. The human amylin analog, pramlintide, reduces postprandial hyperglucagonemia in patients with type 2 diabetes mellitusHorm Metab Res, 2002 · PMID 12384827
  28. Amylin agonists: a novel approach in the treatment of diabetesDiabetes Technol Ther, 2002 · PMID 15561917
  29. Pramlintide as an adjunct to insulin therapy in type 1 diabetes reduces A1c without increasing the frequency of severe hypoglycemiaDiabetes Care, 2002 · PMID 16389271
  30. Amylin replacement with pramlintide as an adjunct to insulin therapy in type 1 and type 2 diabetes mellitus: a physiological approach toward improved metabolic controlCurr Pharm Des, 2001 · PMID 11472273
  31. Pramlintide, a synthetic analog of human amylin, improves the metabolic profile of patients with type 2 diabetes using insulin. The Pramlintide in Type 2 Diabetes GroupDiabetes Care, 1998 · PMID 9614619
  32. [Effects of pramlintide, an analog of amylin, on the regulation of glycemia].Journees annuelles de diabetologie de l'Hotel-Dieu, 1998 · PMID 9773629
  33. Effects of amylin and the amylin agonist pramlintide on glucose metabolism.Diabetic medicine : a journal of the British Diabetic Association, 1997 · PMID 9212325
  34. Pramlintide: a human amylin analogue reduced postprandial plasma glucose, insulin, and C-peptide concentrations in patients with type 2 diabetesDiabetologia, 1995 · PMID 9223392