Forschler, F. | bioRxiv Science

bioRxiv2026

An Integrated Analysis of GLP-1R Agonist Mechanisms: Addressing Study Variations in Heterogeneous Cell Systems

Experimental cell systems support the development of pharmacological therapies such as glucagon-like peptide-1 receptor agonists (GLP-1RAs). However, their utility in drug discovery is limited due to study variability, which complicates formation of unified conclusions based on all available data. To address this, we conducted a comprehensive analysis of the GLP-1RA exenatide, incorporating 16 new and five pre-existing mono- or co-culture studies of human liver and pancreatic models. We employed a new pragmatic model-based approach designed to handle the common situation of heterogeneous in vitro datasets with few replicates per condition. All studies are jointly explained (disagreement<{chi}{superscript 2}-limit; 542<732), thereby providing a unified conclusion based on all studies. This work links in vitro biology to clinically relevant mechanisms, such as exenatides effect on glucose-insulin interplay, and predicts previously undescribed inter-study variabilities. Independent validation confirms predictive performance (64<83). Our new integrative approach enhances the utility of experimental cell systems in preclinical drug discovery.

systems biology↗

bioRxiv2025

M4 drug discovery: human drug predictions from integrated pre-clinical insights exemplified with a GLP1-R agonist

A major recent breakthrough in the treatment of type 2 diabetes has been the development of glucagon-like peptide-1 receptor agonists (GLP-1RAs). However, current translational frameworks struggle to predict the clinical outcomes of these drugs from preclinical data. There are several reasons for this struggle, which are generic for many drugs: GLP-1RAs act through multi-timescale mechanisms in which short-term effects propagate into long-term changes; no single preclinical system can capture all their effects in humans; and mechanistic extrapolation requires modelling numerous whole-body biological processes. To address this gap, we present a new extrapolation approach, M4 drug discovery, and retrospectively apply it to the GLP-1RA exenatide in a manner that is generalisable to other drugs. The method integrates: Multi-level data (cellular to whole-body), Multi-timescale data (minutes to months), Multi-species data (e.g., rodents to humans), and Mechanistic knowledge. In this study, we integrate human cell and animal data with drug-free human studies to successfully predict human pharmacokinetics (cost < {chi}2, p=0.05; 64 < 97) and the outcomes of a 30-week clinical trial (36 < 45). We found that integrating information across the four M4 axes improved predictive performance and physiological relevance: multi-species data inform pharmacokinetics, human cell data provide human population- and donor-specific potency estimates, animal data reveal additional drug effects not observable in cell cultures, and the multi-timescale mathematical modelling enables short-term effects of exenatide and meals to inform long-term changes in insulin sensitivity. This work provides new tools for drug extrapolations, supporting the community towards safer and more informed preclinical-to-clinical drug extrapolations.

systems biology↗