metreleptin at a glance
Medicine class
Recombinant human leptin analogue.
Main role
Replacement therapy for complications of leptin deficiency in specific forms of lipodystrophy.
Administration
Injected under the skin after the powder has been mixed with water for injections. Patients and carers require training.
Food
Administration does not need to be coordinated with meals.
Specialist treatment
Treatment should be started and monitored by a clinician experienced in metabolic disorders.
What is metreleptin used for?
Licensed uses, alongside an appropriate diet, are:
Confirmed congenital generalised lipodystrophy or acquired generalised lipodystrophy in adults and children aged 2 years and over.
Confirmed familial partial lipodystrophy or acquired partial lipodystrophy in adults and children aged 12 years and over when standard treatments have not achieved adequate metabolic control.
How does metreleptin work?
Fat tissue normally produces leptin, which helps regulate appetite, energy balance and glucose metabolism. Metreleptin activates human leptin receptors and their JAK–STAT signalling pathway, replacing some physiological leptin activity when leptin levels are deficient.
metreleptin preparations and strengths
Injection
Route: Parenteral
Strengths: 3 mg, 5.8 mg, 11.3 mg
How to take metreleptin
Use only after training and follow the supplied preparation and injection instructions exactly.
Mix the powder only with the specified water for injections; gently swirl rather than shake.
Use only a clear, colourless solution without particles, lumps or foam.
Inject under the skin of the abdomen, thigh or upper arm, rotating sites.
Use the prepared solution immediately and discard any remainder safely in the supplied sharps container.
Keep unopened vials refrigerated and protected from light.
metreleptin side effects
Common or expected effects
- Weight loss or reduced appetite
- Low blood sugar, particularly with insulin or insulin-releasing medicines
- Headache
- Abdominal pain or nausea
- Hair loss
- Fatigue
- Heavy or prolonged menstrual bleeding
- Bruising, redness or other reactions at the injection site
Get urgent medical advice
- Severe allergic reaction, including anaphylaxis
- Pancreatitis, which may cause sudden severe abdominal pain with nausea or vomiting
- Severe low blood sugar or marked high blood sugar
- Deep-vein thrombosis
- Serious breathing difficulty or fluid around the lungs
- Serious infection, sometimes associated with antibodies against metreleptin
- New or worsening autoimmune disease
metreleptin in pregnancy
Metreleptin is not recommended during pregnancy or when effective contraception is not being used. It may restore fertility and can reduce the effectiveness of hormonal contraception, so pregnancy plans or a suspected pregnancy require prompt specialist review.
metreleptin while breastfeeding
It is unknown whether metreleptin enters human milk, and a risk to the infant cannot be excluded. The specialist and patient should decide whether to stop breastfeeding or avoid metreleptin after considering the benefits of each.
metreleptin interactions
Human interaction studies are limited. Important potential interactions include:
Insulin and insulin secretagogues
Improved insulin sensitivity can increase hypoglycaemia risk, requiring close glucose monitoring and review of diabetes treatment.
Hormonal contraceptives
Contraceptive effectiveness may be reduced; an additional non-hormonal method should be considered.
Warfarin and similar narrow-therapeutic-index medicines
Metreleptin may alter CYP-mediated exposure, so treatment effect should be monitored when metreleptin is started or stopped.
Common questions about metreleptin
Answers are fully visible for fast scanning and source review.
Is metreleptin the same as insulin?
No. Metreleptin replaces leptin activity; insulin directly regulates blood glucose. Metreleptin can nevertheless change insulin requirements and increase hypoglycaemia risk.
Does metreleptin cure lipodystrophy?
No. It treats complications of leptin deficiency but does not restore missing or abnormal fat tissue.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.