Patient populations and treatment methods
The invention provides 17α-ethynylandrost-5-ene-3β,7β,17β-triol for use in methods to treat, e.g., pre-diabetic hyperglycemia or type 2 diabetes patients having a fasting blood glucose level of at least 110 mg/dL or a post prandial glucose level of at least about 140 mg/dL an optionally a body mass index of >29.9, wherein the patients are not concurrently treated with metformin and optionally another antidiabetic agent. In these methods, the patient will preferably have a fasting insulin level of at least 3.5 to 4 μU/mL.
1 . A treatment method for a patient(s) having pre-diabetic hyperglycemia or type 2 diabetes, comprising,
(a) determining the body mass index (BMI) of the patient(s);
(b) in a patient(s) of step (a) that has a BMI greater than 29.9 (is obese), determining the fasting blood or serum glucose level and/or the post prandial glucose level after an oral 75 g glucose load;
(c) selecting patient(s) with a fasting blood glucose level of at least 110 mg/dL or a post prandial glucose level of at least about 140 mg/dL as patient(s) for treatment; and
(d) treating the patient(s) of step (c) with an effective amount of 17α-ethynylandrost-5-ene-3β,7β,17β-triol,
wherein the patient(s) have and wherein the patient(s) has not been treated with metformin and optionally wherein the patient(s) has not been treated with another insulin sensitizer or another antidiabetic agent.
2 . The method of claim 1 wherein the patient(s) has a BMI of at least 30.5.
3 . The method of claim 1 wherein the patient(s) has a BMI of at least 31.
4 . The method of claim 1 wherein, the selected patients of step (c) have (i) a fasting blood glucose level of at least 120 mg/dL or a post prandial glucose level of at least about 150 mg/dL or (ii) a fasting blood glucose level of at least 126 mg/dL or a post prandial glucose level of at least about 200 mg/dL.
5 . The method of claim 1 wherein, the patient(s) has
(i) a microvascular disease, wherein the microvascular disease optionally is retinopathy, neuropathy or nephropathy;
(ii) a macrovascular disease, optionally atherosclerosis, arteriosclerosis, a stroke, hypertension or a myocardial infarction;
(iii) a dyslipidemia condition, wherein the dyslipidemia condition is hypercholesterolemia or hypertriglyceridemia; or
(iv) nonalcoholic fatty liver disease or hepatitis wherein the hepatitis optionally is nonalcoholic steatohepatitis, viral hepatitis or acute alcoholic hepatitis.
6 . The method of claim 1 wherein the patient(s) has a fasting insulin level of at least 4 μU/mL.
7 . The method of claim 4 wherein the patient(s) has a fasting insulin level of at least 4 μU/mL.
8 . The method of claim 7 wherein the patient(s) has a BMI of at least 31.
9 . A method to treat a patient(s) in need thereof comprising administering an amount of 17α-ethynylandrost-5-ene-3β,7β,17β-triol sufficient to maintain a serum level of about 0.5 ng/mL to about 200 ng/mL for about 2 hours per day to at least about 4 hours per day, wherein the patient(s) has hypercholesterolemia, hypertriglyceridemia, a macrovascular disease, a microvascular disease, nonalcoholic fatty liver disease or hepatitis.
10 . The method of claim 9 wherein the amount of 17α-ethynylandrost-5-ene-3β,7β,17β-triol is sufficient to maintain a serum level of about 3 ng/mL to about 50 ng/mL for at least 4 hours.
11 . The method of claim 9 wherein about 4 mg to about 400 mg of 17α-ethynylandrost-5-ene-3β,7β,17β-triol in the form of a dose for oral administration that is administered each day as a single dose or twice as two doses each containing about 2 mg per dose to about 200 mg per dose.
12 . The method of claim 9 wherein, the patient(s) has
(i) a microvascular disease, wherein the microvascular disease optionally is retinopathy, neuropathy or nephropathy;
(ii) a macrovascular disease, optionally atherosclerosis, arteriosclerosis, a stroke, hypertension or a myocardial infarction;
(iii) hypercholesterolemia or hypertriglyceridemia; or
(iv) nonalcoholic fatty liver disease or hepatitis wherein the hepatitis optionally is nonalcoholic steatohepatitis, viral hepatitis or acute alcoholic hepatitis.