Eolo Pharma has achieved a significant milestone in obesity therapeutics with the publication of its first-in-human study results in Nature Metabolism, demonstrating the safety and early efficacy of SANA (salicylic acid nitroalkene), a first-in-class compound that activates creatine-dependent thermogenesis. The Uruguay-based clinical-stage biotechnology company represents the first to pharmacologically activate this energy-burning pathway in humans, offering a novel mechanism distinct from current appetite-suppressing treatments.
Novel Mechanism Targets Energy Expenditure
SANA establishes a new therapeutic paradigm by increasing energy expenditure through creatine-dependent thermogenesis rather than suppressing appetite like currently marketed GLP-1 receptor agonists. This unique mechanism of action enhances mitochondrial respiration in adipose tissue, creating a natural heat-generating process that burns energy without reducing food intake.
The compound's approach addresses key limitations of existing obesity treatments, particularly the muscle wasting and gastrointestinal side effects associated with GLP-1 receptor agonists. According to Carlos Escande, Ph.D., Chief Scientific Officer and Co-Founder of Eolo Pharma and senior author of the study, "This is the first time a drug has been shown to pharmacologically activate creatine-based thermogenesis, which could lead to a novel therapeutic approach for obesity in humans."
Phase 1 Study Demonstrates Safety and Efficacy
The double-blind, randomized, placebo-controlled Phase 1a/b study evaluated SANA in healthy lean individuals and participants with obesity over 15 days of oral administration. The trial included a single ascending dose (SAD) cohort of 17 healthy volunteers and a multiple ascending dose (MAD) cohort of 24 individuals with obesity.
Results showed SANA was safe and well tolerated at all dose levels, with no serious adverse events reported across the study population. In the Phase 1b portion, patients receiving SANA experienced statistically significant reduction in body weight compared to placebo, accompanied by improvements in fasting glucose and insulin resistance as measured by HOMA-IR.
These metabolic improvements occurred after just two weeks of treatment without any significant changes in diet or activity levels, highlighting the compound's direct impact on metabolic processes.
Preservation of Lean Muscle Mass
A key differentiating factor for SANA emerged from preclinical studies showing preservation and enhancement of lean muscle mass while reducing fat mass. EchoMRI analysis in diet-induced obese mice revealed that SANA-treated animals maintained a greater percentage of lean body mass compared to controls, despite substantial fat loss.
This muscle-preserving effect contrasts sharply with currently marketed GLP-1 receptor agonists, which are associated with muscle wasting and loss of lean mass. The preservation of muscle tissue is attributed to SANA's mechanism of enhancing creatine-dependent thermogenesis and mitochondrial respiration specifically in adipose tissue.
Clinical Development Path Forward
Eolo Pharma plans to initiate Phase 2 clinical trials in 2025 to evaluate SANA's long-term safety and efficacy as both a standalone therapy and in combination with existing treatments for metabolic disease. The compound is being developed for obesity, type 2 diabetes, and other cardiometabolic diseases.
María Pía Garat, CEO and Co-Founder of Eolo Pharma, emphasized the significance of this achievement: "SANA is the result of over a decade of rigorous science in Latin America that has the potential to reshape how we treat obesity and insulin resistance. We're proud to be the first biotech in South America to take a first-in-class small molecule from discovery into the clinic."
The publication in Nature Metabolism represents a significant validation of SANA's potential as a novel therapeutic approach that could complement existing GLP-1 therapies while targeting the body's fundamental energy-burning mechanisms. This breakthrough opens an entirely new therapeutic pathway for obesity and metabolic disorders, offering patients safer and more effective treatment options that preserve muscle mass while promoting fat loss.
