Safety, Tolerability, Pharmacokinetic and Pharmacodynamic Study of MBX 1416 in Healthy Subjects and Patients With Postbariatric Hypoglycemia

Part A Inclusion Criteria: Healthy men and women, between 18 and 65 years of age inclusive. Body mass index (BMI) ≥ 18 and ≤ 30 kg/m2 and stable body weight by history for ≥ 3 months. Fasting plasma glucose < 100 mg/dL and HbA1c < 5.7% Part A Exclusion Criteria: Use of weight-lowering pharmacotherapy or participation in a clinical weight control study. Subjects with a prior history of any serious adverse reaction, hypersensitivity or angioedema to GLP-1 receptor agonists. Presence of any clinically significant physical exam, ECG, or laboratory findings at screening. Part B Inclusion Criteria: Female and male adults, ages ≥ 18 and ≤ 65 years. BMI ≥ 25 kg/m2 to ≤ 35.0 kg/m2 and stable body weight by history for ≥ 3 months. Fasting plasma glucose < 100 mg/dL and HbA1c < 5.7%. Bariatric surgery (i.e., Roux-en-Y Gastric Bypass [RYGB]), or upper-gastrointestinal surgery (i.e., only vertical sleeve gastrectomy [VSG]) at least 6 months before screening. Patients with PBH identified by the following criteria: (Whipple's triad) (Salehi et al., 2018) experiencing post-prandial hypoglycemia occurring 1-3 hours after meals AND with documented hypoglycemia at the time of neuroglycopenic symptoms AND with resolution of symptoms after treatment to raise glucose. Patients must be able and willing to adhere to PBH dietary recommendations. Part B Exclusion Criteria: Patients with confirmed diabetes type 1 or type 2. Patients with dumping syndrome. Other reasons for hypoglycemia than PBH. Patients with a prior history of hypersensitivity or angioedema to GLP-1 receptor agonists, study drug or drug components. Current diagnosis of acute or chronic pancreatitis or factors for pancreatitis, such as cholelithiasis (without cholecystectomy) or alcohol abuse.