PharmaTimes talks to Lotte Bjerre Knudsen, inventor of diabetesdrug liraglutide and scientific vice president at Novo Nordisk

What is your background and current role?

I am a chemist by training, professor and Doctor of Medical Science. Today I am a scientific vice president in our research organisation based in Denmark. I have worked for Novo Nordisk for 30 years, and have been involved in the GLP-1 area for more than 20 years as a project manager for discovery projects and the preclinical area in the liraglutide development project. I was responsible for inventing liraglutide and have published numerous papers on GLP-1, liraglutide, mode of action, toxicology and receptor expression. I am also adjunct professor in translational medicine at Aarhus University.

What does your day-to-day work involve?

I manage projects and activities of a very diverse nature ranging from totally novel drug discovery ideas or, much later in the pipeline, things like solving toxicology issues, supporting late-stage projects with mechanism of action studies for drug about to be marketed, or for drug repurposing. Much of my time also goes into external collaborations, trying to generate new ideas in collaboration with universities or other companies. Finally, communication is a big part of my job. I give many lectures both inside and outside the company, and write many papers. I have one full time academic employee, who helps me manage all activities. Nowadays, I don’t do any actual laboratory activities and instead spend more time managing other people through projects.

Why the focus on diabetes and obesity?

Diabetes is one of the biggest killers in the world, people die perhaps not from the diabetes, but with the diabetes, from cardiovascular disease. Preventing this is of profound importance, not only to the individual patients but also to the world economies since more than 400 million people are affected. Obesity is a primary cause of type II diabetes, and also a very important disease in its own right. Treating obesity is among the best thing one can do to prevent diabetes, and preventing diabetes is the only way to fully avoid diabetes-related co-morbidities like cardiovascular disease, kidney disease, blindness and painful neuropathy.

Is Novo Nordisk involved in any other initiatives to improve the management of these conditions outside of medicines development?

Our purpose as a company is to defeat diabetes and other serious chronic diseases and we know that this will take more than medicine. We’re working hard to prevent diabetes and obesity through programmes such as Cities Changing Diabetes and to drive access to care in partnership with organisations including The Red Cross movement and the United Nations Office for Project Services (UNOPS). Within the area of obesity, although attitudes are changing, we see a relatively low understanding of the complexities of the disease among healthcare professionals and insufficient and suboptimal interaction between patients and carers. We are working with a number of partners to educate and drive awareness around obesity and also to establish clinical frameworks and success metrics for obesity management, for example with the American Medical Group Association Foundation.

What do you see as the most exciting project in the company’s current R&D pipeline?

Oral semaglutide for diabetes is very exciting as it is the first time ever an injectable diabetes drug has successfully been delivered orally in Phase III trials. We are hopeful that it will soon become the first approved oral GLP-1 therapy. Semaglutide for obesity is also exciting and promises greater weight loss than existing treatments with cardiovascular risk reduction at the same time – something that has never been shown before. We also have a new, first-in-class obesity agent built on the amylin biology. This is important since we need new different classes of agents with good safety, for obesity. If I was to mention something earlier in the pipeline, our stem cell research for Parkinson’s is very exciting. It would be so important if something new could be done for such a terrible neurodegenerative disease.

How would you like to see the traditional model of pharmaceutical R&D evolve to improve success rates?

The easy answer is more collaborations and more artificial intelligence (AI). Science moves so fast these days that few companies can do everything and have experts in everything, so collaborations are key to future success. Data science and AI is very important because those who can figure out how to get to the new information smartest will have an advantage.On the people side, giving more freedom to scientists will make them work harder in solving all the traditional issues ever-present in drug discovery. In this sense, the industry should become less corporate and more biotech-like.

What has been the greatest achievement of your career?

Raising my daughter to graduate from law school at 25, and at the same time she is a very nice person, who cares for other people. Getting liraglutide to market, from early idea, to invention, to solving all kinds of issues on the way, to documenting how it works in diabetes, in obesity and in cardiovascular complications in diabetes.

Do you expect Brexit to have an impact on the company’s research activities, or its relationship with the UK?

In September last year we inaugurated our Research Centre at Oxford University and we’re very excited about the translational research being done there within cardiometabolic disease. Our view is that Oxford University has a long and established tradition of scientific excellence and this will remain the case regardless of the uncertainties that come with Brexit. Last year we also acquired Ziylo, a spin-out company from the University of Bristol with whom we are working to accelerate our work in the field of glucose- responsive insulins. We believe in the strength of the UK life science sector and are confident that the UK will remain a supportive environment for research and innovation.

What are your goals for the future?

Building new innovation in cognitive impairment (dementia). Getting GLP-1 properly tested in neurodegenerative disease because a lot of science supports its potential utility there. Maintain Novo Nordisk as a fantastic place for young scientists to work. Learn much more about artificial intelligence.

What keeps you awake at night?

Not much and I sleep very well. I know that I have always done things with great care for quality and ethics, and I teach everyone around me to do the same. My concerns for the world are more general, for economic greed and failure to save the planet for future generations.

If you could invite anyone (alive or dead) over for dinner, who would it be and why?

This is a tough one. I think I would have to go for Marie Curie, or Simone Beauvoir, or perhaps those two French ladies together. How brave they must have both been in very different ways. I would love to hear how Marie tackled being a woman in science in those days, or what both of them would say to young women of today. For someone alive I would go for the – in my opinion – most inspirational couple in the world, Barack and Michelle Obama. I want to ask if there is not something I could please help them with, I would love to do some work on the side on one of their initiatives.