Conference Reports
The American Diabetes Association’s
Grand Gathering
Chicago, USA, 22nd-26th June 2007
The American Diabetes Association (ADA) held its 67th annual meeting in the gargantuan McCormick Center in Chicago on the 22-26th June 2007. The conference covered a range of areas of diabetes research, with a programme packed full of presentations, posters and panel discussions. This year, around 13,000 delegates were in attendance, filling the meeting rooms, hallways and exhibition centres. The view of Lake Michigan provided a scenic backdrop to discussions of the latest findings in diabetes research.
The need for ongoing diabetes research was highlighted by Dr Larry Deeb during his presidential address, in which he stated that there are 225,000 diabetes-related deaths per year in the US alone, with a new case diagnosed every 21 seconds and an estimated 6 million sufferers remaining undiagnosed. He called for a significant increase in research funding following the near 30% increase in prevalence in the US over the past 5 years.
The clinical highlights of the conference included successes in developing treatments for microvascular complications such as neuropathy and retinopathy. A study with fibrate therapeutics found they reduced neuropathy risk by 70%, and trials with Crestor (rosuvastatin) showed that it too could produce significant improvements in neuropathy scores. Preclinical results for the Phase II drug SB-509 demonstrated that it produced an improvement in motor nerve conduction, a result which was validated in a 12-person clinical trial that also showed that it improvemed qualitative sensory test results.
Studies into diabetic retinopathy focused on alternatives to invasive laser photocoagulation treatment. Some of the most promising results utilized VEGFA, which is elevated in retinopathy sufferers, as a target for antibody and Trap therapeutics. Intravitreal peptinib sodium is also under investigation and was reported to abrogate progressive retinopathy without reducing vision.
The finding that diabetic patients have reduced volumes of the hippocampus and amygdala caused a stir, suggesting link between diabetes and Alzheimer’s disease. Intranasal administration of insulin was found to lead to increased cerebrospinal fluid (CSF) levels of insulin compared to plasma levels, and to increase the removal of amyloid from the intraneuronal space to the CSF and plasma. In some Alzheimer’s disease patients and animal models, intranasal insulin was reported to enhance cognitive performance.
Significant findings were presented for the GLP-1 agonist class of antidiabetics, with AVE-0010 showing potential in protecting insulin-producing ß cells by reducing apoptosis both alone and in combination with insulin analogues. CJC-1134-PC, a conjugated exendin-4 analogue, effectively lowered glucose levels in a short-term clinical trial. In a preclinical study utilising adeno-associated viral vectors fused to GLP-1, the feasibility of direct pancreatic gene delivery of GLP-1 with long-term expression was demonstrated and was the focus of a great deal of attention.
The major talking point of the meeting was undoubtedly the panel discussion, featuring Dr Steve Nissen and Prof Philip Home, reviewing Dr Nissen’s recently-published meta-analysis of the safety and efficacy of GlaxoSmithKline’s (GSK) Avandia (rosiglitazone). The focus was on the potentially increased risks of cardiovascular events seen with this drug, following Dr Nissen’s finding of a 43% increased risk of myocardial infarction Strengths and flaws of clinical trial designs and of the meta-analysis were discussed. Critics pointed out that negative results published before completion of all long-term trials could have a huge impact on patient dropout rates. An interim analysis of the GSK-sponsored long-term RECORD trial, conducted by Prof Home in light of the meta-analysis, found no significant difference in cardiovascular events. The mixed bag of results were discussed, with Dr Nissen stating he was not calling for a withdrawal or regulatory action, but simply awareness of a potential safety issue and a requirement for an appropriately-designed trial to further investigate this result.
As proceedings were drawing to a close, the lively ADA awards ceremony was held. In a poignant moment, outgoing president Dr Richard Rubin was the recipient of an award for all his efforts in diabetes care as an ADA psychologist, despite his own recent diagnosis of prostate cancer. The packed auditorium was delighted to hear treatment had been successful, receiving this news with a rapturous round of applause. Dr Donald Steiner, the noted researcher responsible for elucidation of the double chain structure of insulin, was awarded the Albert Reynold Award for Distinguished Training in Diabetes to acknowledge his further contribution to the field by guiding future generations of researchers.
The 67th ADA meeting presented a diverse mixture of medical research with old and new drugs, alongside a variety of patient-care topics to keep all those in the field well and truly in the know on all current developments in diabetes research and care. The 68th Scientific Sessions, to be held Jun 6-10 2008, in San Francisco, CA, is already hotly anticipated.
Sophie Green and Leanne Coyne
Pharmaprojects Analysts
