ADA Meeting Reveal Results of Major Trials
Reprinted with permission by Close Concerns
The annual meeting of the American Diabetes Association (ADA) was held in San Francisco, California from June 6th-10th 2008 with more than 13,000 participants in attendance. The five-day conference featured extensive news of recent developments in drugs and devices. The program included an impressive eight tracks, 200 exhibits, and 2,840 oral and poster sessions. The highlights of this year's meeting included the announcement of results from three landmark clinical trials, ADVANCE, ACCORD, and VADT, along with news of studies on a relatively new class of medications called incretin, which are hormones that work to increase insulin secretion from beta cells.
The ADA meeting opened with the presentation of results from three clinical trials, ACCORD, ADVANCE, and the VADT, comparing cardiovascular health benefits in patients assigned to "intensive" or "conventional" diabetes treatment. The three studies differed in the precise target blood glucose levels and their patient population but each intended to determine whether reducing blood sugar levels would alter cardiovascular disease risk. None of the studies showed a significant relationship between intensive glucose control and cardiovascular disease risk. The studies concluded that older patients with long-term type 2 diabetes were unlikely to benefit from aggressive blood glucose control. These results confirmed a theme of the conference that diabetes should be treated earlier in its progression. Numerous speakers at the conference suggested that the failure of ACCORD, ADVANCE, and VADT to show a positive connection between intensive glucose control and risk of cardiovascular disease could be due to the long duration of diabetes (eight to ten years) in the patient population. The researchers commented that earlier interventions would not only prevent diabetes in those with pre-diabetes but it could also decrease the associated risk for cardiovascular disease. Get up to date on the full background on these trials at http://www.diatribe.us/issues/9/what-were-reading.php.
On the drug front, much attention was devoted to incretins. Prominent researchers in the field, such as Dr. Ralph DeFronzo from the University of Texas (San Antonio), argued that exenatide should be used as a first-line therapy along with metformin and thiazolidinediones. There are currently only two FDA-approved incretin drugs on the market within the United States – Byetta (Amylin Pharmaceuticals and Eli Lilly & Co.) and Januvia (Merck & Co.) – with others, such as liraglutide (Novo Nordisk) and exenatide once weekly (Amylin/Eli Lilly/Alkermes), in development. Participants at the conference were especially eager to hear the long-awaited test results from the longer acting formulation of exenatide, which attempts to reduce the frequency of drug injections from the current twice-daily regimen to once-weekly. Data presented at ADA on once-weekly exenatide showed a significant 2% reduction in A1c along with weight loss and minimal hypoglycemia. The predominant side effect was nausea. Learn more about incretins at http://www.diatribe.us/issues/1/learning-curve.php and at http://www.diatribe.us/issues/8/learning-curve.php.
Kelly Close is editor in chief of diaTribe (www.diaTribe.us), a free online newsletter for patients looking for more information on products and research.
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.