Miriam E Tucker

September 05, 2017

The 2017 meeting of the European Association for the Study of Diabetes (EASD) will offer 11 major clinical-trial presentations yet still maintain a balance among basic, translational, and clinical science.

The meeting takes place Tuesday, September 12, through Friday, September 15, in Lisbon, Portugal. The agenda includes 48 oral abstract sessions, six poster events, five award lectures, and 30 symposia featuring cutting-edge diabetes-related topics. For young investigators, a new "EASD Young Academy" and a "Rising Star" symposium exemplify the association's new outreach efforts.

"It's an exciting time for endocrinology and diabetes research and care, and I think this meeting really holds that up," EASD president Juleen R Zierath, PhD, professor of physiology at the Karolinska Institutet, Stockholm, told Medscape Medical News.

If not an EASD record, the 11 major trial sessions — each of them 60 or 90 minutes in length — is certainly an unusually high number and required some work on the part of the program committee to fit into the meeting agenda, program chair Francesco Beguinot, MD, professor of clinical pathology at Federico Secundo University, Naples, Italy, added.

"We had several requests. We had to provide additional slots in the program so as not to reduce slots in experimental medicine and basic science. We had to work very hard," Dr Beguinot told Medscape Medical News.

Importantly, he noted, each of the 11 trial sessions will include an independent commentator, chosen by the program committee. "These individuals are totally independent of the studies, to prompt discussion and highlight the strengths and weaknesses."

Trials Examine CV Outcomes, Adjunctive Medications in T1D, and More

One trial already generating great interest on the "Virtual Meeting" site is Exenatide Study of Cardiovascular Event Lowering (EXSCEL), AstraZeneca's investigation of the impact of the once-weekly glucagonlike peptide-1 (GLP-1) receptor agonist exenatide (Bydureon ) on major cardiovascular outcomes, to be presented Thursday evening. "This will be very interesting," Dr Beguinot promised.

Top-line results from EXSCEL, reported in May, show the agent met the goal of cardiovascular safety but failed to show any cardiovascular benefit.

Another cardiovascular-outcomes trial receiving quite a few premeeting hits is TOSCA IT, comparing the effects of add-on pioglitazone vs a sulfonylurea in type 2 diabetes patients inadequately controlled on metformin. The findings will be presented on Wednesday.

"I think it is a fairly novel and important study.…The [interim] data we were given were quite interesting and convincing. I'm dying to see the final data. I think it may have an impact," Dr Beguinot said, adding that this trial is also noteworthy in that it's not pharma-sponsored.

Results from another cardiovascular-outcomes trial of an older drug, acarbose, will also be presented on Wednesday. This one, the Acarbose Cardiovascular Evaluation, is sponsored by Bayer.  

Two major studies also generating interest both involve the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors in type 1 diabetes, continuing the recent trend in investigations of adjunctive therapies to insulin, particularly in the setting of obesity.

One of these involves sotagliflozin, a dual SGLT1 and SGLT2 inhibitor. Some phase 3 data from the Sotagliflozin Clinical Program (Lexicon Pharmaceuticals) have already been released, with additional new results to be presented in a session on Wednesday.

Another session on Thursday will feature results of the DEPICT-1 study (AstraZeneca), investigating the use of the SGLT2 inhibitor dapagliflozin (Forxiga/Farxiga) along with insulin in type 1 diabetes patients.

Given that previous reports of ketoacidosis and other safety issues with SGLT2 inhibitors have prompted particular concern about their use in type 1 patients specifically, "we are quite interested in terms of safety," Dr Beguinot said, but added, "Apparently, the data they've provided are quite satisfactory.…I doubt these agents can be used in pediatric [type 1 diabetes] patients, but in adult patients they might be an additional help."

Other major trials include CONCEPTT, an investigation of continuous glucose monitoring (CGM) during pregnancy in women with type 1 diabetes, and J-DOIT3, a multifactorial intervention trial for prevention of macrovascular complications and mortality.

And new data from three studies for which primary results were reported in June at the American Diabetes Association Scientific Sessions are also featured in special symposia, including ODYSSEY DM on the role of alirocumab (Praluent, Sanofi/Regeneron Pharmaceuticals) in lipids management in type 2 diabetes; DEVOTE, looking at insulin degludec (Tresiba, Novo Nordisk) vs insulin glargine in type 2 diabetes; and CANVAS, the cardiovascular-outcomes trial of another SGLT2 inhibitor, canagliflozin (Invokana, Johnson & Johnson).

Beyond the big trials, other noteworthy 60- and 90-minute sessions include an "East-West Forum" examining diabetes outcome trends in different regions of the world, a joint EASD/European Society of Cardiology (ESC) symposium on "hot topics" in cardiovascular complications of diabetes, a debate on the future of type 2 diabetes prediction and prevention, and an overview of advances in infusion sets and insulin pumps.

Keynote Speeches on Cutting-Edge Basic and Translational Science

Dr Zierath will chair all but one of five sessions involving presentation of a special EASD award, followed by a lecture from the recipient.

The first, on Tuesday, is the 49th Claude Bernard Lecture, to be given by Bernard Thorens, PhD, of the University of Lausanne, Switzerland, entitled, "A glucose-centric view on diabetes pathogenesis from islet biology to integrated physiology and precision medicine."

"That will be a great one," she predicted.

Also on Tuesday, the Camillo Golgi Lecture will be given by Brian M Frier, MD, of the University of Edinburgh, Scotland, on the topic "Recurrent hypoglycemia in diabetes: The long-term complications."

Dr Zierath noted, "This is important because it's what patients suffer from. It will have a strong clinical-translational component."  

At the same time, the Albert Renold Lecture will be given by Prof Jorge Ferrer, chair in genetics and medicine at Imperial College London, United Kingdom. Entitled "DNA switches, beta cells, and diabetes," it will be relevant to both diabetes types, she said.

On Wednesday, the EASD-Novo Nordisk Foundation Diabetes Prize for Excellence will go to an American, Phillip Scherer, MD, professor and director of the Touchstone Diabetes Center at the University of Texas Southwestern Medical Center, Dallas. His lecture topics is "The many secret lives of adipocytes: Implications for diabetes."

According to Dr Zierath, Dr Scherer is "an extraordinary speaker. He's a very basic molecular biologist, but he's thinking a lot about application to humans. You definitely don't want to miss his talk."

And finally, on Thursday, Ewan R Pearson, professor at the University of Dundee, Scotland, will give the Minkowski prize lecture entitled "Target therapy in diabetes: Insights from genetics."

Reaching Out to Young Investigators

This year, EASD is also making a special effort to reach out to young investigators. A new conference feature, the EASD Young Academy, will offer three 2-hour meet-the-professor sessions during lunchtimes Tuesday through Thursday, affording young basic and clinical researchers the chance to interact with leaders in the field and to network with one another.

And on Friday, in the "Rising Star Symposium," four promising young researchers will present their work.

"I always say if you're only going to go to a couple things every day, that's one to attend. They're geared up to do their best. It's accessible data. They're great," notes Dr Zierath.

Dr Beguinot commented, "Clinical, translational, and basic scientists all want their areas highlighted. I believe this year we have done a very good job in having a very balanced program that I hope will satisfy everyone, especially young people."

Dr Zierath has a research grant from AstraZeneca and is involved in a collaboration with Janssen. Dr Beguinot has no relevant financial relationships.  

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