Back to the Future: Reproductive Health Is Focus of 100th ENDO

Miriam E Tucker

March 08, 2018

Reproductive health will play a major role in the ENDO 2018 agenda, along with late-breaking adrenal and diabetes research and a session that looks set to upend everything you were taught about salt and water balance.

The Society's centennial conference, ENDO 2018: The Endocrine Society Annual Meeting, takes place March 17–20 in Chicago, Illinois.

"This meeting is continuing a trend of trying to highlight controversies, new issues, and guidelines. It's cross-cutting, not just in basic to clinical, but also across fields," Endocrine Society president Lynnette K Nieman, MD, a senior investigator at the National Institute of Diabetes and Digestive and Kidney Diseases, told Medscape Medical News.

Indeed, the agenda will also feature what are likely to be lively expert debates on the controversial topics of adrenal vein sampling in primary aldosteronism, the role of diet in weight loss, and the optimal extent of lipid lowering.

Three new clinical practice guidelines will be presented. One will address management of gender-dysphoric/gender-incongruent persons. Two others relate to reproductive health: recommendations on testosterone therapy in men with hypogonadism, and an international evidence-based guideline on assessment and management of polycystic ovary syndrome (PCOS).

There will be hundreds of new research presentations during 34 oral abstract sessions and 70 poster sessions, each including multiple individual abstracts.

Late-breaking adrenal abstracts on March 17 will include a randomized trial that compared phenoxybenzamine and doxazosin for the preoperative treatment of pheochromocytoma (PRESCRIPT trial), and a study on a new child-friendly granule formulation of hydrocortisone.

The other late-breaking oral session on diabetes will include an abstract on the use of dapagliflozin in patients with diabetes and kidney disease and another on the effects of empagliflozin on nonalcoholic fatty liver disease. 

Other abstract sessions address the entirety of endocrinology, from thyroid to pituitary to bone to reproductive and transgender medicine.

Medscape will be there, so please visit us at booth 2020 in the exhibition hall, where you can find out more about our partnership with The Endocrine Society.

First Guideline to Have Patient Input

The 90-minute PCOS guideline session, taking place Tuesday March 20, will summarize a project led by a group in Australia targeting an international clinical audience.

The novel initiative was informed by patient input, noted the meeting steering committee chair, John Newell-Price, MA, PhD, chair of endocrinology at the University of Sheffield, UK.

"That hasn't been done with prior guidelines. I think that's novel, and it will be very interesting to see how it pans out...We're delighted they're going to be presented at this meeting," he told Medscape Medical News

PCOS has been a source of confusion and controversy, from debate about its origin — whether it's an ovarian or neuroendocrine defect — to the role of genetics, Nieman noted.

"In endocrinology, it's a bit of a grab bag. People even disagree on diagnosis and treatment. This session will address that," she noted. 

Reproductive Health, Past, Present, and Future

Other sessions related to reproductive health will span the entire meeting program, and the ages.

On the historical side, on Sunday March 18 the Clark T Sawin Memorial History of Endocrinology Lecture entitled "Estrogens Over 90 Years: Discovery, Indications, and Implications" will feature two speakers, Richard J Santen, MD, and Evan R Simpson, PhD, who are "real experts in this area," Newell-Price noted.

Also on March 18, another historical session, "Celebration of the 50th Anniversary of the Discovery of Dihydrotestosterone (DHT)," will feature four expert lectures on the last bioactive steroid to be discovered.

In addition to the guideline presentations on PCOS and hypogonadism, those topics will also be addressed in the oral abstract sessions "Male Reproductive Endocrinology: Aging to Metabolism" on March 18, and "Disorders of the Female Reproductive Axis — PCOS, Premature Ovarian Insufficiency, and Metabolism" on March 20.

And the Presidential Plenary, on March 17 at 8:00 am, will feature talks on "Male Contraception: Prospects, Clinical Pipeline, and Future Directions, " and "The Journey of an Entrepreneur, From Hormones to Women's Health."

Two other sessions will take a futuristic approach to reproduction.

On March 19, "Endocrine Systems on a Chip" will explore uses of microfluidic organ-on-a-chip technologies, which are a new approach to studying multicellular tissues and multiorgan interactions.

One of three speakers in that session will address "EVATAR: Female Reproduction Organs on a Chip," while two others will discuss use of the technology for studying human adipose tissue and the kidney.

"I think these are really cutting-edge technologies," Newell-Price commented.

And another session that is "out there" on March 17, "Mission to Mars: Will Our Fertility Survive Interplanetary Space Travel and Colonization?" will feature three presenters who will speak on how space flight impacts gonadal and gamete function, and sensitivity of the ovary to galactic cosmic radiation.

Newell-Price said that although the subject sounds a bit "kooky," nonetheless, "There's a lot of discussion about space flight...Will we actually do this? If so, what will happen to the reproduction rate? This will make people think."

Moreover, Nieman noted, the topic has relevance to current declines in fertility. "We know fertility is declining. Is that because the ozone isn't as thick as it used to be? I think some people may be interested in that."

Powerful Plenaries, Education, and If You Have Time, a Green River

Of course, there is much more. In addition to the Presidential Plenary, other plenaries scheduled throughout the meeting will address circadian rhythm and metabolic disease, weight manipulation as cancer therapy, role of the hormone kisspeptin, and others, in menopausal symptoms, and role of the adipocyte in diabetes.

One final plenary, on March 19, has the intriguing title "Why we Eat What We Eat, and Why What You Thought You Knew About Salt and Water Balance Was All Wrong."

Lectures during the session include "Endocrinology of the Tongue," and "Salt and Water Balance: Not So Simple." In the latter, Jens M Titze, MD, of Duke-NUS, Singapore, will present findings suggesting that changes in sodium concentrations are key modulators of energy metabolism, fuel utilization, appetite control, and immune function.

"It's completely counter to what we learned in physiology," Newell-Price noted.

Master Clinician sessions on osteoporosis, hyperprolactinoma/prolactinoma, and indeterminate thyroid nodules will also feature panels of well-known experts in those areas who will present challenging cases with the aim of going "beyond the guidelines."

"Master clinician sessions have become extremely popular...These sessions present a case and show how to interpret guidelines for an individual patient," Nieman explained.

Finally, she added, there's one more special feature of ENDO 2018. As it takes place over Saint Patricks' Day, "if people come, they can see the Chicago river turn green," she said. 

Nieman has received research funding from HRA Pharma and is a contributor to UpToDate. Newell-Price has conducted research for and is a consultant to Novartis, Ipsen, HRA Pharma, and Diurnal. 

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