Teprotumumab, Canagliflozin, and Kevin Pho Top AACE Agenda

Miriam E. Tucker

April 16, 2019

LOS ANGELES —An investigational treatment for Graves' ophthalmopathy, an encore presentation of the findings of the new "home run" canagliflozin renal study, a social media star physician, and a mystery speaker are among the many highlights of the upcoming American Association of Clinical Endocrinologists (AACE) 2019 Annual Scientific & Clinical Congress.

Taking place April 24-28 in Los Angeles, California, the meeting will also feature two plenaries on late-breaker topics, one on treatment remission as a goal of type 2 diabetes management and the other on Graves' eye disease. Other plenaries delivered by expert speakers will address Cushing's syndrome, anabolic therapy for osteoporosis, and adverse endocrine events related to checkpoint inhibitor therapy.

And on Saturday morning, Kevin Pho, MD, of Twitter and Internet fame, will discuss social media and the physician.    

New research findings will be presented in hundreds of eposters — no more rows and rows of bulky cork boards — with a handful of noteworthy ones chosen to be presented in oral sessions in the exhibit hall. Those topics include a new imaging technique for detecting parathyroid adenomas, a handheld sodium analyzer for adipsic diabetes insipidus, and an investigational treatment for endogenous hypercortisolism. 

Over a dozen meet-the-expert sessions on Thursday and Saturday afternoons will address a wide range of practical topics, including laboratory pitfalls with endocrine testing, how to optimize procedural billing, and telehealth. On Friday afternoon, a multispeaker "in-depth symposia" will cover even more ground, including a special two-part session for fellows in training to help them find their career paths.

And Sunday, the final day, will be devoted to topics on endocrine surgery.

Two major social events will change format this year. Rather than a big Saturday night party at the end of the conference after the convocation, there will be an opening celebration to bring everyone together at the start of the meeting on Thursday night. And the Women's Leadership lunch is now a dinner that will take place on Friday night.   

"The theme this year is 'get inspired.' To me, that means there's nothing like meeting your colleagues, hearing about cutting-edge clinical work, and looking forward to getting back to your clinic on Monday, changing how you do things, and improving your care of patients," conference program chair Susan L. Samson, MD, PhD, told Medscape Medical News in an interview.

Indeed, AACE president Dan Hurley, MD, said, "I think the expertise of the speakers from the plenaries to the meet the experts and other sessions will draw attendees — and the wide variety of topics. Endocrinology is changing so fast and interdigitates with so many different organ systems — there's a lot to know."

Late-Breakers Feature Medications  

An hour-long late-breaking oral session on Friday will be devoted to new phase 3 data on the fully human insulin-like growth factor 1 (IGF1) receptor inhibitory monoclonal antibody teprotumumab (Horizon Pharma). Initially explored as a cancer drug, teprotumumab had previously shown benefit in reducing proptosis associated with Graves' disease in a 24-week phase 2 trial and its 72-week extension.   

In February, the company announced top-line results of the confirmatory phase 3 study, the details of which will be presented at the meeting. Teprotumumab has received Breakthrough Therapy, Orphan Drug, and Fast Track designations from the US Food and Drug Administration, and Horizon plans to submit a Biologics License Application for the drug in mid-2019.

Those results will be presented by co-investigator Raymond Douglas, MD, PhD, an orbital and oculoplastic surgeon at Cedars-Sinai Medical Center, Los Angeles. But just prior to that, principal investigator George Kahaly, MD, PhD, of Johannes Gutenberg University Medical Center, Mainz, Germany, will set the stage with a plenary talk about Graves' eye disease.

"The eye disease can be devastating for patients, both in terms of their appearance and their vision...It's very scary. We haven't had a lot of tools in our toolbox until recently...Teprotumumab has shown some amazing results for these patients," Samson said.

The other late-breaking session will be an encore presentation of the CREDENCE trial, which showed a renal benefit for canagliflozin (Invokana, Janssen). The data were announced April 14 at the International Society of Nephrology 2019 World Congress in Melbourne, Australia, and simultaneously published in the New England Journal of Medicine. As reported last year, the trial was halted early because of its strong efficacy data.

"This will be the first domestic presentation of the data. It's going to be very exciting because renal disease is a significant deterrent to quality of life for people with diabetes, and this is pretty impressive data," Hurley said.

Social Media Star and a Mystery Endocrine Blogger to Take the Stage

Featured speaker Kevin Pho, MD, Nashua, New Hampshire, is a board-certified internist and blogger with more than 150,000 Twitter followers and has become "social media's leading physician voice." He'll discuss how physicians can best use social media to interact with patients and the public.

"It will be very entertaining," Hurley said, noting that "our [field] is becoming younger all the time and they're engaged in social media in their personal lives. So, how to engage in your professional lives? Is it a good thing to use or not? It will be exciting to hear his experience."

And in what may be a first for any medical meeting, on Saturday afternoon a mystery speaker who is also a blogger and Twitter user (@hormoneblog) will take the stage to provide The Definitive* Guide to Surviving Encounters With Alternative-Medicine Obsessed Patients. *No guarantee of success.

Speaking about the meeting as a whole, Hurley said, "I think hearing from experts in the field is going to be exciting and invigorating, and will help people to think outside the box a little bit, and then go back home and delve into the literature and fine-tune what they see in Los Angeles to their practices."

Samson has reported acting as a steering committee chair for a Novartis trial and an advisory board member and/or consultant for Corcept Therapeutics and Pfizer. Hurley has reported no relevant financial relationships. 

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