ADA 2019 goes beyond diabetes as 'holistic' care comes into focus

San Francisco skyline
The American Diabetes Association's annual meeting wrapped up Tuesday in San Francisco. (Pixabay)

SAN FRANCISCO—If you’d popped into just a few sessions at the American Diabetes Association annual meeting, you easily could have thought you’d wandered into a cardiovascular meeting, a kidney disease meeting, or even a nonalcoholic steatohepatitis (NASH) meeting. And that has drugmakers excited.

“You definitely notice a trend of … how to treat the cardiometabolic patient,” Kiersten Combs, AstraZeneca’s U.S. VP of cardiovascular and metabolic diseases, said. The data and “the medicines now being discussed here are really much more holistic in the treatment of this patient than in the past,” she added.

Pharma execs at ADA agreed nearly across the board—and considering the data their companies presented, it would have been difficult not to. Companies including Eli Lilly, Boehringer Ingelheim and Novo Nordisk continued to roll out cardiovascular outcomes data, which have been a hallmark at ADA for the last few years.

But several others, including AZ and Johnson & Johnson, also focused on their drugs’ effects on kidney disease, while still others dove into NASH and beyond.

“I think what’s reflected generally is the increased awareness and thought on NASH as a core complication of diabetes and really metabolic syndrome,” said Sam Engel, associate VP of diabetes, endocrinology and women’s health at Merck Research Laboratories.

"The increasing recognition by ADA, for example, and the number of sessions related to NASH and symposia—I think it’s been an unrecognized complication that’s finally getting its due," Engel added.

And in the eyes of drugmakers—who are initiating trials left and right aimed at snagging new indications—that’s a positive.  

The complications of diabetes are “where we’re putting a lot more effort,” said Jim List, Janssen's cardiovascular and metabolism R&D head, noting that his company has a team of scientists working in Boston on related conditions such as chronic kidney disease, NASH, retinal disease, obesity and hypertension.

And focusing on diabetes comorbidities “is very, very important,” he said. “I think it’s a good thing that the world is paying more attention to that.”

More attention on those diseases could also translate into more individualized care for patients, Chris Sorli, Sanofi’s VP of medical affairs and head of diabetes for North America, pointed out.

“We’ve been talking about it for a long time now,” he said, adding that she believes we're seeing a point in time where we’re shifting into that.

The field is “really trying to understand what’s the best way to treat an individual patient rather than a population of patients," he said.

Of course, providing individualized care comes with its own challenges, especially as pharma looks to position its drugs across specialties. For drugmakers, it’s a job that’ll require plenty of work with advocacy partners, healthcare providers and payers to make sure they understand just where a drug’s benefits lie, AZ’s Combs said.

“How do all of these specialties work together with primary care around the A1C and not only slow the progression of diabetes, but also the complications and comorbidities that are exacerbated by their diabetes?” she said. “I think that is fundamentally the challenge and the future of where we are going.”