Welcome to Trends-in-Medicine, offering independent, cutting-edge articles and information on drugs and devices in development. Our subscribers have access to news and analysis on the latest data, regulatory issues, and trends of interest to the healthcare community.

American Diabetes Association (ADA)

Insulin pumps and continuous glucose monitors are under-used, but increases are likely to be incremental. Dexcom’s G5 and G6 remain the favorite CGM of doctors, but patients really like the simplicity and lower cost of Abbott’s FreeStyle Libre, which doesn’t require fingersticks. Senseonics’ Eversense got attention at the meeting but is not expected to really catch on until fingersticks are eliminated. n A number of new closed-loop systems are being investigated that are more user-friendly. n On the drug front, AstraZeneca’s MEDI-0382 looked interesting but there wasn’t a lot of enthusiasm for it. Evidence is building that SGLT2 inhibitors can be used in combination with insulin in Type 1 diabetics, and an oral GLP-1 is on the horizon. n Doctors were reassured that the two new basal insulins – Sanofi’s Toujeo and Novo Nordisk’s Tresiba – looked very similar in the BRIGHT trial. n Islet cell transplants are still extremely limited, and cell therapy is considered far off.

American Academy Of Neurology (AAN)

The AAN meeting lasts longer than many major medical conferences, but it covers a broad array of neurological conditions. The key news this year was in migraine, Parkinson’s disease, and spinal muscular atrophy. In addition, this report covers developments in treatments for Alzheimer’s disease, Dravet and Lennox-Gastaut syndrome, Huntington’s disease, and multiple sclerosis. There are also some shorter notes at the end on Duchenne muscular dystrophy (DMD), dyskinesia, epileptic seizures, and myasthenia gravis (MG).

Bulletin: American Society Of Clinical Oncology (ASCO) – Preview

In a web and teleconference with reporters, ASCO highlighted six studies.ASCO abstracts – other than late breakers – are now off embargo, and these are the ones ASCO chose to present to the media.This is a brief write-up mostly to provide a sense of the tone and focus of those choices and the webcast.About 39,000 attendees are expected at ASCO in Chicago June 1-5, 2018, and there will be ~5,000 abstracts. The theme this year: Delivering, Discovering, and Expanding the Reach of Precision Medicine.

American Society Of Cataract And Refractive Surgery (ASCRS)

Cataract surgeons are increasingly interested in learning how to do minimally-invasive glaucoma surgery (MIGS), but the move to MIGS is still slow, and doctors agree that there is a steep learning curve when it comes for these techniques. Glaukos’ iStent is the overwhelming favorite, mostly because doctors have the most experience with it. Ophthalmologists are also interested in Glaukos’ next-generation iStent inject, which appears to be very easy to implant. There is great interest in Allergan’s Xen subconjunctival device. Novartis/Alcon’s CyPass is popular but has some side effects, and doctors said they will only use it in patients for whom they have to get even lower IOP. Reimbursement for MIGS is a continual and aggravating problem, and doctors don’t know what will be reimbursed from month to month. However, there is a feeling that as MIGS increases in popularity, insurance companies will have no choice but to cover it.

American Psychiatric Association (APA)

There was a lot of news about treatment and testing for depression at APA, and that is the main focus of this report – treatment-resistant depression, postpartum depression, and major depressive disorder – but there also was some medication news in bipolar disorder and schizophrenia.

World Federation Of Hemophilia (WFH)

For a rare disease, the explosion in new treatments is really remarkable. They offer better control, more normal control, easier administration, and less bone/joint damage. The newest extended half-life agent – Roche and Chugai’s Hemlibra (emicizumab) – is expected to be adopted widely and quickly, but there are a number of exciting agents in the pipeline, including Sanofi/Bioverativ’s BIVV-001. Gene therapy was the hottest topic at the meeting, and there are several gene therapies in development, but the data are still scant.

Society Of Critical Care Medicine (SCCM)

Shock – mostly septic shock but also cardiac shock – was a big topic at the meeting. Although in-hospital mortality from shock – distributive (septic) and cardiac – has declined, it is still alarmingly high. The first new drug in many years was recently approved for distributive shock, La Jolla’s Giapreza. However, critical care doctors are taking a cautious approach to this new agent. In cardiac shock a key message was the need to get more of these patients to the cardiac cath lab – and get them there fast. The meeting was also an opportunity to see if or how CAR T therapy for cancer patients is impacting intensive care units (ICUs).

Angiogenesis, Exudation, And Degeneration 2018

Retinal diseases are an active area of research, not just to find and test new drugs and gene therapies but also to develop new imaging approaches and to better understand the underlying pathology. n Wet AMD: It was disappointing that the Phase II data for Novartis’ brolucizumab, a longer-acting anti-VEGF, were expected but not presented. Does it really last longer? n Geographic atrophy: Apellis Pharmaceuticals’ APL-2, a Complement 3 inhibitor, and Stealth BioTherapeutics’ elamipretide both looked interesting. n Dry AMD: Hemera Biosciences’ HMR59, a gene therapy, had positive early data. n Diabetic macular edema (DME): The star of the day was Roche’s RG-7716 in diabetic macular edema, which showed efficacy better than Roche/Genentech’s Lucentis.