The 83rd Scientific Sessions meeting of the American Diabetes Association (ADA) was held in San Diego over the Swedish midsummer weekend (June 23-26). With over 12,000 attendees present onsite, the four days of the congress were full of basic science, epidemiology, and scientific research, including the results of several clinical trials.
Antaros Medical also presented a poster on novel data on whole-body imaging of in vivo metabolism using Positron Emission Tomography (PET) / Magnetic Resonance Imaging (MRI). In addition to this, we were able to attend many interesting sessions, and below we describe a couple of our personal highlights.
Highlight 1: Nutrient-stimulated hormones – Anti-obesity pharmacotherapy game changers
The Nutrient-stimulated hormones – Anti-obesity pharmacotherapy game changers symposium, and the entire Obesity/Integrated Physiology theme area, really demonstrated the growing presence that obesity is having in diabetes research. The session, co-chaired by Richard DiMarchi and Jenny Tong, raised the opportunities that are presented with combination therapies that can target multiple pathways.
Obesity appeared in many session and presentations throughout the congress, but in this session the focus was on the roles of glucose dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), amylin, peptide YY (PYY), which were presented by Jonathan Campbell, David C. W. Lau, and Tricia M. Tan, respectively. Ania M. Jastreboff then commented on the potential clinical implications of nutrient-stimulated hormone pharmacotherapy on the future of obesity treatment. For more details, ADA has published a nice summary of the session here.
The link between type 2 diabetes (T2D) and obesity has long been observed and it is believed that there are several underlying mechanisms at play, including but not limited to, adiposity-induced changes to β cell function and the development of multi-organ insulin resistance. As such, it stands to reason that targeting multiple pathways with combination therapies holds promise for more efficacious treatment results.
This session gave an overview of several different therapeutic pathways for inducing weight loss via nutrient-stimulated hormones, and there are numerous other promising targets that were not mentioned. While it was exciting to hear about the latest developments, this session also highlighted how much there is still to be understood and uncovered in the research of combination therapies for treatment of obesity. For example, investigating the relative contributions of each component of a combination therapy could help to elucidate various mechanisms of action, taking a closer look at treatment responses could help to identify synergistic vs. competitive effects, or using techniques such as imaging could enable simultaneous assessment of effects across multiple organs.
Highlight 2: Overcoming obesity: the discovery of multi receptor drugs
The 2023 Banting Medal for Scientific Achievement Lecture was given by Matthias H. Tschöp, who was awarded the honour for his contributions to diabetes research.
His lecture covered incretins, ‘twincretins’, triple incretins, and the road to pharmacological discovery. He described the journey from early studies looking at ghrelin, gut hormones, and brain circuits in his lab to the US Food & Drug Administration (FDA)’s recent approval of the first dual GIP/GLP-1 agonist. On the basis of these earlier studies, it was hypothesised that targeting only one receptor or pathway would not be sufficient for realising the full potential of weight loss therapies.
The impact of this research is evident in the number of bi- and trimodal agonists for GIP, GLP-1 and glucagon that are currently in development and being investigated for both type 2 diabetes (T2D) and obesity, and the results from many of these clinical trials were also presented at the meeting.
Even so, Prof. Tschöp admits that there is still work to be done in understanding the molecular mechanisms behind this new class of drugs. Here again, efforts should be made to investigate the pharmacology of these therapies, as we have done by using PET imaging to understand the pharmacokinetic and pharmacodynamic effects of bimodal incretin agonists.
This could become increasingly important as we start to consider treating different obesity phenotypes with varying drivers of disease with precision medicine. An exciting avenue for future obesity research, this was another reflection be Prof. Tschöp that we found particularly interesting.
To summarise briefly, we chose and described 2 personal highlights from the multitude of interesting research that was presented at this year’s ADA Scientific Sessions meeting:
- Nutrient-stimulated hormones – Anti-obesity pharmacotherapy game changers, Richard Di Marchi, Jenny Tong, Jonathan Campbell, David C. W. Lau, Tricia M. Tan, and Ania M. Jastreboff
- Overcoming obesity: the discovery of multi receptor drugs, Matthias H. Tschöp
We are looking forward to seeing what advances in research are presented at the ADA’s 84th Scientific Sessions next year in Orlando, Florida.
The views and opinions expressed in this article are solely those of the contributing author/s. These views and opinions do not necessarily represent those of Antaros Medical.
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