Type 2 Diabetes ICYMI

Key clinical point: Stringent management of blood pressure (BP) with amlodipine in addition to standard diabetes therapy significantly improved glycemic control in patients with type 2 diabetes  (T2D) compared with standard diabetes therapy alone.

Major finding: After 24 weeks, amlodipine plus standard diabetes therapy vs. standard diabetes therapy alone led to a significant reduction in the mean glycated hemoglobin level (6.62% vs 7.01%; P = .01), fasting plasma glucose level (122 vs 129 mg/dL; P < .001), systolic blood pressure (132 vs 143 mm Hg; P < .001), and diastolic blood pressure (78.9 vs 86.0 mm Hg; P < .001), with neural effects on the lipid profile and urinary albumin excretion.

Study details: Findings are from a prospective cohort study including 168 patients with newly diagnosed T2D who received amlodipine plus standard diabetes therapy (n = 87) or standard diabetes therapy alone (n = 81).

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Li JC et al. Antihypertensive treatment improves glycemic control in patients with newly diagnosed type 2 diabetes mellitus: A prospective cohort study. Front Endocrinol (Lausanne). 2022;13:935561  (Sep 9). Doi: 10.3389/fendo.2022.935561.

Key clinical point: Stringent management of blood pressure (BP) with amlodipine in addition to standard diabetes therapy significantly improved glycemic control in patients with type 2 diabetes  (T2D) compared with standard diabetes therapy alone.

Major finding: After 24 weeks, amlodipine plus standard diabetes therapy vs. standard diabetes therapy alone led to a significant reduction in the mean glycated hemoglobin level (6.62% vs 7.01%; P = .01), fasting plasma glucose level (122 vs 129 mg/dL; P < .001), systolic blood pressure (132 vs 143 mm Hg; P < .001), and diastolic blood pressure (78.9 vs 86.0 mm Hg; P < .001), with neural effects on the lipid profile and urinary albumin excretion.

Study details: Findings are from a prospective cohort study including 168 patients with newly diagnosed T2D who received amlodipine plus standard diabetes therapy (n = 87) or standard diabetes therapy alone (n = 81).

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Li JC et al. Antihypertensive treatment improves glycemic control in patients with newly diagnosed type 2 diabetes mellitus: A prospective cohort study. Front Endocrinol (Lausanne). 2022;13:935561  (Sep 9). Doi: 10.3389/fendo.2022.935561.

Key clinical point: Stringent management of blood pressure (BP) with amlodipine in addition to standard diabetes therapy significantly improved glycemic control in patients with type 2 diabetes  (T2D) compared with standard diabetes therapy alone.

Major finding: After 24 weeks, amlodipine plus standard diabetes therapy vs. standard diabetes therapy alone led to a significant reduction in the mean glycated hemoglobin level (6.62% vs 7.01%; P = .01), fasting plasma glucose level (122 vs 129 mg/dL; P < .001), systolic blood pressure (132 vs 143 mm Hg; P < .001), and diastolic blood pressure (78.9 vs 86.0 mm Hg; P < .001), with neural effects on the lipid profile and urinary albumin excretion.

Study details: Findings are from a prospective cohort study including 168 patients with newly diagnosed T2D who received amlodipine plus standard diabetes therapy (n = 87) or standard diabetes therapy alone (n = 81).

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Li JC et al. Antihypertensive treatment improves glycemic control in patients with newly diagnosed type 2 diabetes mellitus: A prospective cohort study. Front Endocrinol (Lausanne). 2022;13:935561  (Sep 9). Doi: 10.3389/fendo.2022.935561.

Key clinical point: Patients with type 2 diabetes mellitus (T2D) receiving metformin vs other antidiabetic drugs or placebo had a higher risk for gastrointestinal (GI) adverse events (AE) such as abdominal pain, nausea, and diarrhea, with the risk for bloating and diarrhea being higher with metformin immediate release (IR) vs extended release (XR).

Major finding: Patients treated with metformin vs. placebo or any other antidiabetic drug were at a significantly higher risk for abdominal pain (risk ratio [RR] 1.491; P = .0001), diarrhea (RR 2.445; P = .0001), and nausea (RR 1.641; P = .0004). The risks for bloating (coefficient −0.89; P = .76) and diarrhea (coefficient −0.344; P = .0437) were higher with metformin IR vs XR.

Study details: The data come from a meta-analysis of 71 randomized controlled trials including 55,042 patients with T2D who were randomly assigned to receive metformin or comparators.

Disclosures: This study received no specific funding. The authors declared no conflicts of interest.

Source: Nabrdalik K et al. Gastrointestinal adverse events of metformin treatment in patients with type 2 diabetes mellitus: A systematic review, meta-analysis and meta-regression of randomized controlled trials. Front Endocrinol (Lausanne). 2022;13:975912 (Sep 14). Doi: 10.3389/fendo.2022.975912

Key clinical point: Patients with type 2 diabetes mellitus (T2D) receiving metformin vs other antidiabetic drugs or placebo had a higher risk for gastrointestinal (GI) adverse events (AE) such as abdominal pain, nausea, and diarrhea, with the risk for bloating and diarrhea being higher with metformin immediate release (IR) vs extended release (XR).

Major finding: Patients treated with metformin vs. placebo or any other antidiabetic drug were at a significantly higher risk for abdominal pain (risk ratio [RR] 1.491; P = .0001), diarrhea (RR 2.445; P = .0001), and nausea (RR 1.641; P = .0004). The risks for bloating (coefficient −0.89; P = .76) and diarrhea (coefficient −0.344; P = .0437) were higher with metformin IR vs XR.

Study details: The data come from a meta-analysis of 71 randomized controlled trials including 55,042 patients with T2D who were randomly assigned to receive metformin or comparators.

Disclosures: This study received no specific funding. The authors declared no conflicts of interest.

Source: Nabrdalik K et al. Gastrointestinal adverse events of metformin treatment in patients with type 2 diabetes mellitus: A systematic review, meta-analysis and meta-regression of randomized controlled trials. Front Endocrinol (Lausanne). 2022;13:975912 (Sep 14). Doi: 10.3389/fendo.2022.975912

Key clinical point: Patients with type 2 diabetes mellitus (T2D) receiving metformin vs other antidiabetic drugs or placebo had a higher risk for gastrointestinal (GI) adverse events (AE) such as abdominal pain, nausea, and diarrhea, with the risk for bloating and diarrhea being higher with metformin immediate release (IR) vs extended release (XR).

Major finding: Patients treated with metformin vs. placebo or any other antidiabetic drug were at a significantly higher risk for abdominal pain (risk ratio [RR] 1.491; P = .0001), diarrhea (RR 2.445; P = .0001), and nausea (RR 1.641; P = .0004). The risks for bloating (coefficient −0.89; P = .76) and diarrhea (coefficient −0.344; P = .0437) were higher with metformin IR vs XR.

Study details: The data come from a meta-analysis of 71 randomized controlled trials including 55,042 patients with T2D who were randomly assigned to receive metformin or comparators.

Disclosures: This study received no specific funding. The authors declared no conflicts of interest.

Source: Nabrdalik K et al. Gastrointestinal adverse events of metformin treatment in patients with type 2 diabetes mellitus: A systematic review, meta-analysis and meta-regression of randomized controlled trials. Front Endocrinol (Lausanne). 2022;13:975912 (Sep 14). Doi: 10.3389/fendo.2022.975912

Key clinical point: Patients with type 2 diabetes (T2D) who used metformin vs. sulfonylurea were at a significantly lower risk for all-cause dementia, Alzheimer’s disease (AD), and vascular dementia (VD), but not Parkinson’s disease (PD) or mild cognitive impairment (MCI).

Major finding: The risk for all-cause dementia (hazard ratio [HR] 0.80; 95% CI 0.73-0.88), AD (HR 0.81; 95% CI 0.70-0.94), and VD (HR 0.79; 95% CI 0.63-1.00) was significantly lower in metformin vs sulfonylurea users, with no significant difference in the risk for PD and MCI.

Study details: Findings are from a new user active comparator study including 112,591 patients with T2D, of which 96,140 were new metformin users and 16,451 were new sulfonylurea users.

Disclosures: This study was supported by Janssen Pharmaceuticals. AJ Nevado-Holgado declared receiving funding from Janssen Pharmaceuticals and others. QS Li declared being an employee of Janssen Research & Development, Johnson & Johnson, or holding equity in Johnson & Johnson.

Source: Newby D et al. Comparative effect of metformin versus sulfonylureas with dementia and Parkinson's disease risk in US patients over 50 with type 2 diabetes mellitus. BMJ Open Diabetes Res Care. 2022;10(5):e003036 (Sep 15). Doi: 10.1136/bmjdrc-2022-003036

Key clinical point: Patients with type 2 diabetes (T2D) who used metformin vs. sulfonylurea were at a significantly lower risk for all-cause dementia, Alzheimer’s disease (AD), and vascular dementia (VD), but not Parkinson’s disease (PD) or mild cognitive impairment (MCI).

Major finding: The risk for all-cause dementia (hazard ratio [HR] 0.80; 95% CI 0.73-0.88), AD (HR 0.81; 95% CI 0.70-0.94), and VD (HR 0.79; 95% CI 0.63-1.00) was significantly lower in metformin vs sulfonylurea users, with no significant difference in the risk for PD and MCI.

Study details: Findings are from a new user active comparator study including 112,591 patients with T2D, of which 96,140 were new metformin users and 16,451 were new sulfonylurea users.

Disclosures: This study was supported by Janssen Pharmaceuticals. AJ Nevado-Holgado declared receiving funding from Janssen Pharmaceuticals and others. QS Li declared being an employee of Janssen Research & Development, Johnson & Johnson, or holding equity in Johnson & Johnson.

Source: Newby D et al. Comparative effect of metformin versus sulfonylureas with dementia and Parkinson's disease risk in US patients over 50 with type 2 diabetes mellitus. BMJ Open Diabetes Res Care. 2022;10(5):e003036 (Sep 15). Doi: 10.1136/bmjdrc-2022-003036

Key clinical point: Patients with type 2 diabetes (T2D) who used metformin vs. sulfonylurea were at a significantly lower risk for all-cause dementia, Alzheimer’s disease (AD), and vascular dementia (VD), but not Parkinson’s disease (PD) or mild cognitive impairment (MCI).

Major finding: The risk for all-cause dementia (hazard ratio [HR] 0.80; 95% CI 0.73-0.88), AD (HR 0.81; 95% CI 0.70-0.94), and VD (HR 0.79; 95% CI 0.63-1.00) was significantly lower in metformin vs sulfonylurea users, with no significant difference in the risk for PD and MCI.

Study details: Findings are from a new user active comparator study including 112,591 patients with T2D, of which 96,140 were new metformin users and 16,451 were new sulfonylurea users.

Disclosures: This study was supported by Janssen Pharmaceuticals. AJ Nevado-Holgado declared receiving funding from Janssen Pharmaceuticals and others. QS Li declared being an employee of Janssen Research & Development, Johnson & Johnson, or holding equity in Johnson & Johnson.

Source: Newby D et al. Comparative effect of metformin versus sulfonylureas with dementia and Parkinson's disease risk in US patients over 50 with type 2 diabetes mellitus. BMJ Open Diabetes Res Care. 2022;10(5):e003036 (Sep 15). Doi: 10.1136/bmjdrc-2022-003036

Key clinical point: Combination of saxagliptin with metformin, acarbose, or gliclazide modified release was safe and effective as an initial treatment option in patients with newly diagnosed type 2 diabetes (T2D) and poor glycemic control.

Major finding: At 24 weeks, the mean changes in glycated hemoglobin (A1c) levels were −2.9% (95% CI −3.1% to −2.8%), −2.6% (95% CI −2.8% to −2.5%), and −2.8% (95% CI −2.9% to −2.6%) in saxagliptin+metformin (Saxa+Met), saxagliptin+acarbose (Saxa+Aca), and saxagliptin+gliclazide (Saxa+Gli) groups, respectively. Overall, 84.9%, 74.7%, and 80.3% of participants achieved an A1c < 7.0% in Saxa+Met, Saxa+Aca, and Saxa+Gli groups, respectively (P = .05), with the rates of hypoglycemia being low across all groups.

Study details: Findings are from a 24-week, randomized clinical trial including 648 treatment-naive patients with T2D and high A1c level who were randomly assigned to receive Saxa+Met (n = 216), Saxa+Aca (n = 216), or Saxa+Gli (n = 216).

Disclosures: This study was funded by AstraZeneca Pharmaceutical Company. The authors declared no conflicts of interest.

Source: Chen X et al. Saxagliptin combined with additional oral antihyperglycemic agents in drug-naive diabetic patients with high glycosylated hemoglobin: A 24-week, multicenter, randomized, open-label, active parallel-controlled group clinical trial in China (SUCCESS). Diabetes Obes Metab. 2022 (Sep 13). Doi: 10.1111/dom.14873

Key clinical point: Combination of saxagliptin with metformin, acarbose, or gliclazide modified release was safe and effective as an initial treatment option in patients with newly diagnosed type 2 diabetes (T2D) and poor glycemic control.

Major finding: At 24 weeks, the mean changes in glycated hemoglobin (A1c) levels were −2.9% (95% CI −3.1% to −2.8%), −2.6% (95% CI −2.8% to −2.5%), and −2.8% (95% CI −2.9% to −2.6%) in saxagliptin+metformin (Saxa+Met), saxagliptin+acarbose (Saxa+Aca), and saxagliptin+gliclazide (Saxa+Gli) groups, respectively. Overall, 84.9%, 74.7%, and 80.3% of participants achieved an A1c < 7.0% in Saxa+Met, Saxa+Aca, and Saxa+Gli groups, respectively (P = .05), with the rates of hypoglycemia being low across all groups.

Study details: Findings are from a 24-week, randomized clinical trial including 648 treatment-naive patients with T2D and high A1c level who were randomly assigned to receive Saxa+Met (n = 216), Saxa+Aca (n = 216), or Saxa+Gli (n = 216).

Disclosures: This study was funded by AstraZeneca Pharmaceutical Company. The authors declared no conflicts of interest.

Source: Chen X et al. Saxagliptin combined with additional oral antihyperglycemic agents in drug-naive diabetic patients with high glycosylated hemoglobin: A 24-week, multicenter, randomized, open-label, active parallel-controlled group clinical trial in China (SUCCESS). Diabetes Obes Metab. 2022 (Sep 13). Doi: 10.1111/dom.14873

Key clinical point: Combination of saxagliptin with metformin, acarbose, or gliclazide modified release was safe and effective as an initial treatment option in patients with newly diagnosed type 2 diabetes (T2D) and poor glycemic control.

Major finding: At 24 weeks, the mean changes in glycated hemoglobin (A1c) levels were −2.9% (95% CI −3.1% to −2.8%), −2.6% (95% CI −2.8% to −2.5%), and −2.8% (95% CI −2.9% to −2.6%) in saxagliptin+metformin (Saxa+Met), saxagliptin+acarbose (Saxa+Aca), and saxagliptin+gliclazide (Saxa+Gli) groups, respectively. Overall, 84.9%, 74.7%, and 80.3% of participants achieved an A1c < 7.0% in Saxa+Met, Saxa+Aca, and Saxa+Gli groups, respectively (P = .05), with the rates of hypoglycemia being low across all groups.

Study details: Findings are from a 24-week, randomized clinical trial including 648 treatment-naive patients with T2D and high A1c level who were randomly assigned to receive Saxa+Met (n = 216), Saxa+Aca (n = 216), or Saxa+Gli (n = 216).

Disclosures: This study was funded by AstraZeneca Pharmaceutical Company. The authors declared no conflicts of interest.

Source: Chen X et al. Saxagliptin combined with additional oral antihyperglycemic agents in drug-naive diabetic patients with high glycosylated hemoglobin: A 24-week, multicenter, randomized, open-label, active parallel-controlled group clinical trial in China (SUCCESS). Diabetes Obes Metab. 2022 (Sep 13). Doi: 10.1111/dom.14873

Key clinical point: As an adjunct to metformin, bexagliflozin (20 mg) demonstrated antidiabetic potency equivalent to titrated glimepiride in patients with type 2 diabetes (T2D) inadequately controlled on metformin. Additional benefits were demonstrated in the form of weight loss, reduced systolic blood pressure (SBP), and fewer hypoglycemic events.

Major finding: At week 60, the least squares mean difference in glycated hemoglobin levels between bexagliflozin and glimepiride was −0.05% (95% CI −0.21% to 0.11%), showing noninferiority of bexagliflozin over glimepiride; however, bexagliflozin was superior to glimepiride for weight loss (P < .0001), decrease in SBP (P = .0008), and hypoglycemia incidence (P < .0001).

Study details: This 96-week randomized controlled trial included 426 patients with T2D (7.0% ≤ A1c ≤ 10.5%) inadequately controlled on metformin who were randomly assigned to receive bexagliflozin (n = 213) or titrated glimepiride (n = 213).

Disclosures: This study was funded by Theracos Sub, LLC. Some authors including the lead author were supported by a research grant to the Massachusetts General Hospital from Theracos Sub, LLC.

Source: Halvorsen YD et al. A 96-week, double-blind, randomized, controlled trial comparing bexagliflozin to glimepiride as an adjunct to metformin for the treatment of type 2 diabetes in adults. Diabetes Obes Metab. 2022 (Sep 30). Doi: 10.1111/dom.14875

Key clinical point: As an adjunct to metformin, bexagliflozin (20 mg) demonstrated antidiabetic potency equivalent to titrated glimepiride in patients with type 2 diabetes (T2D) inadequately controlled on metformin. Additional benefits were demonstrated in the form of weight loss, reduced systolic blood pressure (SBP), and fewer hypoglycemic events.

Major finding: At week 60, the least squares mean difference in glycated hemoglobin levels between bexagliflozin and glimepiride was −0.05% (95% CI −0.21% to 0.11%), showing noninferiority of bexagliflozin over glimepiride; however, bexagliflozin was superior to glimepiride for weight loss (P < .0001), decrease in SBP (P = .0008), and hypoglycemia incidence (P < .0001).

Study details: This 96-week randomized controlled trial included 426 patients with T2D (7.0% ≤ A1c ≤ 10.5%) inadequately controlled on metformin who were randomly assigned to receive bexagliflozin (n = 213) or titrated glimepiride (n = 213).

Disclosures: This study was funded by Theracos Sub, LLC. Some authors including the lead author were supported by a research grant to the Massachusetts General Hospital from Theracos Sub, LLC.

Source: Halvorsen YD et al. A 96-week, double-blind, randomized, controlled trial comparing bexagliflozin to glimepiride as an adjunct to metformin for the treatment of type 2 diabetes in adults. Diabetes Obes Metab. 2022 (Sep 30). Doi: 10.1111/dom.14875

Key clinical point: As an adjunct to metformin, bexagliflozin (20 mg) demonstrated antidiabetic potency equivalent to titrated glimepiride in patients with type 2 diabetes (T2D) inadequately controlled on metformin. Additional benefits were demonstrated in the form of weight loss, reduced systolic blood pressure (SBP), and fewer hypoglycemic events.

Major finding: At week 60, the least squares mean difference in glycated hemoglobin levels between bexagliflozin and glimepiride was −0.05% (95% CI −0.21% to 0.11%), showing noninferiority of bexagliflozin over glimepiride; however, bexagliflozin was superior to glimepiride for weight loss (P < .0001), decrease in SBP (P = .0008), and hypoglycemia incidence (P < .0001).

Study details: This 96-week randomized controlled trial included 426 patients with T2D (7.0% ≤ A1c ≤ 10.5%) inadequately controlled on metformin who were randomly assigned to receive bexagliflozin (n = 213) or titrated glimepiride (n = 213).

Disclosures: This study was funded by Theracos Sub, LLC. Some authors including the lead author were supported by a research grant to the Massachusetts General Hospital from Theracos Sub, LLC.

Source: Halvorsen YD et al. A 96-week, double-blind, randomized, controlled trial comparing bexagliflozin to glimepiride as an adjunct to metformin for the treatment of type 2 diabetes in adults. Diabetes Obes Metab. 2022 (Sep 30). Doi: 10.1111/dom.14875

Key clinical point: Patients with type 2 diabetes (T2D) who used sulfonylurea were at a higher risk for ventricular arrhythmia or sudden cardiac death (VA/SCD) compared with those who used metformin, irrespective of the severity of diabetes or history of coronary heart disease.

Major finding: Patients receiving sulfonylurea vs metformin had a significantly higher risk for VA/SCD (hazard ratio [HR] 1.90; 95% CI 1.73-2.08), with the results being consistent in both insulin users (HR 1.82; 95% CI 1.52-2.18) and nonusers (HR 1.92; 95% CI 1.73-2.13) and patients with (HR 1.64; 95% CI 1.34-2.02) and without (HR 1.95; 95% CI 1.76-2.16) coronary heart disease.

Study details: Findings are from a population-based cohort study including patients with T2D receiving metformin (n = 16,596) who were matched with those receiving sulfonylurea (n = 16,596) using propensity score matching.

Disclosures: This study did not receive any funding. The authors declared no competing interests.

Source: Lee TTL et al. Sulfonylurea is associated with higher risks of ventricular arrhythmia or sudden cardiac death compared with metformin: A population-based cohort study. J Am Heart Assoc. 2022;11(18):e026289 (Sep 14). Doi: 10.1161/JAHA.122.026289

Key clinical point: Patients with type 2 diabetes (T2D) who used sulfonylurea were at a higher risk for ventricular arrhythmia or sudden cardiac death (VA/SCD) compared with those who used metformin, irrespective of the severity of diabetes or history of coronary heart disease.

Major finding: Patients receiving sulfonylurea vs metformin had a significantly higher risk for VA/SCD (hazard ratio [HR] 1.90; 95% CI 1.73-2.08), with the results being consistent in both insulin users (HR 1.82; 95% CI 1.52-2.18) and nonusers (HR 1.92; 95% CI 1.73-2.13) and patients with (HR 1.64; 95% CI 1.34-2.02) and without (HR 1.95; 95% CI 1.76-2.16) coronary heart disease.

Study details: Findings are from a population-based cohort study including patients with T2D receiving metformin (n = 16,596) who were matched with those receiving sulfonylurea (n = 16,596) using propensity score matching.

Disclosures: This study did not receive any funding. The authors declared no competing interests.

Source: Lee TTL et al. Sulfonylurea is associated with higher risks of ventricular arrhythmia or sudden cardiac death compared with metformin: A population-based cohort study. J Am Heart Assoc. 2022;11(18):e026289 (Sep 14). Doi: 10.1161/JAHA.122.026289

Key clinical point: Patients with type 2 diabetes (T2D) who used sulfonylurea were at a higher risk for ventricular arrhythmia or sudden cardiac death (VA/SCD) compared with those who used metformin, irrespective of the severity of diabetes or history of coronary heart disease.

Major finding: Patients receiving sulfonylurea vs metformin had a significantly higher risk for VA/SCD (hazard ratio [HR] 1.90; 95% CI 1.73-2.08), with the results being consistent in both insulin users (HR 1.82; 95% CI 1.52-2.18) and nonusers (HR 1.92; 95% CI 1.73-2.13) and patients with (HR 1.64; 95% CI 1.34-2.02) and without (HR 1.95; 95% CI 1.76-2.16) coronary heart disease.

Study details: Findings are from a population-based cohort study including patients with T2D receiving metformin (n = 16,596) who were matched with those receiving sulfonylurea (n = 16,596) using propensity score matching.

Disclosures: This study did not receive any funding. The authors declared no competing interests.

Source: Lee TTL et al. Sulfonylurea is associated with higher risks of ventricular arrhythmia or sudden cardiac death compared with metformin: A population-based cohort study. J Am Heart Assoc. 2022;11(18):e026289 (Sep 14). Doi: 10.1161/JAHA.122.026289

Key clinical point: Glucagon-like peptide-1 receptor agonists (GLP1-RAs) and sulfonylureas (SUs) provide better protection against fractures in patients with type 2 diabetes (T2D) compared with thiazolidinedione (TZD). Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) and dipeptidyl peptidase-4 inhibitors (DPP-4is) increase fracture risk vs. GLP1-RAs.

Major finding: Compared with TZD, the risk for fracture was significantly lower with GLP1-RA (risk ratio [RR], 0.50; 95% CI, 0.31-0.79) and sulfonylurea (RR, 0.56; 95% CI, 0.41-0.77); however, the risk was significantly higher with DPP-4i (RR, 1.76; 95% CI, 1.21-2.55) and SGLT-2i (RR, 1.50; 95% CI, 1.05-2.16) vs. GLP1-RA.

Study details: The data come from a meta-analysis of 161 trials including 191,361 patients with T2D who reported 2,916 fractures.

Disclosures: This study received no specific funding. The authors declared no conflicts of interest.

Source: Tsai WH et al. Risk of fracture caused by anti-diabetic drugs in individuals with type 2 diabetes: A network meta-analysis. Diabetes Res Clin Pract. 2022;192:110082  (Sep 16). Doi: 10.1016/j.diabres.2022.110082.

Key clinical point: Glucagon-like peptide-1 receptor agonists (GLP1-RAs) and sulfonylureas (SUs) provide better protection against fractures in patients with type 2 diabetes (T2D) compared with thiazolidinedione (TZD). Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) and dipeptidyl peptidase-4 inhibitors (DPP-4is) increase fracture risk vs. GLP1-RAs.

Major finding: Compared with TZD, the risk for fracture was significantly lower with GLP1-RA (risk ratio [RR], 0.50; 95% CI, 0.31-0.79) and sulfonylurea (RR, 0.56; 95% CI, 0.41-0.77); however, the risk was significantly higher with DPP-4i (RR, 1.76; 95% CI, 1.21-2.55) and SGLT-2i (RR, 1.50; 95% CI, 1.05-2.16) vs. GLP1-RA.

Study details: The data come from a meta-analysis of 161 trials including 191,361 patients with T2D who reported 2,916 fractures.

Disclosures: This study received no specific funding. The authors declared no conflicts of interest.

Source: Tsai WH et al. Risk of fracture caused by anti-diabetic drugs in individuals with type 2 diabetes: A network meta-analysis. Diabetes Res Clin Pract. 2022;192:110082  (Sep 16). Doi: 10.1016/j.diabres.2022.110082.

Key clinical point: Glucagon-like peptide-1 receptor agonists (GLP1-RAs) and sulfonylureas (SUs) provide better protection against fractures in patients with type 2 diabetes (T2D) compared with thiazolidinedione (TZD). Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) and dipeptidyl peptidase-4 inhibitors (DPP-4is) increase fracture risk vs. GLP1-RAs.

Major finding: Compared with TZD, the risk for fracture was significantly lower with GLP1-RA (risk ratio [RR], 0.50; 95% CI, 0.31-0.79) and sulfonylurea (RR, 0.56; 95% CI, 0.41-0.77); however, the risk was significantly higher with DPP-4i (RR, 1.76; 95% CI, 1.21-2.55) and SGLT-2i (RR, 1.50; 95% CI, 1.05-2.16) vs. GLP1-RA.

Study details: The data come from a meta-analysis of 161 trials including 191,361 patients with T2D who reported 2,916 fractures.

Disclosures: This study received no specific funding. The authors declared no conflicts of interest.

Source: Tsai WH et al. Risk of fracture caused by anti-diabetic drugs in individuals with type 2 diabetes: A network meta-analysis. Diabetes Res Clin Pract. 2022;192:110082  (Sep 16). Doi: 10.1016/j.diabres.2022.110082.

Key clinical point: Once-weekly tirzepatide vs. insulin glargine slowed estimated glomerular filtration rate (eGFR) decline, and reduced urine albumin-creatinine ratio (UACR) and the risk for composite kidney outcomes in patients with type 2 diabetes (T2D) with varying degrees of chronic kidney disease and high cardiovascular risk.

Major finding: Combined tirzepatide vs. insulin glargine was associated with slower annual rates of eGFR decline (between-group difference [Δ], 2.2 [95% CI, 1.6-2.8] mL/min per 1.73 m²) and reduced UACR increase (Δ, −31.9%; 95% CI, −37.7% to −25.7%) and risk for composite kidney outcomes (hazard ratio, 0.58; 95% CI, 0.43-0.80).

Study details: This was a post hoc analysis of SURPASS-4 trial including 2,002 patients with T2D and high cardiovascular risk who were randomly assigned to receive once-weekly tirzepatide (5, 10, or 15 mg; n=997) or insulin glargine (n=1,005).

Disclosures: This study was funded by Eli Lilly and Company. Some authors declared receiving research grants, contract support, payment/honoraria for speaking, and/or consulting fees from various sources, including Eli Lilly. Some authors declared being employees and shareholders of Eli Lilly.

Source: Heerspink HJL et al. Effects of tirzepatide versus insulin glargine on kidney outcomes in type 2 diabetes in the SURPASS-4 trial: Post-hoc analysis of an open-label, randomised, phase 3 trial. Lancet Diabetes Endocrinol. 2022 (Sep 21). Doi: 10.1016/S2213-8587(22)00243-1.

Key clinical point: Once-weekly tirzepatide vs. insulin glargine slowed estimated glomerular filtration rate (eGFR) decline, and reduced urine albumin-creatinine ratio (UACR) and the risk for composite kidney outcomes in patients with type 2 diabetes (T2D) with varying degrees of chronic kidney disease and high cardiovascular risk.

Major finding: Combined tirzepatide vs. insulin glargine was associated with slower annual rates of eGFR decline (between-group difference [Δ], 2.2 [95% CI, 1.6-2.8] mL/min per 1.73 m²) and reduced UACR increase (Δ, −31.9%; 95% CI, −37.7% to −25.7%) and risk for composite kidney outcomes (hazard ratio, 0.58; 95% CI, 0.43-0.80).

Study details: This was a post hoc analysis of SURPASS-4 trial including 2,002 patients with T2D and high cardiovascular risk who were randomly assigned to receive once-weekly tirzepatide (5, 10, or 15 mg; n=997) or insulin glargine (n=1,005).

Disclosures: This study was funded by Eli Lilly and Company. Some authors declared receiving research grants, contract support, payment/honoraria for speaking, and/or consulting fees from various sources, including Eli Lilly. Some authors declared being employees and shareholders of Eli Lilly.

Source: Heerspink HJL et al. Effects of tirzepatide versus insulin glargine on kidney outcomes in type 2 diabetes in the SURPASS-4 trial: Post-hoc analysis of an open-label, randomised, phase 3 trial. Lancet Diabetes Endocrinol. 2022 (Sep 21). Doi: 10.1016/S2213-8587(22)00243-1.

Key clinical point: Once-weekly tirzepatide vs. insulin glargine slowed estimated glomerular filtration rate (eGFR) decline, and reduced urine albumin-creatinine ratio (UACR) and the risk for composite kidney outcomes in patients with type 2 diabetes (T2D) with varying degrees of chronic kidney disease and high cardiovascular risk.

Major finding: Combined tirzepatide vs. insulin glargine was associated with slower annual rates of eGFR decline (between-group difference [Δ], 2.2 [95% CI, 1.6-2.8] mL/min per 1.73 m²) and reduced UACR increase (Δ, −31.9%; 95% CI, −37.7% to −25.7%) and risk for composite kidney outcomes (hazard ratio, 0.58; 95% CI, 0.43-0.80).

Study details: This was a post hoc analysis of SURPASS-4 trial including 2,002 patients with T2D and high cardiovascular risk who were randomly assigned to receive once-weekly tirzepatide (5, 10, or 15 mg; n=997) or insulin glargine (n=1,005).

Disclosures: This study was funded by Eli Lilly and Company. Some authors declared receiving research grants, contract support, payment/honoraria for speaking, and/or consulting fees from various sources, including Eli Lilly. Some authors declared being employees and shareholders of Eli Lilly.

Source: Heerspink HJL et al. Effects of tirzepatide versus insulin glargine on kidney outcomes in type 2 diabetes in the SURPASS-4 trial: Post-hoc analysis of an open-label, randomised, phase 3 trial. Lancet Diabetes Endocrinol. 2022 (Sep 21). Doi: 10.1016/S2213-8587(22)00243-1.

Mind and body practices, especially yoga, improve glycemic control in type 2 diabetes to a similar extent as medications such as metformin, new research shows.

“To our knowledge, this is the first study that has looked across different modalities of mind-body interventions and the first to show that there is a very consistent effect on A1c regardless of which modality you use,” senior author, Richard Watanabe, PhD, professor of biostatistics, Keck School of Medicine of the University of Southern California, Los Angeles, told this news organization.

none needed

Regularity of yoga practice makes the difference

A total of 28 studies of patients with type 2 diabetes published between 1993 and 2022 were included in the meta-analysis. In all studies, patients who were taking insulin or had any medical complications of diabetes were excluded.

A significant mean reduction in A1c of 0.84% was observed across the board for all types of mindfulness interventions (P < .0001).

For mindfulness-based stress reduction, A1c was reduced by 0.48% (P = 0.03), while the practice of qigong – a coordinated body-posture movement – was associated with a 0.66% drop in A1c (P = .01). For meditation, A1c dropped by 0.50% (P = .64).

However, the largest drop in A1c was seen with yoga, where it fell by 1.00% (P < .0001) – about the same degree of glycemic control achieved with metformin, the authors point out.  

Indeed, for every additional day of yoga practiced per week, mean A1c differed by –0.22% (P = .46) between those who engaged in mind-body interventions and those who did not.

There was also a reduction in fasting blood glucose (FBG) with yoga and other practices. “The mean change in FBG was consistent with the mean change in A1c at –22.81 mg/dL (P < .0001),” the authors continue.

The researchers found that the duration of yoga didn’t matter but the frequency did, so it’s the regularity “with which you do yoga that makes the difference,” Dr. Watanabe said.

Dr. Watanabe and his coauthors also point out that because most patients were actively receiving metformin before and throughout the studies, the observed effect of mind and body practices on A1c represents an additional reduction beyond that of medication.

“This raises the question [as to] whether mind and body practices could be useful when initiated early in the course of diabetes therapy along with conventional lifestyle treatments,” they suggest.

While more research is needed to study this specifically, “our results suggest that these mind-body practices might be a good preventative measure,” Dr. Watanabe noted. Mind-body practices may also effectively prevent type 2 diabetes in at-risk patients, the authors propose.
 

Does meditation help alleviate psychological distress?

How mind-body practices work to improve glycemic control isn’t clear, but one possible theory is that patients experience a decrease in psychological distress when they undertake such practices and in so doing, may be more compliant with their prescribed treatment regimen.

A few of the studies analyzed showed that mind-body work resulted in a significant decrease in serum cortisol, the stress hormone that could plausibly mediate the benefit of mind and body practices through reduced inflammation.

In addition, “people with diabetes live with what we call ‘diabetes distress,’ ” Dr. Watanabe explained.

“Management of blood glucose is very stressful. You have to watch what you eat, you have to measure your glucose, and for the average person, that gets stressful. And that stress just contributes to the difficulty of controlling blood glucose,” he noted.

The authors have reported no relevant financial relationships.

A version of this article first appeared on Medscape.com.

Mind and body practices, especially yoga, improve glycemic control in type 2 diabetes to a similar extent as medications such as metformin, new research shows.

“To our knowledge, this is the first study that has looked across different modalities of mind-body interventions and the first to show that there is a very consistent effect on A1c regardless of which modality you use,” senior author, Richard Watanabe, PhD, professor of biostatistics, Keck School of Medicine of the University of Southern California, Los Angeles, told this news organization.

none needed

Regularity of yoga practice makes the difference

A total of 28 studies of patients with type 2 diabetes published between 1993 and 2022 were included in the meta-analysis. In all studies, patients who were taking insulin or had any medical complications of diabetes were excluded.

A significant mean reduction in A1c of 0.84% was observed across the board for all types of mindfulness interventions (P < .0001).

For mindfulness-based stress reduction, A1c was reduced by 0.48% (P = 0.03), while the practice of qigong – a coordinated body-posture movement – was associated with a 0.66% drop in A1c (P = .01). For meditation, A1c dropped by 0.50% (P = .64).

However, the largest drop in A1c was seen with yoga, where it fell by 1.00% (P < .0001) – about the same degree of glycemic control achieved with metformin, the authors point out.  

Indeed, for every additional day of yoga practiced per week, mean A1c differed by –0.22% (P = .46) between those who engaged in mind-body interventions and those who did not.

There was also a reduction in fasting blood glucose (FBG) with yoga and other practices. “The mean change in FBG was consistent with the mean change in A1c at –22.81 mg/dL (P < .0001),” the authors continue.

The researchers found that the duration of yoga didn’t matter but the frequency did, so it’s the regularity “with which you do yoga that makes the difference,” Dr. Watanabe said.

Dr. Watanabe and his coauthors also point out that because most patients were actively receiving metformin before and throughout the studies, the observed effect of mind and body practices on A1c represents an additional reduction beyond that of medication.

“This raises the question [as to] whether mind and body practices could be useful when initiated early in the course of diabetes therapy along with conventional lifestyle treatments,” they suggest.

While more research is needed to study this specifically, “our results suggest that these mind-body practices might be a good preventative measure,” Dr. Watanabe noted. Mind-body practices may also effectively prevent type 2 diabetes in at-risk patients, the authors propose.
 

Does meditation help alleviate psychological distress?

How mind-body practices work to improve glycemic control isn’t clear, but one possible theory is that patients experience a decrease in psychological distress when they undertake such practices and in so doing, may be more compliant with their prescribed treatment regimen.

A few of the studies analyzed showed that mind-body work resulted in a significant decrease in serum cortisol, the stress hormone that could plausibly mediate the benefit of mind and body practices through reduced inflammation.

In addition, “people with diabetes live with what we call ‘diabetes distress,’ ” Dr. Watanabe explained.

“Management of blood glucose is very stressful. You have to watch what you eat, you have to measure your glucose, and for the average person, that gets stressful. And that stress just contributes to the difficulty of controlling blood glucose,” he noted.

The authors have reported no relevant financial relationships.

A version of this article first appeared on Medscape.com.

Mind and body practices, especially yoga, improve glycemic control in type 2 diabetes to a similar extent as medications such as metformin, new research shows.

“To our knowledge, this is the first study that has looked across different modalities of mind-body interventions and the first to show that there is a very consistent effect on A1c regardless of which modality you use,” senior author, Richard Watanabe, PhD, professor of biostatistics, Keck School of Medicine of the University of Southern California, Los Angeles, told this news organization.

none needed

Regularity of yoga practice makes the difference

A total of 28 studies of patients with type 2 diabetes published between 1993 and 2022 were included in the meta-analysis. In all studies, patients who were taking insulin or had any medical complications of diabetes were excluded.

A significant mean reduction in A1c of 0.84% was observed across the board for all types of mindfulness interventions (P < .0001).

For mindfulness-based stress reduction, A1c was reduced by 0.48% (P = 0.03), while the practice of qigong – a coordinated body-posture movement – was associated with a 0.66% drop in A1c (P = .01). For meditation, A1c dropped by 0.50% (P = .64).

However, the largest drop in A1c was seen with yoga, where it fell by 1.00% (P < .0001) – about the same degree of glycemic control achieved with metformin, the authors point out.  

Indeed, for every additional day of yoga practiced per week, mean A1c differed by –0.22% (P = .46) between those who engaged in mind-body interventions and those who did not.

There was also a reduction in fasting blood glucose (FBG) with yoga and other practices. “The mean change in FBG was consistent with the mean change in A1c at –22.81 mg/dL (P < .0001),” the authors continue.

The researchers found that the duration of yoga didn’t matter but the frequency did, so it’s the regularity “with which you do yoga that makes the difference,” Dr. Watanabe said.

Dr. Watanabe and his coauthors also point out that because most patients were actively receiving metformin before and throughout the studies, the observed effect of mind and body practices on A1c represents an additional reduction beyond that of medication.

“This raises the question [as to] whether mind and body practices could be useful when initiated early in the course of diabetes therapy along with conventional lifestyle treatments,” they suggest.

While more research is needed to study this specifically, “our results suggest that these mind-body practices might be a good preventative measure,” Dr. Watanabe noted. Mind-body practices may also effectively prevent type 2 diabetes in at-risk patients, the authors propose.
 

Does meditation help alleviate psychological distress?

How mind-body practices work to improve glycemic control isn’t clear, but one possible theory is that patients experience a decrease in psychological distress when they undertake such practices and in so doing, may be more compliant with their prescribed treatment regimen.

A few of the studies analyzed showed that mind-body work resulted in a significant decrease in serum cortisol, the stress hormone that could plausibly mediate the benefit of mind and body practices through reduced inflammation.

In addition, “people with diabetes live with what we call ‘diabetes distress,’ ” Dr. Watanabe explained.

“Management of blood glucose is very stressful. You have to watch what you eat, you have to measure your glucose, and for the average person, that gets stressful. And that stress just contributes to the difficulty of controlling blood glucose,” he noted.

The authors have reported no relevant financial relationships.

A version of this article first appeared on Medscape.com.

Researchers have developed a computer program to identify drugs for other diseases that might be repurposed to treat type 2 diabetes and/or obesity by targeting genetic pathways for these two conditions.

The scientists identified four pathways with known drug targets for type 2 diabetes and five with known drug targets for obesity.

Their findings suggest that:

• Palbociclib (used to treat breast cancer) and cardiac glycosides (used to treat heart failure and heart rhythm disorders) might be repurposed to treat type 2 diabetes.
• Baclofen (a muscle relaxant) and carfilzomib (a chemotherapy) could potentially be used to treat obesity.
• Fostamatinib (used to treat thrombocytopenia), sucralfate (used to treat stomach ulcers), and regorafenib (used to treat cancer) might be used to treat type 2 diabetes and obesity.
• Baclofen and sucralfate would have favorable safety profiles as repurposed treatments.

Sahar El Shair, a PhD student at the Faculty of Health and Medicine, University of Newcastle, New South Wales, Australia, presented the research during an oral session at the International Congress on Obesity, the biennial congress of the World Obesity Federation, in Melbourne.

“New treatments with higher activity and specificity are urgently needed to tackle a pandemic of chronic illness associated with type 2 diabetes and obesity,” senior coauthor Murray Cairns, PhD, said in a press release from the ICO.   

“Our technology harnesses genetically informed precision medicine to identify and target new treatments for these complex disorders,” said Dr. Cairns, from the school of biomedical sciences and pharmacy at the University of Newcastle.

Matchmaking between individual, their genetic traits, and drugs

Dr. Cairns and senior coauthor William Reay, PhD, also from the school of biomedical sciences and pharmacy, have cofounded a company called PolygenRx.

The company website explains that they have developed a propriety platform termed the pharmagenic enrichment score (PES), which is “essentially a matchmaking service between patients and drugs, allowing treatment to be optimized for each individual using their unique combination of genetic risk factors.”

It is important to note the genetic risk from complex traits, such as type 2 diabetes and obesity, “are quite different [from] the rare genetic disorders caused mostly by a devastating mutation in a single gene,” Dr. Cairns explained in an email.

“Complex traits,” he noted, “are associated with thousands of [genetic] variants that are common in people and have a cumulative effect.”

For this specific research, the investigators obtained genetic data from genome-wide association studies of obesity and type 2 diabetes.

“By using very large cohorts (hundreds of thousands of individuals) and comparing the frequency of millions of genetic variants in subjects with these conditions with controls, these studies have revealed regions of the genome and genes associated with the condition,” Dr. Cairns noted.

The pharmagenic enrichment score integrates a person’s genetics with drug pharmacology to determine if a person would respond more readily to a certain drug.

“We are investigating the potential of thousands of drugs across a broad spectrum of complex traits (the list is almost endless),” Dr. Cairns explained.

From the PES score, “we have an estimate of each individual’s likelihood of a positive response to said drug,” he noted. “We all have variants that increase (and decrease) the risk of these conditions to various degrees as they are common (high frequency) genetic variants.”

With this research, “we can implement this precision medicine strategy to match the right [repurposed] drugs for individuals based on their specific burden of genetic risk” for obesity and type 2 diabetes.

“Drug repurposing can be a fast track to new medicines because there is existing knowledge about their safety and activity in humans,” he said.

Next steps: Raising funds for clinical trials

“We would like to progress some of these compounds to preclinical and clinical trials,” Dr. Cairns said, “but need to raise the funds for this expensive research. With limited government research funding opportunities, we have recently spun out a startup company to attract commercial investment in our platform and the development of new drug candidates.”

The authors have reported no relevant financial relationships. Dr. Reay and Dr. Cairns are cofounders of PolygenRx.

A version of this article first appeared on Medscape.com.

Researchers have developed a computer program to identify drugs for other diseases that might be repurposed to treat type 2 diabetes and/or obesity by targeting genetic pathways for these two conditions.

The scientists identified four pathways with known drug targets for type 2 diabetes and five with known drug targets for obesity.

Their findings suggest that:

• Palbociclib (used to treat breast cancer) and cardiac glycosides (used to treat heart failure and heart rhythm disorders) might be repurposed to treat type 2 diabetes.
• Baclofen (a muscle relaxant) and carfilzomib (a chemotherapy) could potentially be used to treat obesity.
• Fostamatinib (used to treat thrombocytopenia), sucralfate (used to treat stomach ulcers), and regorafenib (used to treat cancer) might be used to treat type 2 diabetes and obesity.
• Baclofen and sucralfate would have favorable safety profiles as repurposed treatments.

Sahar El Shair, a PhD student at the Faculty of Health and Medicine, University of Newcastle, New South Wales, Australia, presented the research during an oral session at the International Congress on Obesity, the biennial congress of the World Obesity Federation, in Melbourne.

“New treatments with higher activity and specificity are urgently needed to tackle a pandemic of chronic illness associated with type 2 diabetes and obesity,” senior coauthor Murray Cairns, PhD, said in a press release from the ICO.   

“Our technology harnesses genetically informed precision medicine to identify and target new treatments for these complex disorders,” said Dr. Cairns, from the school of biomedical sciences and pharmacy at the University of Newcastle.

Matchmaking between individual, their genetic traits, and drugs

Dr. Cairns and senior coauthor William Reay, PhD, also from the school of biomedical sciences and pharmacy, have cofounded a company called PolygenRx.

The company website explains that they have developed a propriety platform termed the pharmagenic enrichment score (PES), which is “essentially a matchmaking service between patients and drugs, allowing treatment to be optimized for each individual using their unique combination of genetic risk factors.”

It is important to note the genetic risk from complex traits, such as type 2 diabetes and obesity, “are quite different [from] the rare genetic disorders caused mostly by a devastating mutation in a single gene,” Dr. Cairns explained in an email.

“Complex traits,” he noted, “are associated with thousands of [genetic] variants that are common in people and have a cumulative effect.”

For this specific research, the investigators obtained genetic data from genome-wide association studies of obesity and type 2 diabetes.

“By using very large cohorts (hundreds of thousands of individuals) and comparing the frequency of millions of genetic variants in subjects with these conditions with controls, these studies have revealed regions of the genome and genes associated with the condition,” Dr. Cairns noted.

The pharmagenic enrichment score integrates a person’s genetics with drug pharmacology to determine if a person would respond more readily to a certain drug.

“We are investigating the potential of thousands of drugs across a broad spectrum of complex traits (the list is almost endless),” Dr. Cairns explained.

From the PES score, “we have an estimate of each individual’s likelihood of a positive response to said drug,” he noted. “We all have variants that increase (and decrease) the risk of these conditions to various degrees as they are common (high frequency) genetic variants.”

With this research, “we can implement this precision medicine strategy to match the right [repurposed] drugs for individuals based on their specific burden of genetic risk” for obesity and type 2 diabetes.

“Drug repurposing can be a fast track to new medicines because there is existing knowledge about their safety and activity in humans,” he said.

Next steps: Raising funds for clinical trials

“We would like to progress some of these compounds to preclinical and clinical trials,” Dr. Cairns said, “but need to raise the funds for this expensive research. With limited government research funding opportunities, we have recently spun out a startup company to attract commercial investment in our platform and the development of new drug candidates.”

The authors have reported no relevant financial relationships. Dr. Reay and Dr. Cairns are cofounders of PolygenRx.

A version of this article first appeared on Medscape.com.

Researchers have developed a computer program to identify drugs for other diseases that might be repurposed to treat type 2 diabetes and/or obesity by targeting genetic pathways for these two conditions.

The scientists identified four pathways with known drug targets for type 2 diabetes and five with known drug targets for obesity.

Their findings suggest that:

• Palbociclib (used to treat breast cancer) and cardiac glycosides (used to treat heart failure and heart rhythm disorders) might be repurposed to treat type 2 diabetes.
• Baclofen (a muscle relaxant) and carfilzomib (a chemotherapy) could potentially be used to treat obesity.
• Fostamatinib (used to treat thrombocytopenia), sucralfate (used to treat stomach ulcers), and regorafenib (used to treat cancer) might be used to treat type 2 diabetes and obesity.
• Baclofen and sucralfate would have favorable safety profiles as repurposed treatments.

Sahar El Shair, a PhD student at the Faculty of Health and Medicine, University of Newcastle, New South Wales, Australia, presented the research during an oral session at the International Congress on Obesity, the biennial congress of the World Obesity Federation, in Melbourne.

“New treatments with higher activity and specificity are urgently needed to tackle a pandemic of chronic illness associated with type 2 diabetes and obesity,” senior coauthor Murray Cairns, PhD, said in a press release from the ICO.   

“Our technology harnesses genetically informed precision medicine to identify and target new treatments for these complex disorders,” said Dr. Cairns, from the school of biomedical sciences and pharmacy at the University of Newcastle.

Matchmaking between individual, their genetic traits, and drugs

Dr. Cairns and senior coauthor William Reay, PhD, also from the school of biomedical sciences and pharmacy, have cofounded a company called PolygenRx.

The company website explains that they have developed a propriety platform termed the pharmagenic enrichment score (PES), which is “essentially a matchmaking service between patients and drugs, allowing treatment to be optimized for each individual using their unique combination of genetic risk factors.”

It is important to note the genetic risk from complex traits, such as type 2 diabetes and obesity, “are quite different [from] the rare genetic disorders caused mostly by a devastating mutation in a single gene,” Dr. Cairns explained in an email.

“Complex traits,” he noted, “are associated with thousands of [genetic] variants that are common in people and have a cumulative effect.”

For this specific research, the investigators obtained genetic data from genome-wide association studies of obesity and type 2 diabetes.

“By using very large cohorts (hundreds of thousands of individuals) and comparing the frequency of millions of genetic variants in subjects with these conditions with controls, these studies have revealed regions of the genome and genes associated with the condition,” Dr. Cairns noted.

The pharmagenic enrichment score integrates a person’s genetics with drug pharmacology to determine if a person would respond more readily to a certain drug.

“We are investigating the potential of thousands of drugs across a broad spectrum of complex traits (the list is almost endless),” Dr. Cairns explained.

From the PES score, “we have an estimate of each individual’s likelihood of a positive response to said drug,” he noted. “We all have variants that increase (and decrease) the risk of these conditions to various degrees as they are common (high frequency) genetic variants.”

With this research, “we can implement this precision medicine strategy to match the right [repurposed] drugs for individuals based on their specific burden of genetic risk” for obesity and type 2 diabetes.

“Drug repurposing can be a fast track to new medicines because there is existing knowledge about their safety and activity in humans,” he said.

Next steps: Raising funds for clinical trials

“We would like to progress some of these compounds to preclinical and clinical trials,” Dr. Cairns said, “but need to raise the funds for this expensive research. With limited government research funding opportunities, we have recently spun out a startup company to attract commercial investment in our platform and the development of new drug candidates.”

The authors have reported no relevant financial relationships. Dr. Reay and Dr. Cairns are cofounders of PolygenRx.

A version of this article first appeared on Medscape.com.