Summary of recent progress in the field of diabetes research (03.14)

Summary of recent progress in the field of diabetes research (03.14)

March 14, 2018 Source: WuXi PharmaTech

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1. Janssen type 2 diabetes drugs significantly reduce the risk of cardiovascular death

Janssen Pharmaceutical Companies of Johnson & Johnson recently announced a new analysis that INVOKANA (canagliflozin) can significantly reduce the risk of cardiovascular death or heart failure hospitalization (HHF) in patients with type 2 diabetes. This exploratory analysis of the CANVAS project was presented at the 67th Annual Scientific Meeting of the American College of Cardiology and published in the journal Circulation.

Diabetes is a growing global epidemic. As of 2015, 400 million adults worldwide are affected by diabetes, of which about 100 million are in China. People with type 2 diabetes are resistant to insulin or are unable to secrete enough insulin to maintain normal blood sugar levels. Sustained high glucose levels can lead to complications of diabetes such as heart disease, stroke, kidney failure, neuropathy, lower extremity amputation and blindness.

INVOKANA is a daily oral diabetes drug, a new class of drugs that are inhibitors of sodium glucose cotransporter 2 (SGLT2). These drugs reduce the body's blood sugar levels by blocking the kidney's reabsorption of blood sugar and increasing the excretion of blood sugar in the urine.

The CANVAS project is the longest and most extensive focus on cardiovascular efficacy in all SGLT2 inhibitors to date, and the first in more than 10,000 patients with a history of cardiovascular disease, or at least two cardiovascular risk factors. Among the patients with type 2 diabetes, the efficacy, safety and persistence of INVOKANA were evaluated. The analysis showed that INVOKANA significantly reduced cardiovascular risk or HHF risk by 22%, reduced heart failure or hospitalization by 30%, and reduced HHF risk by 33% alone. Patients with a history of heart failure had a 39% reduction in cardiovascular death or HHF risk, and patients without a history of heart failure were also reduced from baseline13. The effect of INVOKANA on cardiovascular death or HHF risk can be compared across multiple subgroups. In addition, the data also confirmed that INVOKANA has a proportional effect in patients with type 2 diabetes who have a high risk of cardiovascular disease compared with placebo.

Dr. Robert Cuddihy, vice president of medical affairs at Janssen's R&D department, said: "Heart failure and its more serious cardiovascular deaths are key to many doctors and patients managing type 2 diabetes. A new analysis of this landmark CANVAS project will help To strengthen the important clinical benefits of canagliflozin."

2. Artificial intelligence for significant behavioral intervention in diabetic patients

Recently, a clinical trial based on mobile medical application Sweetch, conducted by Johns Hopkins University, was released. Sweetch aims to improve the risk of disease in people with diabetes by encouraging changes in long-term behavior. The results of this trial show that using Sweetch significantly reduces the user's glycated hemoglobin (A1C) levels, increases physical activity time, and reduces user weight. The findings were published in the Journal of Medical Internet Research.

Sweetch's proprietary machine learning technology predicts and reduces the risk of developing diabetes in users and provides highly individualized interventions to improve patient outcomes. Those large-scale recommendations for people with diabetes, such as walking 10,000 steps and eating less carbohydrates, are not effective for long-term patients. Sweetch analyzes the user's personal habits by processing the data streams collected by the smartphone, including user location, schedule, sports patterns, driving and walking routes, and weather and surroundings, and by using real-time artificial intelligence. Sending users the right advice for individualization and contextualization, maximizing behavioral adherence, is expected to allow behavioral change to achieve progressive, super-individualized, and long-term retention.

The three-month trial included 55 pre-diabetic adult patients with varying degrees of obesity. During the trial, Sweetch significantly changed the behavior of the participants, with a retention rate as high as 86%. The data showed that the user's physical activity increased significantly - an average of 2.8 metabolic equivalents (MET) per person per week, an average weight loss of 1.6 kg, an average waist circumference reduction of 1.4 cm, and a clinically significant reduction in A1C (0.1%). According to previous studies, the risk of diabetes is reduced by 16% for every kilogram of weight loss.

“About one-third of Americans, Europeans, and Chinese suffer from chronic diseases associated with unhealthy lifestyle habits,” said Ms. Dana Chanan, CEO of Sweetch, “to provide individualized counseling to these people through manual means. The method is not realistic, and Sweetch's technology does not involve human intervention, so that it can perform large-scale intervention at low cost, and it has achieved significant clinical results."

3. Screening for diabetic retinopathy, Eyenuk artificial intelligence system approved

Eyenuk is a leading artificial intelligence company dedicated to identifying diseases and providing clinical support through retinal image analysis. The company recently announced that it has received a medical device license from the Health Canada to use its artificial intelligence and cloud computing diabetes retinopathy (DR) automated screening software system EyeArt. Eyenuk has had some success in Europe before, and the permit issued by Health Canada means that Eyenuk is one step closer to its goal, which is to use EyeArt as a screening tool to improve diabetic retinopathy worldwide. So that more clinicians can use it.

Diabetic retinopathy (DR) is an eye disease that causes blindness in humans, and many of the 415 million people with diabetes worldwide are plagued by this condition. If a diagnosis can be made through early annual screening of the eye, vision loss caused by DR can be prevented. However, in many places, the current number of eye care professionals is unable to meet the needs of current patients for annual eye screening, making DR the leading cause of blindness in today's society. Experts have realized that the only viable way to solve this problem is through computer and artificial intelligence technology to effectively extend the scope of DR screening in the current medical environment.

Eyenuk is focused on identifying patients with underlying blinding and chronic conditions quickly and accurately. Utilizing expertise and technology in computer vision and machine learning, the company is developing a product portfolio based on its proprietary retinal image analysis technology and deep learning to identify and track the progression of a variety of diseases, including diabetic retinopathy, glaucoma, Age-related macular degeneration, stroke, cardiovascular disease, and Alzheimer's disease.

Eyenuk's first product, EyeArt, is a fully automated cloud computing software device for screening for diabetic retinopathy. This disease is the leading cause of blindness in adults. The key breakthrough for EyeArt is that the software allows doctors and nurses to quickly master how to use it without the need for professional and eye care experts to perform excessive manual interpretation and analysis of the results. EyeArt screening software delivers results in 60 seconds and works with most fundus cameras that provide high quality images. Eyenuk launched EyeArt to provide a cost-effective and effective method for screening for diabetic retinopathy for large-scale promotion in primary care settings.

“We are very excited to launch EyeArt Screening Software in Canada,” said Dr. Kaushal Solanki, founder and CEO of Eyenuk. “For many patients, eye screening is difficult and expensive, which has led to diabetic retinopathy. The main cause of preventable blindness, which has a huge impact on adults in the workplace. We are proud to extend EyeArt to other countries to make it easier, more effective and cheaper for people with diabetes. Screening to reduce the number of patients blinded by diabetes complications."

Reference materials:

[1] INVOKANA® (canagliflozin) Significantly Reduces the Risk of Heart Failure-Related Outcomes in Type 2 Diabetes Patients at Risk for or With a History of Cardiovascular Disease

[2] Johns Hopkins Study Reveals Artificial Intelligence (AI)-Driven Mobile App Sweetch Reduces Blood Sugar Levels in Early Stage Diabetes Patients

[3] Eyenuk, Inc. Receives Health Canada Approval for EyeArtTM, an AI-enabled Cloud-based Automated Diabetic Retinopathy Screening Software

Original Title: Summary of Recent Progress in Diabetes Research (No. 53)

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