Cardiovascular outcomes trials will be the hot topic of the 73rd American Diabetes Association (ADA) Scientific Session in Chicago. This is based on the ongoing disappointment about the lack of a cardiovascular (CV) risk reduction benefit from current type 2 Diabetes drugs. Just prior to the ADA, Bristol-Myers Squibb (BMS) and AstraZeneca announced that their jointly-marketed DPP-4 inhibitor, Onglyza (saxagliptin),failed to show any CV benefit over placebo in a post-marketing study conducted in 16,500 type 2 diabetes patients. However, some analysts expect that the continued failure of any DPP-4 inhibitors to demonstrate CV benefit (and differentiate themselves within the class) may have a positive effect on a new drug class, the SGLT-2 inhibitors including BMS/AZ's Forxiga (dapaglaflozin; currently under review by the FDA and marketed in Europe) and J&J's Invokana (canagliflozin; approved in the United States, and under review by the European Medicines Agency).

Another interesting battle currently underway is between the GLP-1 analogues: Eli Lilly's dulaglutide and Novo Nordisk's Victoza (liraglutide). Victoza has been an important driver of growth for Novo but is experiencing increasing competition as a series of novel GLP-1 analogues launch. After a series of successful Phase III clinical trials, Eli Lilly will be able to present strong data at the ADA. However, AWARD-6, a key head-to-head study of dulaglutide and Victoza will not complete until late-2013 so is unlikely to be discussed at this year's conference.

Sanofi will be presenting data on its novel insulin, U300, an improved sustained-release formulation of Lantus (insulin glargine). Additionally, a seven-year CV Outcomes study of Lantus in diabetes and pre-diabetes patients at high CV risk has just been completed the results of this study are likely to be of great interest given the recent plethora of similar studies which have failed to show benefit.

Timothy Blackstock, Business Insights Analyst in the Cardiovascular, Metabolic, and Renal disease team is attending the ADA conference and is available to meet and discuss our take on Diabetes. You can contact Tim on

Stefanie Matlok is a data analyst with the Cardiovascular, Metabolic and Renal Disorders team at Decision Resources.

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