Latest Conference Content

To build on the success and ideas generated at last year's inaugural event, Joslin Diabetes Center once again brought together numerous key stakeholders in the collective battle to conquer diabetes and to provoke thought, innovation, and action. Highlights from Diabetes Innovation, which took place on October 3-5, 2013, in Washington, DC, are available in a special report published by The American Journal of Managed Care.

As the prevalence of obesity continues to increase and treatment strategies evolve, pharmacists are not only in a position to advise on appropriate use of pharmacotherapy for obesity, but also to assist in improving outcomes from gastric bypass surgery.

Speakers at the ASHP Midyear Clinical Meeting ranging from ASHP President Gerald Meyer, PharmD, to Michael Lee, PharmD, of the Indian Health Service, argued that pharmacists are closer than ever before to achieving their goal of attaining provider status.

Genomic sequencing is rapidly increasing its value as a clinical tool in the diagnosis and treatment of many diseases, including cancer. In his presentation, Justin M. Balko, PharmD, PhD, from Vanderbilt University, provided a background on the current state of next-generation genomic sequencing (NGS), and the potential role that pharmacists play as this science continues to evolve.

New and experienced pharmacists are always on the lookout for ways to improve their careers. This presentation focuses on some key strategies for identifying new opportunities that allow new and experienced pharmacists to develop and apply their clinical skills.

Quality and performance measurement has become an integral part of the healthcare system. As pharmacists continue to increase their role and exposure as healthcare providers, they are well positioned to assist in identifying ways to improve the quality of care delivered and to play an integral role in the development of quality measures, according to Curtis Collins, PharmD, MS, BCPS (AQ-ID), FASHP, who spoke at the ASHP Midyear Meeting.

llicit drug use continues to be a prevalent and growing problem in the United States, and the use of newer substances is on the rise. Because of the increasing prevalence and tweaking of compounds to avoid detection, the identification of drug abuse by practitioners often relies on signs and symptoms. In this session, presenters reviewed some of these agents, including their history and their impact on those abusing them.

Retired general and former secretary of state Colin Powell discussed his thoughts on the US healthcare system and the role pharmacists play within it during his keynote address at the ASHP Midyear Clinical Meeting.

Taking aim at relapse rates and overall poor outcomes among adult patients with acute lymphoblastic leukemia (ALL) demands both new therapies and new ways of thinking, according to Anjali S. Advani, MD, of the Cleveland Clinic. Antibodies, which have produced success in treating other blood cancers, offer promise because in some cases the same antigens are involved.

Treating newly diagnosed patients even older ones with a combination of lenalidomide, marketed by Celgene as Revlimid, and low-dose dexamethasone, a steroid, seems likely to become the new treatment standard for multiple melanoma, based on the presentation of a mass vascular endothelial growth factor inhibitor, ive, multinational Phase III study presented Sunday at the 55th American Society of Hematology Meeting and Exhibition in New Orleans.

In recent years, overall progress in treating acute lymphoblastic leukemia (ALL), in which malignant white cells multiply in the bone marrow, has been tempered by this fact: Survival rates among children far outstrip those of adults, with childhood rates reaching 85% and adults registering at 45%.

Progress in treating multiple myeloma, or cancer of the plasma cells in bone marrow, has advanced significantly over the past decade. Today, questions about the disease often involve finding a treatment that balances the goal of putting a patient into remission especially if stem cell transplantation is a possibility against the toxicity of the treatment itself.

New therapies to treat chronic lymphocytic leukemia (CLL) will receive plenty of attention this week at the 55th American Society of Hematology Annual Meeting and Exposition in New Orleans. At an education session that opened the meeting Saturday, a physician with the Mayo Clinic made it clear that cost considerations are a reality for many older patients.

Ample evidence supports obesity as an independent risk factor for cardiovascular disease (CVD). Traditionally, obesity is defined by body mass index (BMI); however, recent data suggest metabolic syndrome and excess adipose tissue play more of a role than BMI in determining CVD risk. In this session, Jaime Armando, PhD, and colleagues from the University of Texas Southwestern Medical Center; and Amparo Figueroa, MD, MPH, from Massachusetts General Hospital, presented results from studies that examined the roles of metabolic syndrome and excess adipose tissue in determining CVD risk.

In a presentation titled Readmission for Stroke and Quality of Care Among Hospitalized Patients With Transient Ischemic Attack: Real World Delivery of Care, Emily C. O'Brian, PhD, from Duke University School of Medicine, presented results from the American Heart Association's Get With the Guidelines (GWTG)-Stroke program. GWTG is a hospital improvement program designed to improve adherence to evidence-based care.

In this session, data were presented from 3 separate trials that focused on potential ways to reduce the risk for bleeding in patients who require anticoagulation therapy, including the use of genetic tests to optimize warfarin dosing and the use of the factor Xa inhibitor edoxaban. Munir Pirmohamed, MD, PhD, from the University of Liverpool, discussed results from the EU-PACT trial; Stephen Kimmel, MD, from the University of Pennsylvania School of Medicine discussed results from the COAG trial; and Robert P. Giugliano, MD, SM, FAHA, FACC, from Brigham and Women's Hospital, discussed results from the ENGAGE TIMI-AF 48 trial.

In this session, Denise Bonds, MD, MPH, from the National Heart, Lung, and Blood Institute, discussed the limitations of outcomes research conducted using claims or registry data. According to Dr Bonds, the trend is to use new data, big data, and patient-powered data. In another presentation, Catarina Kiefe, PhD, MD, from the University of Massachusetts Medical School, provided preliminary findings from her research in patients with acute coronary syndrome as an example of how outcomes research is evolving.

Patients spend far more time in the home than with their healthcare providers, making the home an ideal and perhaps essential place to improve adherence and outcomes. In this session, Kathryn Donofrio, DNP, MBA, RN, from Swedish Covenant Hospital, and Debra Moser, DNSc, MN, RN, from the University of Kentucky, discussed home-based strategies for care improvements in patients with heart failure.

Accountable Care Organizations (ACOs) are designed to improve the quality and continuity of care, but it remains unclear how stakeholders can be successful in this new model and also how the shift in incentives will truly impact care. In this session, W. Douglas Weaver, MD, from the Henry Ford Heart and Vascular Institute and Henry Ford Hospital, and Karen E. Joynt, MD, MPH, from Brigham and Women's Hospital and Harvard Medical School, discussed the potential impact of ACOs on specialty care and the potential for ACOs to limit access to care.

Recently released guidelines from the American College of Cardiology and American Heart Association base treatment on a 10-year risk for atherosclerotic cardiovascular disease, a shift from the previous guidelines' overall emphasis on treat to target. In this session, C. Noel Bairey Mertz, MD, FACC, from the Cedars-Sinai Heart Institute; Jennifer G. Robinson, MD, MPH, from the University of Iowa; and Karol Watson, MD, PhD, FACC, from the University of Southern California, Los Angeles, discussed the evidence supporting cholesterol lowering in women, the elderly, and minorities.

The participants in this session noted that the medical record of the future will likely include a prognostic genetic component that will have short- and long-term implications. Panelists included Jennifer Hall, PhD, FACC, FAHA, from the University of Minnesota; Dan Roden, MD, from Vanderbilt University; Gary H. Gibbons, MD, from the National Heart, Lung, and Blood Institute; and Christopher Cannon, MD, from Brigham and Women's Hospital.

The fourth session of the FDA Town Hall Meeting at the Transcatheter Cardiovascular Therapeutics (TCT) conference was titled Regulation and Reimbursement: Global Imperatives and Trends. It began with the keynote address, The Intersection of Innovation, Payment and Regulatory Approval in the Future of Interventional Cardiology, delivered by Jack L. Lewin, MD, CEO of the Cardiovascular Research Foundation. He discussed 5 critical trends affecting innovation: progression of science, information technology and big data, changing politics and public scrutiny of healthcare quality and costs, regulatory expansion, and healthcare payment reform.

FDA Year in Review

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FDA Town Hall Meeting is a multi-part session held yearly at the Transcatheter Cardiovascular Therapeutics (TCT) conference. At this year's conference, the first portion, titled The Year in Review: A Year in Transition, was introduced by Martin B. Leon, MD, and Bram D. Zuckerman, MD. The Town Hall Meeting is meant to be dynamic and inclusive of key forces from the regulatory environment, clinical scientists, and representatives from industry.

The multi-part session, On Deck: Next Generation Biologics, was part of a larger session at the Transcatheter Cardiovascular Therapeutics (TCT) conference, called Strategies for Cardiovascular Repair: Stem Cells and Beyond. The first portion on extracellular matrices and related products was presented by Karen Christman, PhD, associate professor of bioengineering at the University of California San Diego. Dr Christman discussed the use biomaterials for treating the extracellular matrix of the heart after MI.

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