2160-PUB: Development of an Evidence-Based Tool to Facilitate Individualized Treatment in the Clinic for Patients with Type 2 Diabetes

2020 
Type 2 diabetes (T2D) is a heterogeneous disease with many therapies available. Current guidelines recommend individualized therapy, and this could be facilitated by using estimates of outcomes based on individual characteristics instead of population-level outcomes. There are challenges to defining and implementing individualized therapy in a data-driven and patient-oriented way. We propose criteria to aid implementation of individualized medicine, including: 1) robust insights based on high-quality clinical data, to guide treatment selection; 2) integration of patient-oriented outcomes with engagement of providers and patients; 3) provision of a user-friendly, efficient tool for use in the clinic. We are developing an interactive tool that draws on data from a wide range of randomized controlled trials, e.g., all treatment arms from the full phase 3a program for once-weekly semaglutide. The tool selects the appropriate trial from a database and shows the predicted change in outcomes on initiation/continuation with different therapies over 26-30 weeks. Estimates are based on characteristics such as age, BMI, and T2D duration (Figure). In conclusion, a tool such as this could help clinicians and patients use high-quality, large-scale data from contemporary trials to select individualized treatment regimens. Disclosure A.R. Kahkoska: Other Relationship; Self; Novo Nordisk A/S. J.B. Buse: Consultant; Self; Cirius Therapeutics, CSL Behring, Neurimmune. Research Support; Self; American Diabetes Association, National Institutes of Health, Novo Nordisk A/S, Patient-Centered Outcomes Research Institute, Sanofi, Tolerion, Inc., vTv Therapeutics. Stock/Shareholder; Self; Mellitus Health, Pendulum Therapeutics, PhaseBio Pharmaceuticals, Inc., Stability Health. Other Relationship; Self; ADOCIA, AstraZeneca, Dance Biopharm Holdings, Inc., Eli Lilly and Company, MannKind Corporation, NovaTarg Therapeutics, Novo Nordisk A/S, Senseonics, Inc, vTv Therapeutics, Zafgen, Inc. S. Harring: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. I. Holst: Employee; Self; Novo Nordisk A/S. F.K. Knop: Advisory Panel; Self; AstraZeneca, Merck Sharp & Dohme Corp., Mundipharma International, Novo Nordisk A/S, Sanofi. Consultant; Self; Carmot Therapeutics, Inc., Eli Lilly and Company, Novo Nordisk A/S. Research Support; Self; AstraZeneca, Gubra, Novo Nordisk A/S, Sanofi, Zealand Pharma A/S. Speaker’s Bureau; Self; AstraZeneca, Lupin Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Norgine B.V., Novo Nordisk A/S. K. Kvist: Employee; Self; Novo Nordisk A/S. R.E. Pratley: Other Relationship; Self; AstraZeneca, Eli Lilly and Company, GlaxoSmithKline plc., Glytec, Janssen Scientific Affairs, LLC., Lexicon Pharmaceuticals, Inc., Ligand Pharmaceuticals Incorporated, Merck & Co., Inc., Novo Nordisk Inc., Sanofi. Funding Novo Nordisk A/S
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