<?xml version="1.0" encoding="utf-8"?>
<recommendedContent xmlns="http://api.mspoke.com">
    <recommendedItem id="20100101_19_3248"
                     title="Increased Cardiac Events Seen With Sibutramine (CME/CE)"
                     score="0.015"
                     href="http://www.medpagetoday.com/Cardiology/MyocardialInfarction/tb/22008?impressionId=1283456802162"
                     
      &lt;p&gt;Overweight patients with cardiovascular risks who took the weight-loss drug sibutramine (Meridia) had a 16% increased likelihood of experiencing a cardiac event, a large randomized trial found.&lt;/p&gt;
&lt;p&gt;The overall hazard ratio for a fatal or nonfatal cardiovascular event was 1.16 (95% CI 1.03 to 1.31, &lt;em&gt;P&lt;/em&gt;=0.02) among patients receiving sibutramine compared with those receiving placebo, according to W. Philip T. James, MD, of the London School of Hygiene and Tropical Medicine, and colleagues.&lt;/p&gt;
&lt;p&gt;Specifically, the hazard ratio for nonfatal myocardial infarction was 1.28 (95% CI 1.04 to 1.57, &lt;em&gt;P&lt;/em&gt;=0.02), and the hazard ratio for nonfatal stroke was 1.36 (95% CI 1.04 to 1.77, &lt;em&gt;P&lt;/em&gt;=0.03), the researchers reported in the Sept. 1 &lt;em&gt;New England Journal of Medicine&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;A &lt;a href=&quot;http://www.medpagetoday.com/ProductAlert/Prescriptions/17147&quot; mce_href=&quot;http://www.medpagetoday.com/ProductAlert/Prescriptions/17147&quot; target=&quot;_blank&quot;&gt;preliminary analysis&lt;/a&gt;&lt;a target=&quot;_blank&quot;&gt; &lt;/a&gt;of data from the SCOUT (Sibutramine Cardiovascular Outcomes) trial previously suggested this increased risk, and the FDA required stronger &lt;a href=&quot;http://www.medpagetoday.com/ProductAlert/DevicesandVaccines/18088&quot; mce_href=&quot;http://www.medpagetoday.com/ProductAlert/DevicesandVaccines/18088&quot; target=&quot;_blank&quot;&gt;cautionary language&lt;/a&gt; in the drug&apos;s labeling.&lt;/p&gt;
&lt;p&gt;The final publication has now confirmed it, with James and colleagues stating, &quot;On the basis of these results, sibutramine should continue to be excluded from use in patients with preexisting cardiovascular disease.&quot;&lt;/p&gt;
&lt;p&gt;Sibutramine is a norepinephrine and serotonin reuptake inhibitor that has sympathomimetic effects and therefore can increase blood pressure and pulse rate. Because even small increases in blood pressure and pulse rate are associated with an increased likelihood of cardiovascular events, the SCOUT investigators wanted to determine the drug&apos;s long-term cardiovascular risk.&lt;/p&gt;
&lt;p&gt;They enrolled 9,804 obese or overweight patients who were at least 55 years old. All participants had a history of cardiovascular disease and/or type 2 diabetes.&lt;/p&gt;
&lt;p&gt;The study consisted of a six-week lead-in period in which all patients received 10 mg/day of sibutramine, after which they were randomized to the active treatment or placebo.&lt;/p&gt;
&lt;p&gt;Mean duration of treatment was 3.4 years, and slightly more than 40% of patients in both groups discontinued treatment.&lt;/p&gt;
&lt;p&gt;All patients also participated in individualized diet and exercise programs designed for cardioprotection, and blood pressure decreased in both groups during the lead-in phase.&lt;/p&gt;
&lt;p&gt;However, after randomization the sibutramine group had small but consistent increases in blood pressure and resting pulse rate.&lt;/p&gt;
&lt;p&gt;While there were increases in the nonfatal events, there was no between-group difference for cardiovascular death (HR 0.99, 95% CI 0.82 to 1.19, &lt;em&gt;P&lt;/em&gt;=0.90) or death from any cause (HR 1.04, 95% CI 0.91 to 1.20, &lt;em&gt;P&lt;/em&gt;=0.54).&lt;/p&gt;
&lt;p&gt;The investigators noted that fewer than half of the events they had expected at the outset of the trial occurred during its six-year overall duration, and that during that time the incidence of cardiovascular disease decreased in most of Europe and Australia, where most of the study centers were located.&lt;/p&gt;
&lt;p&gt;They also pointed out that the study was limited by the lack of a true placebo group, the inclusion of only high-risk patients, and the longer-than-recommended time of treatment (one to two years).&lt;/p&gt;
&lt;p&gt;In an accompanying editorial, Gregory D. Curfman, MD, executive editor of &lt;em&gt;NEJM, &lt;/em&gt;and colleagues commented that the cardiovascular risk findings of SCOUT need to be considered in light of the potential clinical benefit of the weight loss seen among those on sibutramine.&lt;/p&gt;
&lt;p&gt;Patients on the drug lost 4.3 kg at one year, but regained about 0.5 kg thereafter, for a net loss of less than 4 kg from a baseline average weight of 96 kg.&lt;/p&gt;
&lt;p&gt;In January 2010, after the preliminary analysis of the SCOUT data, the European Medicines Agency suspended marketing authorizations for sibutramine-containing medications throughout the European Union.&lt;/p&gt;
&lt;p&gt;On Sept. 15, an advisory committee of the FDA plans to meet to decide whether additional regulatory action should be taken here as well.&lt;/p&gt;
&lt;p&gt;Curfman and colleagues concluded, &quot;Given that sibutramine has minimal efficacy for weight loss, no apparent benefit for clinical outcomes, a worrisome cardiovascular risk profile, and a plausible mechanism to explain the cardiovascular risk, it is difficult to discern a credible rationale for keeping this medication on the market.&quot;&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The study was funded by Abbott Laboratories.&lt;/p&gt;&lt;p&gt;Several of the SCOUT investigators reported serving on advisory boards and receiving fees from multiple pharmaceutical companies, including Abbott, sanofi-aventis, Merck, Johnson &amp;amp; Johnson, Novo Nordisk, GlaxoSmithKline, and Boehringer Ingelheim.&lt;/p&gt;&lt;p&gt;In addition, three of the investigtors were full-time employees of Abbott and had equity interest in the company.&lt;/p&gt;&lt;p&gt;Aside from Curfman&apos;s position with &lt;em&gt;NEJM&lt;/em&gt;, the editorialists had no disclosures.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20100101_19_3235"
                     title="ESC: New Anticoagulants Create Buzz"
                     score="0.015"
                     href="http://www.medpagetoday.com/MeetingCoverage/ESCCongress/tb/21988?impressionId=1283456802162"
                     
      &lt;p&gt;STOCKHOLM  --  After years of waiting for an alternative to warfarin (Coumadin), there are now three wending their way through the regulatory process. In this exclusive InFocus video report we review each of these new agents.&lt;/p&gt;
&lt;p&gt;Two factor Xa inhibitors  --  apixiban and rivaroxaban  --  along with the direct thrombin inhibitor, dabigatran, are competing to be the first warfarin alternatives to gain FDA approval and that is good news according to Fausto Pinto, MD, PhD, the program chair at this year&apos;s European Society of Cardiology congress, where the new agents were featured in a number of sessions.&lt;/p&gt;
&lt;p&gt;Ralph L. Sacco, MD, president of the American Heart Association agreed that the news was good, but noted that, as the agents come to market, developing new guidelines for their use will be a critical task for the AHA and the ESC.&lt;/p&gt;
&lt;p&gt;Pinto and Sacco discussed the potential benefits  --  and challenges  --  of the new agents with &lt;em&gt;MedPage Today&lt;/em&gt; executive editor Peggy Peck.&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20100101_19_3221"
                     title="ESC: Warfarin Good, Dabigatran Better (CME/CE)"
                     score="0.015"
                     href="http://www.medpagetoday.com/MeetingCoverage/ESCCongress/tb/21975?impressionId=1283456802162"
                     
      &lt;p&gt;STOCKHOLM  --  Dabigatran, an investigational oral anticoagulant which does not require laboratory monitoring, may be an ideal anticoagulant for atrial fibrillation patients, especially those in centers that are less adept at managing patients taking warfarin, according to a post-hoc analysis from the 18,000-patient RE-LY trial.&lt;/p&gt;
&lt;p&gt;Even at centers where warfarin patients were consistently maintained within the therapeutic range of recommended clotting time, dabigatran, a direct thrombin inhibitor, was superior to warfarin for preventing stroke in patients with atrial fibrillation. But its greatest benefit was at centers where international normalized ratio (INR) control was spotty, Lars Wallentin, MD, PhD, of Uppsala Clinical Research Center University Hospital in Uppsala, Sweden, reported at the European Society of Cardiology meeting here. The paper was simultaneously published online by &lt;em&gt;Lancet.&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;A year ago, the RE-LY investigators &lt;a href=&quot;http://www.medpagetoday.com/MeetingCoverage/ESCCongress/15751&quot; mce_href=&quot;http://www.medpagetoday.com/MeetingCoverage/ESCCongress/15751&quot; target=&quot;_blank&quot;&gt;reported&lt;/a&gt; that a 150-mg dose of dabigatran twice daily was more effective in preventing strokes in high-risk patients than warfarin, while a lower dose  --  110 mg bid  --  was comparable to warfarin.&lt;/p&gt;
&lt;p&gt;In the new analysis, the researchers assessed the three treatment groups  --  two dabigatran arms and the warfarin group  --  according to each center&apos;s mean time in therapeutic range. They then divided the groups into quartiles, with the lowest quartile representing centers where patients were in therapeutic range less than 57.1% of the time, followed by centers at 57.1 to 65.5%, 65.5 to 72.6%, and more than 72.6%.&lt;/p&gt;
&lt;p&gt;There were significant &quot;interactions between [mean time in therapeutic range] and effects of both 110 and 150 mg dabigatran versus warfarin on the composite of all cardiovascular events (interaction &lt;em&gt;P &lt;/em&gt;=0.036 and &lt;em&gt;P &lt;/em&gt;=0.0006, respectively) and total mortality (interaction &lt;em&gt;P &lt;/em&gt;=0.066 and &lt;em&gt;P &lt;/em&gt;=0.052, respectively) with reduced event rates at low [mean time in therapeutic range] and similar rates at high [mean time in therapeutic range].&quot;&lt;/p&gt;
&lt;p&gt;Michael Ezekowitz, MB, ChB, DPhil, of the Lankenau Institute for Medical Research and Heart Center in Wynnewood, Pa., who was a co-investigator, told &lt;em&gt;MedPage Today&lt;/em&gt; that the analysis also demonstrated that even when INR was well controlled with warfarin, the superiority of the higher dose of dabigatran was still apparent as was the noninferiority of the lower dose.&lt;/p&gt;
&lt;p&gt;In the &lt;em&gt;Lancet&lt;/em&gt; paper, the authors wrote that &quot;there were no significant interactions between [time in therapeutic range] and stroke and systemic embolism in either dose of dabigatran versus warfarin.&quot;&lt;/p&gt;
&lt;p&gt;&quot;So this makes the findings from RE-LY even more powerful,&quot; Ezekowitz said in an interview that was monitored by a public relations person representing Boehringer Ingelheim, the sponsor of the RE-LY trial.&lt;/p&gt;
&lt;p&gt;In a commentary that accompanied the &lt;em&gt;Lancet&lt;/em&gt; study, Deirdre A. Lane, MD, and Gregory Y.H. Lip, MD, of the University of Birmingham Center for Cardiovascular Sciences in Birmingham, England, echoed Ezekowitz, noting &quot;this post-hoc analysis shows that despite very good [time in therapeutic range], either dose of dabigatran was associated with fewer adverse events than was warfarin.&quot;&lt;/p&gt;
&lt;p&gt;Clyde Yancy, MD, of Baylor University Medical Center in Dallas, told &lt;em&gt;MedPage Today&lt;/em&gt; that he was concerned about the ways in which the analysis might be used to promote dabigatran. &quot;If the message is that centers who don&apos;t do a good job of controlling INR should simply switch to this drug, I find that concerning,&quot; he said &quot;The ideal would be to get centers to improve INR control.&quot; Yancy is past president of the American Heart Association.&lt;/p&gt;
&lt;p&gt;Lane and Lip agreed with the need to improve current treatment, recommending that until &quot;the new oral anticoagulants become widely available (a positive advance), we should advocate tight INR control at conventional levels, for which there is a wealth of evidence for benefit, and promote strategies to improve the management of therapy with vitamin K antagonists.&quot;&lt;/p&gt;
&lt;p&gt;Beyond its post-hoc design, Wallentin said the new RE-LY analysis was also limited by the decision to use mean time in therapeutic range as a proxy for INR control, noting that it &quot;might not appropriately represent INR control of individual patients and might not represent the full effect of INR control on outcome.&quot;&lt;/p&gt;
&lt;p&gt;Additionally, they cautioned that time in therapeutic range &quot;does not show the effect of good and poor treatment response.&quot;&lt;/p&gt;
&lt;p&gt;Dabigatran will be the subject of a Sept. 20 FDA advisory committee meeting, at which the committee will discuss whether the drug should be approved for preventing stroke in atrial fibrillation patients.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The RE-LY trial was funded by Boehringer Ingelheim.&lt;/p&gt;&lt;p&gt;Wallentin has received consulting and lecture fees, honoraria, and research grants from Boehringer Ingelheim; research grants from AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, and Schering-Plough; honoraria from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, and Schering-Plough; consultant fees from Athera Biotechnologies, AstraZeneca, Eli Lilly, GlaxoSmithKline, and Regado Biotechnologies; and lecture fees from AstraZeneca and Eli Lilly.&lt;/p&gt;&lt;p&gt;Ezekowitz has received consulting fees and grant support from Boehringer Ingelheim, ARYx Therapeutics, Daiichi Sankyo, and Portola Pharmaceuticals; and consulting fees from sanofi-aventis, Pfizer, Bristol-Meyers Squibb, AstraZeneca, and Medtronic.&lt;/p&gt;&lt;p&gt;Yancy declared no financial conflicts.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20100101_19_3220"
                     title="ESC: Novel Drug Beats Aspirin in Afib Patients (CME/CE)"
                     score="0.015"
                     href="http://www.medpagetoday.com/MeetingCoverage/ESCCongress/tb/21974?impressionId=1283456802162"
                     
      STOCKHOLM  --  A novel anticoagulant  --  apixaban  --  cut the rate of stroke in half among patients with atrial fibrillation unsuitable for vitamin K antagonist therapy, according to preliminary results from a phase III trial halted because of the clear benefit.&lt;br&gt;
&lt;br&gt;The multinational AVERROES trial, conducted among 5,600 patients, was stopped early on May 28 after a planned interim analysis showed an obvious advantage for apixaban, according to Stuart Connolly, MD, of the Population Health Research Institute at McMaster University in Hamilton, Ontario.&lt;br&gt;
&lt;br&gt;Through a median follow-up of one year, the analysis revealed an annual rate of stroke or systemic embolic event  --  the primary endpoint  --  of 1.6% in the apixaban group and 3.6% in the aspirin group (RR 0.46, 95% CI 0.33 to 0.64), Connolly reported at the European Society of Cardiology Congress here.&lt;br&gt;
&lt;br&gt;Moreover, the benefit for apixaban was not accompanied with an increase in major bleeding or evidence of liver toxicity.&lt;p&gt;&lt;/p&gt;
&lt;p&gt;Serving as a discussant at Connolly&apos;s presentation, Harald Arnesen, MD, PhD, of Oslo University Hospital Ullev&amp;#229;l in Norway, called AVERROES a landmark study and said &quot;the results will obviously, in my opinion, have an impact on guidelines in atrial fibrillation, and the use of aspirin will probably be drastically reduced.&quot;&lt;/p&gt;
&lt;p&gt;Arnesen cautioned, however, that compliance could be a problem because of apixaban&apos;s twice-daily dosing schedule.&lt;/p&gt;
&lt;p&gt;Ralph Sacco, MD, president of the American Heart Association, told &lt;em&gt;MedPage Today&lt;/em&gt; that apixaban, if approved, would likely be cost-effective  --  considering that many patients with atrial fibrillation do not receive adequate anticoagulation  --  as well as the major detrimental effect that stroke has on quality of life.&lt;/p&gt;
&lt;p&gt;&quot;So when we weigh stroke as an outcome here, I think without knowing the cost of [apixaban] it may be with this kind of magnitude of effect that we will show cost-efficacy,&quot; said Sacco, a stroke neurologist at the University of Miami in Florida who served on the data safety and monitoring board for AVERROES.&lt;/p&gt;
&lt;p&gt;Apixaban is a novel selective direct Factor Xa inhibitor with a 12-hour half life and multiple excretion pathways. There is no need for the routine coagulation monitoring inherent in treatment with warfarin.&lt;/p&gt;
&lt;p&gt;In up to 50% of patients with atrial fibrillation, vitamin K antagonist therapy to prevent stroke is not appropriate because of difficult-to-control INR, increased bleeding risk, drug interactions, and patient reluctance.&lt;/p&gt;
&lt;p&gt;Aspirin is the usual care in these patients, and apixaban is aimed at changing that.&lt;/p&gt;
&lt;p&gt;The AVERROES trial was a double-blind, randomized study conducted at 522 centers in 36 countries. All 5,600 patients (mean age 70) had atrial fibrillation and at least one risk factor, as well as demonstrated or expected unsuitability to vitamin K antagonist therapy.&lt;/p&gt;
&lt;p&gt;Expected unsuitability was determined by interviewing the patients and uncovering factors such as drinking problems, a history of canceling healthcare visits, an unwillingness to undergo the rigor of regular INR checks, and potential drug interactions.&lt;/p&gt;
&lt;p&gt;Patients received either apixaban 5 mg twice daily (94% of patients received this dose, but some patients received a half dose) or aspirin 81 to 324 mg/day (91% of patients received 162 mg a day or less).&lt;/p&gt;
&lt;p&gt;In addition to the primary endpoint, the rates of ischemic stroke, systemic embolic events, and cardiovascular hospitalization were also significantly reduced with apixaban (RRs of 0.38, 0.15, and 0.79, respectively).&lt;/p&gt;
&lt;p&gt;Both nondisabling (RR 0.56, 95% CI 0.32 to 0.96) and disabling or fatal strokes (RR 0.45, 95% CI 0.29 to 0.69) were reduced as well.&lt;/p&gt;
&lt;p&gt;Apixaban did not, however, significantly reduce the annual rate of fatal stroke (0.5% with apixaban versus 0.8% with aspirin, &lt;em&gt;P&lt;/em&gt;=0.18) or total death (3.4% versus 4.4%, &lt;em&gt;P&lt;/em&gt;=0.07).&lt;/p&gt;
&lt;p&gt;Major bleeding occurred at low rates in both groups. There was a significant increase in minor bleeding with apixaban (5.2% versus 4.1%, &lt;em&gt;P&lt;/em&gt;=0.04), but these generally did not require intervention or result in discontinuation, Connolly said at a press briefing.&lt;/p&gt;
&lt;p&gt;Apixaban was well tolerated. Patients in the apixaban group were less likely to permanently discontinue their treatment (RR 0.88, 95% CI 0.78 to 1.00, &lt;em&gt;P&lt;/em&gt;=0.04) and were less likely to have a serious adverse event (21.7% versus 26.6%, &lt;em&gt;P&lt;/em&gt;&amp;lt;0.001).&lt;/p&gt;
&lt;p&gt;Nervous system disorders occurred at a higher rate with aspirin (6.3% versus 3%, &lt;em&gt;P&lt;/em&gt;&amp;lt;0.001), largely related to excess of stroke.&lt;/p&gt;
&lt;p&gt;Connolly calculated that for every 1,000 patients treated with apixaban instead of aspirin for one year, 18 strokes (mostly larger strokes) and 31 cardiovascular hospitalizations would be prevented.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The study was sponsored by Bristol-Myers Squibb and Pfizer, which are jointly developing apixaban.&lt;/p&gt;&lt;p&gt;Connolly reported receiving research grants and lecture and consulting fees from both companies.&lt;/p&gt;&lt;p&gt;Sacco reported that he served on the data safety and monitoring committee for AVERROES.&lt;/p&gt;&lt;p&gt;Arnesen said he had no conflicts of interest.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20100101_19_3189"
                     title="ESC: Economy Makes European Cardiologists Think Twice"
                     score="0.014"
                     href="http://www.medpagetoday.com/MeetingCoverage/ESCCongress/tb/21920?impressionId=1283456802162"
                     
      &lt;p&gt;STOCKHOLM  --  Hours before the official opening of the European Society of Cardiology 2010 congress here, the organization&apos;s leaders told reporters that cardiologists in European countries are feeling heat to hold the line on treatment costs.&lt;/p&gt;
&lt;p&gt;On the other hand, worldwide economic woes don&apos;t seem to have affected attendance or exhibitor support at this year&apos;s meeting, with more than 27,000 active delegates expected.&lt;/p&gt;
&lt;p&gt;ESC President Roberto Ferrari, MD, of the University of Ferrara in Italy, said that even though the group&apos;s 52 member nations have some form of national health insurance, cardiologists in those countries are now often asked to justify the use of brand name drugs over generics.&lt;/p&gt;
&lt;p&gt;Moreover, he said development of new cardiovascular drugs is perceived as a less attractive market for the pharmaceutical industry  --  because of struggling economies and a sense that, because of the tremendous recent strides in cardiovascular disease treatment, future improvements are likely to be small.&lt;/p&gt;
&lt;p&gt;Meanwhile, he noted, a new cancer drug can become a blockbuster for its maker even though it extends life for only a few weeks.&lt;/p&gt;
&lt;p&gt;In cardiology, &quot;we extend life for seven to 10 years,&quot; said Ferrari, but proving that benefit means trials of many thousands of patients or studies that last for many years  --  expensive undertakings when trials of oncology drugs can enroll a few hundred patients with a treatment duration of months rather than years.&lt;/p&gt;
&lt;p&gt;Ferrari and Fausto Pinto, MD, PhD, who serves as chair of the ESC program committee, hastened to add that the scenario described by Ferrari has not yet occurred, but Pinto said, &quot;this is a real concern for us.&quot;&lt;/p&gt;
&lt;p&gt;Pinto, a professor at Lisbon University in Portugal, said at the opening press conference that more than 26,000 &quot;active delegates&quot;  --  physicians, nurses, and other health professionals  --  had already arrived onsite at the meeting and more were expected to register over the next few days.&lt;/p&gt;
&lt;p&gt;A total of 9,511 abstracts were submitted for presentation  --  down about 400 from last year&apos;s meeting in Barcelona  --  and 4,197 were accepted for presentation.&lt;/p&gt;
&lt;p&gt;Of note, the United States, which last year ranked number nine, did not make the list of the top 10 countries presenting abstracts. Germany was ranked first in abstract submissions this year, and Pinto said that one surprise this year was that Japan is now ranked third in abstract submissions.&lt;/p&gt;
&lt;p&gt;About half of the active delegates at this year&apos;s meeting are here because someone else paid for their travel and registration costs. Pinto said that is about the average for supported attendees and he noted that, while many of them are traveling on grants from industry, others are supported by universities and non-profit organizations.&lt;/p&gt;
&lt;p&gt;While U.S. professional meetings have struggled to keep a distance from industry funding while still receiving the support needed to run scientific meetings, the influence of industry at the ESC congress has not been a major concern  --  but the group&apos;s leaders indicated that change is coming.&lt;/p&gt;
&lt;p&gt;Ferrari told &lt;em&gt;MedPage Today&lt;/em&gt; that next year presenters at the ESC will be required to make financial disclosures. At this point, there is no requirement to disclose competing interests.&lt;/p&gt;
&lt;p&gt;&quot;And we are not going to do this by simply requiring that a disclosure slide be shown,&quot; he said, noting the disclosure slide is de rigueur for U.S. meetings. &quot;We are going to try to do something more complete because the slide  --  it is up there for an instant and then it is gone,&quot; said Ferrari who snapped his fingers to illustrate his point.&lt;/p&gt;
&lt;p&gt;But Ferrari declined to elaborate on the ESC&apos;s exact plans for handling disclosure.&lt;/p&gt;

    </recommendedItem>
</recommendedContent>