Academic CRO/Industrial Collaborations in Drug Discovery

The pharmaceutical industry, standing on the shoulders' of academia, has been the driver of drug discovery and development by managing the knowledge for profit. It is now clear that the cost of research is escalating by leaps and bounds, while the number of new molecular entities and the number of drugs approved are at their lowest. Academia has recently become a vital contributor to the otherwise dwindling drug discovery pipeline by establishing in-house high throughput drug screening centers to generate leads. The pharmaceutical industry, in turn, has come to understand the depth of target biology, systems biology and pathobiology knowledge that resides in academia, and recognizes the need for close interaction and collaboration between the two institutions for better targets to pursue and to lower the attrition during efficacy and safety assessment phase of drug development. What we now see evolving is the much needed collaborative spirit between these two diverse institutions in closing this risk-reward gap as exemplified by a number of industry-academia collaborative agreements that are being put in place. With great many academic institutions becoming engaged in drug discovery research, the time is ripe to find ways to bridge the gap, and conquer the 'valley of death' in new drug lead discovery. The goal of this session is to understand the role of academia and CROs in translational research, the guiding principles that define the pharmaceutical industry and Academia, review and analysis of current and prospective partnerships between academia and the pharmaceutical industry, a roadmap for developing a win-win scenario for technology transfer, and proven ways to strengthen drug discovery partnerships between Pharma and Academia.

Anti-Cancer Discovery & Therapy

Cancer remains the second leading cause of death both in industrialized and non-industrialized countries and is increasing in incidence elsewhere in the world as the population ages. The enormous advances in knowledge, science and technology in the 21st century have facilitated the process of globalization with the aim of better quality of life for all. The development of more effective, efficient, less risky and less toxic drugs for treatment of cancer has been a major human endeavor for the past 50 years. With the introduction of the "targeted drugs" and currently available treatment regimens, 5-year survival rate among the adults for all cancers has increased to approximately 65%. The improvement in the survival rate of childhood leukemia (ALL), being the most fatal childhood cancer, over the past 35 years is one of the great success stories of cancer treatment. In the 1960s, while less than 5 percent of children with ALL survived for more than five years, today, about 85% of children live five years or more. The 7th International Conference on Drug Discovery and Therapy is an effort to address all areas towards anti-cancer agents. Emphasis was given to drugs that have recently been introduced into the cancer therapy including: inhibitors of chromatin function, target-based inhibitors of signal transduction (tyrosine kinase inhibitors) Ê and cyclindependent kinases, and angiogenesis inhibitors acting on metalloproteinases, epithelial cell growth, and angiogenesis stimulation. There will be presentations from contributors working on hormone synthesis inhibitors and hormone-receptors blockers, RNA interference, role of pharmacogenomics in anti-cancer drug development and computer aided-strategies for anti-cancer drug design and development and related areas.

Anti-Infectives

CAmong the anti-infective drugs which have recently been approved for clinical use, the antiviral agents, following the trend set by anti-bacterials (antibiotics) a few decades ago, have taken the lead. In recent years, more than forty antiviral compounds have been formally licensed, more than half of which are used in the treatment of human immunodeficiency virus (HIV) infections (AIDS). Others have been licensed for the treatment of herpesvirus infections, hepatitis B and C, and influenza. For other virus infections, i.e. pox (variola, vaccinia), hemorrhagic fever virus, picornavirus, flavivirus, papilloma- and adenovirus infections, effective antiviral drugs still have to be developed or submitted to clinical trials. Even for those virus infections that can already be controlled by therapeutic modalities, the search for additional molecular targets and new treatment strategies should be pursued. The development of antiviral agents requires a multidisciplinary approach encompassing many different fields, such as molecular modeling, medicinal chemistry, biochemistry, pharmacology, toxicology and clinical medicine. Most importantly, the development of antiviral agents may learn from (and should not been dissociated from) other anti-infectives, in particular those compounds targeted at bacterial infections (i.e. tuberculosis) and protozoal infections (i.e. malaria) and other parasitic diseases, as evidence is growing for compounds trespassing these borders, both from a structure-activity relationship (SAR) and mode of action viewpoint.

Biologics

Highly active antiretroviral therapy (HAART) has changed the landscape of HIV-related care in both the developed and developing countries. The availability and widespread use of HAART have resulted in a number of achievements as well as challenges. Since the early days of antiretroviral therapy, adherence has emerged as a milestone to success. There are factors militating against adherence to antiretroviral therapy among HIV-infected individuals particularly in the resource - limited settings. Limited laboratory infrastructure, lack of trained manpower and high cost of laboratory monitoring test pose a major problem to implementing HIV therapy in resource-poor settings. The disclosure of HIV serostatus is a difficult emotional task creating opportunity for support and rejection. The 7th ICDDT will be held in Dubai in February 2016 will address all areas pertinent to this endeavour, concentrating on leads that arise from highly active antiretroviral therapy, effect on the quality of life, laboratory monitoring of patients on HAART and HIV serostatus disclosure. There were presentations in varying subjects of Anaemia, Comparative analysis of malaria parasite density using actual and assumed white blood cell counts, Reference percentiles of haematological and biochemical iron values of blood donors, Prostate cancer diagnosis, Anti-microbiological drug resistance and other interesting topics in the area of Biomedical Science. The list catered to a number of contributions that stem from other sources, aiming to provide a well-informed and productive forum for examination of as wide a range as possible of approaches developed in disparate laboratories worldwide.

Drug Delivery & Targeting (Discovery)

Many biologically active molecules are very active in vitro, but never reach the clinic because of lack of absorption and/or poor in vivo stability. Although a range of delivery systems is available, the delivery of sensitive drugs such as peptides, nucleic acid based therapeutics (including antisense DNA and siRNA), simple and complex carbohydrates, and synthetic vaccines presents a major challenge to the pharmaceutical industry. Industry experts agree that approximately 10% of the costs of drug development program should be allocated to aspects of drug delivery. New developments in drug delivery research are likely to have enormous economic impacts upon the pharmaceutical and biotechnology industries. In fact, drug delivery research represents a US$70 billion a year industry. Centres for Drug Delivery have been established all over the world to promote research, development and training in drug delivery science. There has also been a focus on realizing the commercial potential of innovative molecules (e.g. peptides, nucleic acid based therapies and vaccines) or delivery technologies that are developed from the centres' research. Research in drug delivery is multidisciplinary, requiring knowledge of how drugs work, their chemical and physical properties, how these properties affect the drugs in vivo behaviour, and what could be done to potentially solve any delivery problems associated with drug molecules. Therefore, drug delivery research necessitates interdisciplinary collaborations both at a national and international level.

Drug Delivery & Targeting (Therapy)

Currently, there are no drugs supported by sufficient evidence of efficacy for cerebral vasospasm in patients with subarachnoid hemorrhage, despite abundant evidence of anti-vasospasm drugs at an experimental level. We have developed a drug-delivery system using a vasodilating drug that can be implanted intracranially at the time of surgery for aneurysm clipping, without systemic side effects or side effects associated with long-term intrathecal drug administration through indwelling catheters.

We started our project in 1994 for making slowly-releasing drug-delivery system in vitro, because cerebral vasospasm occurs 4-14 days following subarachnoid hemorrhage. A rod-shaped pellet (1 mm in diameter, 10 mm in length, containing 1 mg of nicardipine) for animal study was prepared by heat compression. Release curve from the pellets was adjusted similar to the time course of cerebral vasospasm by changing the combination of molecular weight and lactic acid ratio of Copoly (lactic/glycolic acid) and nicardipine. We presented the efficacy and safety of this drug delivery system using both canine double hemorrhage and clot placement model. The mean concentration of nicardipine in the clots was 1.5x10-4 mol/L on Day 7 and 5.1x10-6 on Day 14. This drug delivery system can prevent vasospasm significantly in dogs, while maintaining an appropriate concentration of nicardipine in the clot adjacent to the arteries, since maximal relaxation is achieved by 10-6 mol/L of nicardipine. Since October 1999, nicardipine pellets (NPs) (2 mm in diameter, 10 mm in length, containing 4 mg of nicardipine) have been used to prevent vasospasm in patients with SAH. The study was approved by the University Ethical Committee, and informed consent was obtained. A frontotemporal craniotomy and a midline frontal craniotomy (pterional and anterior interhemispheric approach) were performed for aneurysms in the internal carotid artery (ICA), middle cerebral artery (MCA), basilar artery, anterior communicating artery, and distal anterior cerebral artery (ACA). NPs were placed in the cistern of the ICA, the MCA, and/or the ACA, where thick clots existed, and, therefore, vasospasm related to delayed ischemic neurological deficits (DIND) was highly probable. The number of pellets and the location of the placement depended on the amount and site of the subarachnoid clot in the preoperative CT scans, the operative field, and the craniotomy. Cerebral vasospasm was assessed by DIND, and angiography was performed in all patients on Days 7 to 12. We published a preliminary report on the efficacy and safety of NPs to prevent vasospasm in 20 SAH patients. Vasospasm was completely prevented in the arteries in cisterns with thick clots, where vasospasm was highly expected, by placing NPs adjacent to the arteries during surgery. In the first 100 patients treated with NPs, the ratio of DIND, severe angiographical vasospasm and cerebral infarctions was 7%, 11%, and 5%, respectively. No complications were experienced. Thirty-two patients with severe SAH and undergoing aneurysm clipping were included in the single center, randomized, double-blind trial in Germany. The incidence of angiographic vasospasm in proximal vessel segments was significantly reduced after implantation of NPs (73% control versus 7% NPs). Significant differences occurred also for the majority of distal vessel segments. Computed tomography scans revealed a lower incidence of delayed ischemic lesions (47% control versus 14% NPs). The NPs group demonstrated more favorable modified Rankin and National Institute of Health Stroke scales as well as a significantly lower incidence of deaths (38% control versus 6% NPs).

We found that vasospasm is completely prevented in arteries in cisterns with thick clots, where vasospasm is highly expected, by placing NPs adjacent to the arteries during surgery. Lesser efficacy was found for arteries remote from the placement of pellets. Implantation of NPs improves clinical outcome of SAH patients. We consider that this could not be achieved by developing new drugs but by developing methods to maintain an appropriate concentration of the drug in the target cerebral artery and its surrounding environment.

Enabling Technologies

The pace and performance of modern drug discovery and development is based on effective use of a range of technologies. From initial screening to lead identification and drug delivery, emerging technologies are accelerating the drug development. These technologies are also contributing immensely to improvements in the quality and productivity of drug manufacturing. Nanotechnology and ICT are among the most exciting additions in the technology paradigm which hold great promises for future. It is expected that these technologies will not only decrease the cost of the drug development but also reduce the time required for a lead molecule to emerge as a drug for clinical use.

This exciting track will showcase the R&D in emerging technologies to facilitate the drug discovery development process. Based on the very nature of the topic, the speakers and other presenters will include biomedical engineers, physicists, ICT experts, as well as medicinal chemists and health professionals. This important track will be of great interest for scientists, especially with reference to introducing new cutting edge technologies many of which are still not known widely.

The 7th ICDDT will be held in Dubai in February 2016 addresse all areas pertinent to this endeavor concentrating on leads that arise from application of the new knowledge at the cellular and molecular level. The other areas highlighted the impact of Nanomedicine (Application of nanotechnology in Human Health) on diagnosis and treatment of diseases. Nanomedicine is an emerging and expanding field with innumerable applications and may play an important role in translational research or moving from laboratory research to clinical practice.

Inflammation and Immunology: Biomarkers in Targeted-Drug Development for Chronic Inflammatory Diseases (Therapy)

Targeted therapies using biological, such as TNF antagonists, are approved worldwide for the treatment of chronic inflammatory diseases. Despite the success of biological in the treatment of chronic inflammatory diseases, clinical experience revealed that not all patients respond equally, and that there are 'responders' as well as 'nonresponders'. Given the destructive nature of chronic inflammatory diseases, the risk of adverse effects and considerable costs for therapy, there is a strong need to make predictions on success before the start of therapy, aiming towards a personalized form of medicine, whereby a specific therapy will be applied that is best suited to an individual patient. The concept of a personalized form of medicine has attracted interest in the field of drug development to implement biomarker strategies to search for molecular and clinical criteria to dissect clinical responders from non-responders. It is anticipated that implementation of biomarker strategies in drug development will allow:

1. Accelerated drug development and reducing cost by utilizing pharmacodynamic and efficacy biomarkers for rational decision making.
2. Defining enriched populations for clinical trials.
3. Reducing trial size and number through the use of more clinically relevant biomarker endpoints.
4. Utilizing safety markers to identify susce`ptible populations.
5. Enabling therapeutic drug monitoring.
6. Delivering companion diagnostics, thereby driving product differentiation.

To explain the unresponsiveness of anti-TNF antibodies in the treatment of rheumatoid arthritis, essentially two phases of unresponsiveness might be identified: a primary phase directly after the start of treatment, and a secondary phase that develops in initial responders during the course of therapy. The primary phase of unresponsiveness is oriented on the pharmacodynamic and mechanistic aspects of drug intervention. The latter is explained by the formation of anti-drug antibodies (=anti-anti-TNF antibodies) in a subset of patients.

This lecture addressed studies related to pharmacodynamic and immunogenicity issues of treatment with TNF-antagonists in RA towards personalized medicine approaches in rheumatoid arthritis.

Innovative Drug Discovery and Nanotechnology

Nanotechnology has already begun to revolutionize medicine. Nanotechnology involves the use of materials with fundamental length scales in the nanometer dimension which demonstrate significantly changed properties compared to micron structured materials. Such materials can include particles, fibers, grain sizes, etc. This session highlighted the advancements nanotechnology is making in medicine in such fields as disease prevention, diagnosis, and treatment including (but not limited to) drug delivery, tissue engineering, implants, sensors, cancer treatment, and toxicity.

Successful Drug Discovery from the Research Lab to the Marketplace (Discovery)

Every drug has a unique story on its journey from an idea to the marketplace. What is almost always the case though is that each drug has a champion, to help guide the concept and the drug compound through sometimes difficult waters. A company will often be completely reorganized, change management or be acquired by a competitor several times during the period when a promising compound is in late stage discovery or development. There are a number of marketed drugs, including Buspirone, Prozac, Acyclovir, Viagara or Paracetamol that may not have been come to light in modern laboratories. These drugs were invented by scientists relying often on instinctive invention and observation, who sometimes fought shy of formal systems. Many drugs are the product of serendipity, or "lucky" observations, but in fact the scientists involved often "made their own luck", by acting on seemingly disparate data to hunt for a new disease treatment. The session focused on some headline blockbuster drugs, some with well-defined and innovative mechanisms of action as well as some earlier stage compounds with a fascinating rationale and origin. During the talks it was illustrated how every drug is unique; but scientists need to have time and space as well as the motivation to observe and discover, by sound observation. The invention and development of a new drug rarely follows a prescribed pattern. The discipline of Drug-hunting requires determination, openness to new thinking, teamwork and the ability to link apparently disparate observations into a novel rationale. The impact of outstanding project leadership on the process of Drug Discovery and Development was illustrated as an important part of this session.

Successful Drug Discovery from the Research Lab to the Marketplace (Therapy)

In the last decade, drug options for different diseases are rapidly increased, but several of these latters remain a significant global health problem and an area of increased awareness among both patients and medical practitioners. Many scientific results have highlighted new targets for drug discovery, including inhibition of inflammatory mediators and newly formed proteins. Epidemiological and prospective studies have, also, potentially proposed the vital role of bioactive substances, present in the food, and/or set in the context of a dietary, in reducing the risk of cancer and cardiovascular diseases. In addition, the studies for evaluating new molecules to treat painful conditions are in progress. No pharmacologic interventions, such as antioxidants, deserve equal emphasis both in the prevention and treatment of several age-related diseases; therefore, their use as drugs could be useful. New developments in drug delivery research are likely to have important impacts on pharmaceutical and biomedical industries. It is evident that, for the complexity of the disease, strategies targeting different multiple systems involved in disease progression are required to maximize the therapeutic benefits of intervention. To this end, there are a number of approaches currently under active evaluation and for this; the interaction among scientists and industries is required.

Global Roundup of Pharmaceutical Research capabilities and Opportunities

This session will feature six 30-minute Invited Lectures from diverse regions of the world: the Middle East, the Far East, Africa, Europe, North America and South America. Each speaker is to cover the status of biomedical research in their respective regions, especially as it relates to the discovery of new therapeutics and diagnostics for the public good. The very nature of pharmaceutical research has changed dramatically over the past decade, with globalization and networked interactions becoming more prevalent. In addition, there is an increased emphasis being placed upon diseases and disorders of the third world such as for the neglected diseases that afflict one-sixth of humanity. This track of the 7th ICDDT promoted a more globally integrate review of pharmaceutical research.

Generic Pharmaceuticals: Challenges and Opportunities

A generic drug is a compound or formulation which is produced and distributed without patent protection. Note, a drug company could have a patent on the formulation but not on the active ingredients, thus, it would be generic. In the United States (US), a generic drug must contain the same active ingredients as the original formulation. Plus, the US Food and Drug Administration (FDA) identifies and licenses as generic drugs those that are identical or within an acceptable bioequivalent range to the brand name counterpart with respect to pharmacokinetic and pharmacodynamic properties. The generic drug must act very similarly or the same as the brand name product. Thus, any generic considered by the FDA must be identical in dose, strength, route of administration, safety, efficacy, and intended use. Be aware that in the US off label use of drugs often occurs. For example, some anti-angiogenic drugs that are used in colon cancer have been used in ophthalmology for anti-angiogenesis.

The economic aspect of generic products is that once they become available, the market competition results in significantly lower prices for the generic compound as well as for the original brand name product. Thus, there is a saving for the consumer.

In general, US pharmaceuticals companies patent their drugs long before any clinical trial is initiated. Thus, although the US patent is given for 20 years, the effective life of the drug patent tends to vary based on the completion of the clinical trials. The range can be as short as 7 years of exclusive availability of the brand name product up to about 12 years.

The pharmacological, therapeutic, medical, and legal aspects of generic drugs offer significant challenges and opportunities. Industry experts agree that both the brand name drug company (holding the patent) and the generic drug company have the potential to benefit due to the cost reductions. In some instances, there can be cooperation between the brand name company and the generic company. Also, in some select cases in the US, a generic drug developer can be given exclusive rights. This complex dynamic has both medical necessity and justification (legal) components. This can be a unique opportunity for a generic drug company.

The development of generic provides has significant opportunities as well as challenges. The large pharmaceutical companies producing brand names and other companies producing generic products often have complex research and/or business paradigms that appear to be contradictory. If there were regulatory mechanisms in place that would assist both types of enterprises, all the consumers purchasing drugs would benefit. Although regulations can pose barriers, one hopes that in the future these guidelines will be such that they will afford opportunities and rewards for both companies that develop brand names and have patents and companies that produce and market generic drugs.

Generic Pharmaceuticals: Challenges and Opportunities

A generic drug is a compound or formulation which is produced and distributed without patent protection. Note, a drug company could have a patent on the formulation but not on the active ingredients, thus, it would be generic. In the United States (US), a generic drug must contain the same active ingredients as the original formulation. Plus, the US Food and Drug Administration (FDA) identifies and licenses as generic drugs those that are identical or within an acceptable bioequivalent range to the brand name counterpart with respect to pharmacokinetic and pharmacodynamic properties. The generic drug must act very similarly or the same as the brand name product. Thus, any generic considered by the FDA must be identical in dose, strength, route of administration, safety, efficacy, and intended use. Be aware that in the US off label use of drugs often occurs. For example, some anti-angiogenic drugs that are used in colon cancer have been used in ophthalmology for anti-angiogenesis.

The economic aspect of generic products is that once they become available, the market competition results in significantly lower prices for the generic compound as well as for the original brand name product. Thus, there is a saving for the consumer.

In general, US pharmaceuticals companies patent their drugs long before any clinical trial is initiated. Thus, although the US patent is given for 20 years, the effective life of the drug patent tends to vary based on the completion of the clinical trials. The range can be as short as 7 years of exclusive availability of the brand name product up to about 12 years.

The pharmacological, therapeutic, medical, and legal aspects of generic drugs offer significant challenges and opportunities. Industry experts agree that both the brand name drug company (holding the patent) and the generic drug company have the potential to benefit due to the cost reductions. In some instances, there can be cooperation between the brand name company and the generic company. Also, in some select cases in the US, a generic drug developer can be given exclusive rights. This complex dynamic has both medical necessity and justification (legal) components. This can be a unique opportunity for a generic drug company.

The development of generic provides has significant opportunities as well as challenges. The large pharmaceutical companies producing brand names and other companies producing generic products often have complex research and/or business paradigms that appear to be contradictory. If there were regulatory mechanisms in place that would assist both types of enterprises, all the consumers purchasing drugs would benefit. Although regulations can pose barriers, one hopes that in the future these guidelines will be such that they will afford opportunities and rewards for both companies that develop brand names and have patents and companies that produce and market generic drugs.

Inflammation and Immunology: Biomarkers in Targeted-Drug Development for Chronic Inflammatory Diseases (Therapy)

Targeted therapies using biological, such as TNF antagonists, are approved worldwide for the treatment of chronic inflammatory diseases. Despite the success of biological in the treatment of chronic inflammatory diseases, clinical experience revealed that not all patients respond equally, and that there are 'responders' as well as 'nonresponders'. Given the destructive nature of chronic inflammatory diseases, the risk of adverse effects and considerable costs for therapy, there is a strong need to make predictions on success before the start of therapy, aiming towards a personalized form of medicine, whereby a specific therapy will be applied that is best suited to an individual patient. The concept of a personalized form of medicine has attracted interest in the field of drug development to implement biomarker strategies to search for molecular and clinical criteria to dissect clinical responders from non-responders. It is anticipated that implementation of biomarker strategies in drug development will allow:

1. Accelerated drug development and reducing cost by utilizing pharmacodynamic and efficacy biomarkers for rational decision making. 2. Defining enriched populations for clinical trials. 3. Reducing trial size and number through the use of more clinically relevant biomarker endpoints. 4. Utilizing safety markers to identify susce`ptible populations. 5. Enabling therapeutic drug monitoring. 6. Delivering companion diagnostics, thereby driving product differentiation.

To explain the unresponsiveness of anti-TNF antibodies in the treatment of rheumatoid arthritis, essentially two phases of unresponsiveness might be identified: a primary phase directly after the start of treatment, and a secondary phase that develops in initial responders during the course of therapy. The primary phase of unresponsiveness is oriented on the pharmacodynamic and mechanistic aspects of drug intervention. The latter is explained by the formation of anti-drug antibodies (=anti-anti-TNF antibodies) in a subset of patients.

This lecture addressed studies related to pharmacodynamic and immunogenicity issues of treatment with TNF-antagonists in RA towards personalized medicine approaches in rheumatoid arthritis.

Proteomics & Bioinformatics

Proteomics, the large-scale analysis of proteins, contributes greatly to our understanding of gene function in the post-genomic era. Proteomics can be divided into three main areas: (1) protein micro-characterization for large-scale identification of proteins and their post-translational modifications; (2) 'differential display' proteomics for comparison of protein levels with potential application in a wide range of diseases; and (3) studies of protein–protein interactions using techniques such as mass spectrometry or the yeast two-hybrid system. Proteomics technologies are under continuous improvements and new technologies are introduced. Nowadays high throughput acquisition of proteome data is possible. The young and rapidly emerging field of bioinformatics in proteomics is introducing new algorithms to handle large and heterogeneous data sets and to improve the knowledge discovery process. Peptide libraries offer a valuable means for providing functional information regarding protein-modifying enzymes and protein interaction domains.

Crucially, new computational and biochemical tools have emerged that facilitate identification of interaction partners and substrates for proteins on the basis of their peptide selectivity profiles.

Proteomics can be viewed as an experimental approach to explain the information contained in genomic sequences in terms of the structure, function, and control of biological processes and pathways. Proteomics attempts to study biological processes comprehensively by the systematic analysis of the proteins expressed in a cell or tissue.

The field of Bioinformatics provides tools we can use to understand disease processes through the analysis of molecular sequence data. More broadly, bioinformatics facilitates our understanding of the basic aspects of biology including development, metabolism, adaptation, to the environment, genetics and evolution.

Women's Health Drug Discovery & Therapy (Discovery)

The last decade has seen a profound increase in our capacity to treat diseases and conditions affecting women. The discovery and development of new and more effective drugs have played a crucial role in this achievement. In the 7th ICDDT, recent advances made in the discovery of therapeutics and promising new hopes for the improvement of women's health will be reviewed and discussed. Major areas that will be addressed include; treatment of infertility, endometriosis, preterm parturition and cancer. This cutting-edge project will involve multidisciplinary approaches from outstanding scientists across the world.

Women's Health Drug Discovery & Therapy (Therapy)

Osteoporosis is characterized by reduced bone mass and alteration in bone architecture, resulting in increased fracture risk. These fractures are a major cause of morbidity and mortality in postmenopausal women and impose a huge economic burden on health services. Oestrogen deficiency plays a major role in the pathogenesis of bone loss and fracture in women. Other pathogenetic factors include reduced physical activity and vitamin D insufficiency. Several osteoporosis risk-factor screening tools have been developed to identify women at increased risk of low bone mineral density. A range of options is available for the prevention of fractures in high risk postmenopausal women and management of osteoprosis. These include the hormonal therapy, bisphosphonates, strontium ranelate, raloxifene and parathyroid hormone peptides, daily intake of calcium and Vitamin D. Because of their broad spectrum of demonstrated anti-fracture efficacy, alendronate, risedronate, calcitonine and strontium ranelate are generally considered as the first line therapies for most of the women. The optimum duration of treatment for postmenopausal osteoprotic patients has not been established but the re-evaluation of risk and the need for continued therapy should be determined for these women in clinical settings. The compliance and persistence with long-term osteoporosis treatment is generally poor but may be improved by different dosing regimens. Rehabilitation approaches should be considered as the key components of prevention and treatment of osteoporosis. Maintenance of muscle function and balance, as well as daily Vitamin D supplements and calcium intake should also be considered as the main therapies for fracture prevention.

The 7th ICDDT will be held in Dubai in February 2016 and will address all areas related with postmenopausal osteoporosis, concentrating on recent clues in pathophysiology and management strategies at the clinical level. In svarious essions, there will be presentations concerned with the recent advances in pathophsiology of postmenopausal osteoporosis, the screening tools in determining postmenopausal women at the risk of developing osteoporosis, recommendations for prevention and treatment strategies in postmenopausal osteoporosis, adherence to drug treatment in postmenopausal osteoporotic female, patient satisfaction and quality of life in postmenopausal women treated with different groups of drugs, and fall prevention and rehabilitation of osteoporosis. This topic will cover all aspects of postmenopausal osteoporosis and provided a well-informed and productive forum for understanding the basic mechanism of the postmenopausal condition and management approaches based on updated knowledge.