March 24, 2020 Immunotherapy may delay type 1 diabetes

A drug that targets the immune system may help delay type 1 diabetes in children and adults at high risk for the disease. This is the finding of the TrialNet Teplizumab Prevention Study, which is part of the largest clinical trial network ever to research prevention of type 1 diabetes.

The drug teplizumab is designed to stop the immune system from destroying the beta cells (the brown spots pictured above), which is what happens in type 1 diabetes. Earlier research showed that teplizumab can extend insulin production in people recently diagnosed with type 1 diabetes. The goal of this study, which was published in the New England Journal of Medicine, was to test whether the drug could delay or even stop type 1 diabetes from developing in people at high risk.

The study involved 76 people, 55 of whom were under age 18. They were considered high risk because they all had a relative with type 1 diabetes and had two or more type 1 diabetes autoantibodies (proteins that mistakenly attack the body), as well as abnormal blood sugar levels. They were divided into two groups: One group received teplizumab for 14 days, while the control group received a placebo (a drug with no active ingredient).

Almost three-quarters of people in the control group developed type 1 diabetes (in an average of just over two years), compared to less than half of those in the teplizumab group (who, on average, took four years before the disease was diagnosed).

“We are excited to be part of this groundbreaking research and its potential to impact people at risk for type 1 diabetes,” says Dr. Diane Wherrett, staff endocrinologist and principal investigator for TrialNet at the Hospital for Sick Children in Toronto, one of the sites involved in the study.

These findings highlight that type 1 diabetes is an autoimmune disease that can be delayed with immunotherapy.

With more than 200 centres worldwide, TrialNet offers free screening to relatives of people with type 1 diabetes who want to find out their personal risk of developing the disease. This unique screening can identify the early stages of type 1 diabetes years before any symptoms appear. It also helps researchers to learn more about how the disease develops and to plan new studies exploring ways to prevent it. For more information, visit trialnet.org.

(This article appeared in Diabetes Dialogue, Winter 2020)