Immunotherapy delays type 1 diabetes diagnosis in people at high risk.
Researchers are one step closer to preventing type 1 diabetes, thanks to TrialNet research funded by the US National Institutes of Health (NIH), primarily through the Special Diabetes Program, with additional support from JDRF, the leading global organisation funding type 1 diabetes research.
Presented on June 9 at the 2019 American Diabetes Association’s 79th Scientific Sessions and published in the New England Journal of Medicine findings from TrialNet’s Teplizumab (anti-CD3) Prevention Study show a drug that targets the immune system can delay type 1 diabetes a median of two years in children and adults at high risk.
All study participants were relatives of people with type 1 diabetes who had two or more autoantibodies and abnormal blood sugar levels as identified by TrialNet’s Pathway to Prevention study. These individuals are thought to have a lifetime risk of clinical diagnosis nearing 100%. Of the 76 high risk individuals who participated in the study, 55 were under age 18.
Type 1 diabetes occurs when the body’s immune system attacks and destroys insulin-producing beta cells in the pancreas, causing abnormal blood glucose (sugar) levels. Teplizumab interferes with the body’s immune destruction of its own beta cells. While previous studies showed teplizumab prolonged insulin production in people recently diagnosed, this is the first study to test it in people at high risk for the disease.
Importantly, this study highlights that type 1 diabetes is an autoimmune disease that can be delayed with immune therapy. TrialNet has several other immune therapy trials aiming to delay type 1 diabetes.
“This is the first study to show any drug can delay type 1 diabetes diagnosis a median of 2 years in people at high risk,” explains TrialNet Teplizumab Prevention Study Chair Kevan Herold, M.D. “As anyone with type 1 diabetes will tell you, and particularly for children who are most commonly affected, every day you can delay this disease is important.” Dr. Herold is Professor of Immunobiology and Internal Medicine at Yale University.
Karen Addington, UK Chief Executive of type 1 diabetes research charity JDRF, said: “Type 1 diabetes can be tough. We want a cure for those already living with type 1. But we also want to prevent this condition ever developing in those at risk. Learning how to delay onset is the first step.
“Today’s discovery proves the impact of our type 1 diabetes research programme, which is funded by our supporters. My thanks to each and every one of those supporters and to our research partners. We will not waver in our mission to eradicate type 1 diabetes.”
“These results and the potential impact to people living with type 1 diabetes and their families is exactly why JDRF funds prevention research.” said Aaron J. Kowalski, Ph.D., JDRF President and international CEO. “Delaying the progression of the disease is an essential and impactful step toward the prevention, and ultimately a cure for type one, as a delay in diagnosis is likely to have long-term benefits on glycemic control and the development of acute and long-term complications of type 1 diabetes.”
TrialNet Chair Carla Greenbaum, M.D., Director of the Diabetes Research Program at Benaroya Research Institute in Seattle, says, “In addition to being able to accurately predict who will develop T1D, we have now found a way to delay it. This is an incredible advancement that gets us one step closer to our ultimate goal: a future without T1D. Relatives are urged to get screened for risk at TrialNet.org.”
The Teplizumab Prevention Study was primarily funded by NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and JDRF. MacroGenics/Provention Bio donated the study drug and provided funds for additional site monitoring.