Experimental Drug Delays Type 1 Diabetes in People at High Risk; NIH-Funded Study Shows That Immunotherapy with Monoclonal Anti-CD3 Antibody (Teplizumab) Slows Progression to Clinical Disease by Two Years or More

A treatment affecting the immune system effectively slowed the progression to clinical type 1 diabetes in high-risk individuals, according to findings from National Institutes of Health-funded research. The study is the first to show that clinical type 1 diabetes can be delayed by two or more years among people who are at high risk. These results were published online on June 9, 2019 in The New England Journal of Medicine and presented at the American Diabetes Association Scientific Sessions (June 7-11) in San Francisco. The NEJM article is titled “An Anti-CD3 Antibody, Teplizumab, in Relatives at Risk for Type 1 Diabetes.” The study, involving treatment with an anti-CD3 monoclonal antibody (teplizumab), was conducted by Type 1 Diabetes TrialNet (https://www.trialnet.org/), an international collaboration aimed at discovering ways to delay or prevent type 1 diabetes. Researchers enrolled 76 participants ages 8-49 who were relatives of people with type 1 diabetes, had at least two types of diabetes-related autoantibodies (proteins made by the immune system), and abnormal glucose (sugar) tolerance. Participants were randomly assigned to either the treatment group, which received a 14-day course of teplizumab, or the control group, which received a placebo. All participants received glucose tolerance tests regularly until the study was completed, or until they developed clinical type 1 diabetes - whichever came first. During the trial, 72% of people in the control group developed clinical diabetes, compared to only 43% of the teplizumab group. The median time for people in the control group to develop clinical diabetes was just over 24 months, while those who developed clinical diabetes in the treatment group had a median time of 48 months before progressing to diagnosis.
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