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Teplizumab Delays Progression of Type-1 Diabetes

Patients need less insulin in phase II trial (August 7)

An experimental drug was able to block the advance of type-1 diabetes in its earliest stages over a period of 2 years in about 50% of the patients in a phase 2 randomized clinical trial. The results were published in Diabetes.

Teplizumab (Eli Lilly) uses an antibody targeted against a molecule called CD3 to bind T cells and to restrain them from attacking beta cells. The drug enabled many patients to maintain their level of insulin production for the entire 2 years, although some participants did lose an ability to produce insulin. The varied responses might have been a result of differences in the patients’ metabolic condition and in the severity of disease at the trial’s start. The researchers suggested that the sooner treatment begins, the sooner a prediabetes condition can be detected and the patient can be protected from the progressive damage caused by an autoimmune attack.

The new study was led by Kevan Herold, MD, PhD, at Yale University, and Jeffrey Bluestone, PhD, at the University of California–San Francisco. The trial included 52 patients, most of them younger than 14 years of age. All of the patients received teplizumab for 2 weeks at diagnosis and again 1 year later. Their capacity to produce their own insulin was compared with that of a non-treated group. Because the participants received daily insulin injections before and during the trial, researchers monitored blood levels of C-peptide, a molecule produced in the pancreas at the same rate as insulin.

Formerly called juvenile diabetes, type-1 diabetes is caused by an autoimmune condition in which the body’s immune system destroys insulin-producing beta cells in the pancreas. For unknown reasons, the incidence of this disease is increasing and the age of onset is decreasing.

Sources: UCSF; August 7, 2013; and Diabetes; July 8, 2013.

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