A widely prescribed rheumatoid arthritis pill could potentially stop the progression of type 1 diabetes, according to a pioneering study.
The results gave hope that many patients who began treatment soon after diagnosis would require fewer insulin injections or a lower dose of insulin injections as their ability to naturally produce insulin was “maintained” during the 48 weeks of treatment. although this was so, it is still not so. The question is whether this potential will continue in the long term.
If cases are identified and treated very early, the hope is that patients will eventually be able to stop taking insulin injections altogether, the researchers say, emphasizing that this has not yet been proven in studies and may never happen.
Insulin helps control blood sugar levels and prevent serious short- and long-term health problems called diabetes complications.
Reducing or eliminating the amount of insulin needed to compensate for deficiency in diabetics would make their disease much easier to manage, the researchers said.
Researchers predict the treatment will reduce the risk of long-term complications such as kidney failure and low blood sugar or hypoglycemia, with symptoms such as anxiety and dizziness.
A world-first study in humans found that the drug, known as baricitinib or Olumiant, could safely and effectively support the body’s insulin production and suppress the development of type 1 diabetes in people who started treatment within 100 days of diagnosis.
Most study participants required some amount of insulin as their condition progressed to the point where their ability to produce insulin decreased. But they required much less of the drug than those who did not take the drug.
Although other treatments for type 1 diabetes are currently being tested that appear to have a similar effect on insulin levels, such as the immunotherapy drugs teplizumab and low-dose antithymocyte globulin, the key difference is that they require intravenous infusions or injections. while this method does not require intravenous infusions or injections. Treatment is given in the form of daily tablets, the study says.
“We are very optimistic that this treatment will become clinically available. “This will be a huge advance in the treatment of type 1 diabetes and we believe it promises to be a fundamental improvement in the ability to control type 1 diabetes,” said Professor Helen Thomas from St Vincent’s Institute of Medical Research (SVI). . . in Melbourne.
It is unclear how much the drug would cost if used in this way, but in the UK it costs around £10,000 a year to treat arthritis.
Professor Thomas Kay, also from St Vincent’s, who led the trial, told the story. I He hoped the drug would be available within three to five years because it is already used for arthritis and there is plenty of safety data.
However, he said another clinical trial would likely be needed first to confirm the benefit.
He said: “When type 1 diabetes is first diagnosed, a significant number of insulin-producing cells are still present. This is a new way to support the natural way of producing insulin with a well-tolerated daily tablet, whereas for the last 100 years, treatment of type 1 diabetes has been limited to controlling insulin loss by injecting insulin.
“Maintaining insulin production makes diabetes easier to manage and may lead to fewer long-term complications.
“When type 1 diabetes occurs, treatment is difficult, especially for young children, adolescents and their families. The development of diabetes and insulin treatment entails physical and mental stress, which can be reduced with this treatment.”
Professor Kay continued: “Until now, people with type 1 diabetes have had to rely on insulin administered through an injection or infusion pump. Our study found that participants’ insulin production was maintained when they started early enough after diagnosis and continued taking the medication. People with type 1 diabetes in the study who received the drug required significantly less insulin for treatment.”
“In our study, relatively few people no longer needed insulin at all. But it’s entirely possible that if baricitinib had been started earlier (we started it within 100 days of diagnosis) or even before routine diagnosis, when people could have been identified through screening. [they may no longer need insulin injections]. We have not yet tested baricitinib in this latter situation.”
Experts not involved in the study welcomed the results.
Dr Fay Riley, research communications manager at Diabetes UK, said the results were “incredibly exciting”.
“This can help people with type 1 diabetes have much more stable blood sugar levels and help protect against serious diabetes complications later in life,” she said.
“For more than 100 years, people with type 1 diabetes have relied solely on insulin, but these results suggest that an existing drug may help protect the pancreas by targeting the cause of type 1 diabetes – an attack on the immune system ‘may’ they be diagnosed with type 1 to they were able to produce more insulin for longer.”
Sharyn Forbes, from the University of Edinburgh, said: “There have been other clinical trials of type 1 diabetes using injectable immunotherapies such as tepluzimab; What is new is that baricitinib is an orally active ingredient. This has potential great benefits for the treatment of patients, especially young children, diagnosed with type 1 diabetes.”
“It’s a well-organized process,” she added.
Professor Lucy Walker, from University College London, said: “The drug tested here appears to weaken the immune system’s ability to damage insulin-producing cells in the pancreas, thereby slowing the progression of type 1 diabetes.” larger ones. We would like to see follow-up studies of this drug to determine the extent and duration of benefit.”
Jonny Ludvigsson, from Linköping University in Sweden, said it was “a promising treatment that could soon be offered to patients with type 1 diabetes in the early stages of the disease. “With sufficient healthcare resources, such treatment would be feasible.”
Before the discovery of insulin more than 100 years ago, type 1 diabetes was a fatal disease. Despite the vital role of insulin, the therapy itself is potentially dangerous if too much or too little insulin is given, and the condition is still associated with long-term complications such as heart attacks and strokes, vision problems, kidney disease and nerve damage.
Baricitinib blocks an enzyme that normally helps transmit signals that regulate the immune system and inflammation.
The drug is currently prescribed to treat rheumatoid arthritis, another autoimmune disease. The drug is thought to similarly dampen the immune response that occurs against insulin-producing cells in people newly diagnosed with type 1 diabetes. This delays the onset of full disease symptoms, improves glucose control, and reduces the risk of long-term adverse health effects.
The study monitored the blood sugar levels and insulin production of 91 participants for a year. Of these, 60 received baricitinib and 31 received placebo.
All study participants were aged 10 to 30 years and entered the study within 100 days of being diagnosed with type 1 diabetes.
Participants continued their prescribed insulin therapy throughout the study.
The researchers monitored the participants’ total daily insulin dose, the amount of insulin produced by their own pancreas, blood sugar levels, and HbA1C levels. HbA1c, or glycated hemoglobin, is a measure of your average blood sugar levels over the past two to three months.
Source: I News
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