Ground-breaking clinical trial shows promise for type 1 diabetes

The progression of type 1 diabetes could be suppressed by a commonly prescribed drug used for treating rheumatoid arthritis, a world-first study has revealed.

Professors Thomas Kay and Helen Thomas, from St Vincent’s Institute of Medical Research in Melbourne, Australia, led the trial.

According to the study, a drug called baricitinib can safely and effectively preserve the body’s own insulin production and suppress the progression of type 1 diabetes in people who initiated treatment within 100 days of diagnosis.

Professor Kay said: “When type 1 diabetes is first diagnosed there is a substantial number of insulin-producing cells still present.

“We wanted to see whether we could protect further destruction of these cells by the immune system. We showed that baricitinib is safe and effective at slowing the progression of type 1 diabetes in people who have been recently diagnosed.”

This finding offers new hope for type 1 diabetes as it could be the first disease-modifying treatment of its kind for the condition that can be delivered as a tablet.

“It is tremendously exciting for us to be the first group anywhere in the world to test the efficacy of baricitinib as a potential type 1 diabetes treatment,” said Professor Kay.

He added: “Up until now, people with type 1 diabetes have been reliant on insulin delivered via injection or infusion pump.

“Our trial showed that, if started early enough after diagnosis, and while the participants remained on the medication, their production of insulin was maintained.

“People with type 1 diabetes in the trial who were given the drug required significantly less insulin for treatment.”

Management of the lifelong autoimmune disease is incredibly burdensome on those diagnosed and their families, requiring meticulous glucose monitoring and insulin administration day and night to stay alive.

Until insulin’s discovery more than 100 years ago, type 1 diabetes was a fatal condition. Despite insulin’s life-saving role, the therapy itself is potentially dangerous if too much or too little is administered, and the condition still comes with long-term complications, including heart attack and stroke, vision impairment, kidney disease and nerve damage.

Professor Thomas said: “We are very optimistic that this treatment will become clinically available. This would be a huge step-change in how type 1 diabetes is managed and we believe it shows promise as a fundamental improvement in the ability to control type 1 diabetes.”

The clinical trial was funded by JDRF, the leading type 1 diabetes research, advocacy and community programs organisation, including through the JDRF Type 1 Diabetes Clinical Research Network.

Partners included The Royal Melbourne Hospital, St Vincent’s Hospital Melbourne, The Royal Children’s Hospital and The Women’s and Children’s Hospital in Adelaide.

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