A commonly prescribed rheumatoid arthritis drug may suppress the progression of type 1 diabetes, according to a study published in the New England Journal of Medicine.
The researchers at St Vincent's Institute of Medical Research (SVI) in Melbourne found that the 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.
Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin. It typically appears in adolescence. The disease can also occur in children and adolescents depending on how many B-cells of the pancreas are non-functioning.
"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," said SVI's Professor Thomas Kay.
"We showed that baricitinib is safe and effective at slowing the progression of type 1 diabetes in people who have been recently diagnosed," Kay said.
The findings show promise as the first disease-modifying treatment of its kind for type 1 diabetes that can be delivered as a tablet, the researchers said.
"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 Kay.
"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," the researcher said.
The randomised, double-blind, placebo-controlled human trial of the drug baricitinib monitored the blood glucose and insulin production of 91 participants over the course of one year.
Of these, 60 were given baricitinib and 31 were given a placebo. All trial participants were aged between 10 years and 30 years and started on the trial within 100 days of having been diagnosed with type 1 diabetes.
The study shows that 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, the researchers 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," said Professor Helen Thomas, preclinical lead on the trial.
