World-first clinical trial shows promise for type 1 diabetes

A commonly prescribed rheumatoid arthritis drug can suppress the progression of type 1 diabetes, according to an Australian world-first clinical trial by researchers at St Vincent’s Institute of Medical Research in Melbourne.

Led by Professors Thomas Kay and Helen Thomas, the trial has showed that 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.