What is the rationale for immunotherapy in type 1 diabetes?

Analysis of pretreatment follicular helper T cell subpopulations could help to identify which patients with newly diagnosed type 1 diabetes are likely to respond to abatacept immunotherapy, suggests research published in Nature Immunology .

Of the immunotherapies tested to date, teplizumab and low-dose antithymocyte globulin are the most promising for slowing the decline in C-peptide in people with newly diagnosed type 1 diabetes, researchers report.

Results of a phase Ib trial published in Science Translational Medicine suggest that immunotherapy with proinsulin peptide is well tolerated in patients with newly diagnosed type 1 diabetes.

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Phase II findings show that the immunotherapy teplizumab significantly prolongs the time until people at very high risk for developing type 1 diabetes are diagnosed with the condition.

A 6-month course of treatment with the tyrosine kinase inhibitor imatinib may slow the decline in beta-cell function in people with newly diagnosed type 1 diabetes, but the effect is not sustained in the longer term, phase 2 study findings indicate.

Phase 2 study results suggest that add-on treatment with an anti-IL-21 antibody plus liraglutide could preserve endogenous insulin secretion in people with recent-onset type 1 diabetes.

They add: “Data presented here suggest that the window for effective immunotherapy starts 6–12 months before the clinical diagnosis.” medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature Group Diabetes Care 2020; doi:10.2337/dc19-2288

But they suggest that their findings will impact the design of immunotherapy trials.