Promising Oral Therapy for Type 1 Diabetes Shows initial Success, Requires Continued Treatment
Recent research presented at the European Association for the Study of Diabetes (EASD) annual meeting in Vienna this September, offers a glimmer of hope for individuals newly diagnosed with Type 1 diabetes. A study conducted by Australian researchers, dubbed “Baricitinib in the recent onset of type 1 diabetes” (bandit study), investigated the potential of the oral drug baricitinib to preserve pancreatic beta cell function and reduce reliance on insulin injections.
the randomized, placebo-controlled trial involved 91 participants aged 10-30, all diagnosed within the previous 100 days. For 48 weeks, half received 4mg of baricitinib daily, while the other half received a placebo. Researchers closely monitored levels of Peptide C (a key indicator of insulin secretion), blood glucose levels, and insulin requirements.
Initial findings were encouraging.Baricitinib demonstrated an ability to maintain beta cell function,stabilize blood sugar,and decrease the amount of injectable insulin needed by participants. Importantly, the drug was well-tolerated with no significant adverse side effects reported.
Though, a crucial follow-up analysis revealed that these benefits are not sustained once treatment ceases. After stopping baricitinib, insulin production declined, and glycemic control deteriorated, effectively erasing the differences observed between the treatment and placebo groups at 72 and 96 weeks.
Baricitinib belongs to a class of drugs called Janus kinase (Jak) inhibitors, which work by suppressing overactive immune responses.Type 1 diabetes is an autoimmune disease where the body’s immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas. By modulating the immune system, baricitinib aims to temporarily protect these remaining functional cells.
The extended analysis also showed that factors like age, body mass index (BMI), or the presence of specific immune genes did not predict a patient’s response to the drug. Approximately two-thirds of patients treated with baricitinib experienced a positive response, with no new safety concerns arising during the extended observation period.
Dr. Michaela Waibel, from the Medical research Institute st. Vincent’s in Australia,highlighted the drug’s advantages: “baricitinib is notable for being administered orally,it is well tolerated even in children and has a clear efficiency in preserving the function of beta cells. For the first time, we have an oral treatment that changes the evolution of the disease and can intervene early enough to allow people with type 1 diabetes to depend on the treatment with insulin, and, simultaneously occurring, reducing the risk of long-term complications.”
Dr. Waibel emphasized the need for further research to determine if long-term treatment can maintain these benefits and whether initiating therapy in even earlier, preclinical stages could perhaps prevent the disease’s onset.
Currently, Type 1 diabetes requires lifelong insulin therapy. Specialists are hopeful that early immunomodulatory interventions, like this oral medication, could alter the disease’s trajectory.
The next steps involve Phase III clinical trials, expanding testing to include individuals with both recent-onset and early-stage autoimmune disease. if these results are confirmed, baricitinib could become the first oral therapy to modify the course of Type 1 diabetes within the next five years.
Notably, baricitinib is already approved in the European Union for treating conditions like rheumatoid arthritis, alopecia, and atopic dermatitis.
