World-first trial finds arthritis drug may help treat type 1 diabetes

A world-first clinical trial has found a common drug used to treat rheumatoid arthritis can suppress the progression of type 1 diabetes in recently diagnosed patients.

Researchers at St Vincent’s Institute of Medical Research in Melbourne, Australia, discovered baricitinib can preserve the body’s own insulin production.

They described the finding as “a huge step-change” in how the condition is managed and treated and said their work “shows promise as a fundamental improvement in the ability to control type 1 diabetes”.

Type 1 diabetes is a chronic condition that causes a person’s blood sugar level to become too high because their body is unable to make insulin.

Their body’s immune system mistakenly attacks and kills the cells in the pancreas that produce the hormone, which means they are dependent on regular insulin injections in order to survive.

Professor Thomas Kay, who led the trial, said: “We wanted to see whether we could protect further destruction of these cells by the immune system.”

The scientists recruited 91 people, aged between 10 and 30 years old, to take part in the double-blind randomised trial.

It meant neither the researchers nor the volunteers knew who was taking baricitinib (60 people) and who was receiving a placebo (31 people).

All patients had been diagnosed with type 1 diabetes within the last 100 days and continued with their prescribed insulin therapy throughout the study.

The researchers monitored their total daily dose of insulin, the amount of insulin produced in the body, as well as their blood sugar levels.

The results showed those in the baricitinib group were able safely and effectively to preserve their body’s own insulin production and suppress the progression of type 1 diabetes.

It is thought the drug works by dampening down the immune response mounted against insulin-producing cells in people with type 1 diabetes.

Professor Kay said: “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.”

It is estimated around 8.4 million people across the world had type 1 diabetes in 2021, with numbers projected to rise to 17.4 million by 2040.

In the UK, around 8% of people with diabetes have type 1 diabetes.

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Dr Faye Riley, research communications manager at Diabetes UK, said of the latest trial: “These findings show by tackling the root of type 1 diabetes – an immune system attack – an existing drug can help to shield the pancreas, in people recently diagnosed with type 1, so they can continue making more insulin for longer.

“This can give people with type 1 diabetes much steadier blood sugar levels and help to protect against serious diabetes complications down the line.

“Immunotherapies are edging us towards a new era in type 1 diabetes treatment, and could help us overcome a major hurdle en route to finding a cure for the condition.

“This trial takes us another step closer.”

The study was funded by JDRF, a non-profit organisation which focuses on type 1 diabetes research.

The research has been published in the New England Journal of Medicine.

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