Common drug could facilitate “huge step-change” in managing type 1 diabetes

Results from a world-first human trial, published in the New England Journal of Medicine, has shown that a drug called baricitinib has promise as the first disease-modifying treatment of its kind for type 1 diabetes, that can be administered as a tablet. 

The researchers noted that baricitinib, a small molecule drug currently used to treat rheumatoid arthritis, could 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.   

According to the researchers, the drug blocks an enzyme that normally aids the transmission of signals that regulate the immune system and inflammation. Fundamentally, the treatment delays the onset of full symptoms of the disease, improving glucose control and reducing potential for detrimental longer term health effects.  

“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,” stated Professor Thomas Kay, Director of the St Vincent’s Institute of Medical Research in Australia. 

A world-first clinical trial in type 1 diabetes

In the Phase II clinical trial for baricitinib, investigators monitored the blood glucose and insulin production of 91 participants aged between 10 and 30 years old, over a one-year period. Of those enrolled, 60 were given baricitinib and 31 were given a placebo.

Participants remained on their prescribed insulin medication throughout the study. Researchers monitored participants’ total daily dose of insulin, the amount of insulin produced endogenously, blood glucose and HbA1C levels or glycated haemoglobin, a measure of average blood glucose levels for the last two to three months. 

If the treatment is approved, it 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,” commented Professor Helen Thomas, preclinical lead on the trial.