A pill prescribed for arthritis could become the first treatment to reduce the severity of Type 1 diabetes, a groundbreaking study has found.
In a world-first trial, researchers discovered baricitinib, a common drug available on the NHS, slows the progression of Type 1 diabetes by preventing the destruction of beta cells, which produce insulin.
Beta cells are still present in large numbers after the onset of Type 1 diabetes but are destroyed over time by the body’s own immune system. A 48-week trial found that this process could be stopped by baricitinib.
The results, published in the New England Journal of Medicine, revealed that people on the drug had 48 per cent more insulin-producing cells than their counterparts taking a placebo, and were less reliant on insulin injections.
Experts said the results were “edging us towards a new era in Type 1 diabetes treatment, and could help us overcome a major hurdle on route to finding a cure for the condition”.
Baricitinib is a type of drug known as an immunotherapy and primarily used to treat rheumatoid arthritis, an autoimmune disease that involves the immune system wrongly identifying a threat and turning on the body.
It has also been used to treat Covid-19 and alopecia in some countries.
First treatment since insulin
If it were to be licensed for use to treat Type 1 diabetes it would become the first treatment for the condition since the discovery of insulin more than 100 years ago.
Patients are currently limited to regular injections or use of an insulin pump, and have to monitor their blood sugar levels around the clock.
Researchers at St Vincent’s Institute of Medical Research (SVI) in Melbourne, Australia, analysed 91 people, with an average age of 18, who had been diagnosed with Type 1 within the last 100 days, and still had adequate reserves of beta cells.
They measured participants’ daily dose of insulin, the amount of insulin produced by their own pancreas, and short and long-term blood sugar levels.
Prof Thomas Kay, the lead researcher from SVI, said it was “safe and effective at slowing the progression of Type 1 diabetes”.
“Our trial showed that, if started early enough after diagnosis, and while the participants remained on the medication, their production of insulin was maintained,” he said.
“People with Type 1 diabetes in the trial who were given the drug required significantly less insulin for treatment.”
The drug works by blocking the immune response against the insulin-producing cells and so delays the onset of severe symptoms and improves glucose control.
People with Type 1 are at increased risk of hypo and hyperglycemia while on insulin injections, as well as life-threatening conditions like heart attacks and strokes, vision impairment, kidney disease and nerve damage.
Around 350,000 people in Britain have Type 1 diabetes, which is a lifelong condition, rather than the more common Type 2, which is heavily influenced by lifestyle factors.
Dr Faye Riley, the research communications manager at Diabetes UK, said: “Immunotherapies are edging us towards a new era in Type 1 diabetes treatment, and could help us overcome a major hurdle on route to finding a cure for the condition. This trial takes us another step closer.”
Prof Helen Thomas, one of the researchers, said they were “very optimistic that this treatment will become clinically available” and added it promised “a fundamental improvement in the ability to control Type 1 diabetes”.