ADA 2019—Teplizumab delays progression to clinical T1D in high-risk relatives


  • Emily Willingham, PhD
  • Conference Reports
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Takeaway

  • Teplizumab delays progression to type 1 diabetes (T1D) in high-risk relatives of people with the condition.

Why this matters

  • These findings are the first to demonstrate an ability to delay progression to T1D, the study authors said in a statement, offering hope to at-risk family members.

Key results

  • During 7 years of the study, 72% (23/32) in placebo group received a T1D diagnosis vs 43% (19/44) in intervention group.
  • Annualized rate of diabetes was reduced by 14.9% with treatment vs 35.9% with placebo.
  • Diagnosis was based on oral glucose tolerance test results.
  • Median time to diagnosis was 48.4 months with treatment vs 24.4 months with placebo (HR, 0.41; 95% CI, 0.22-0.78; 2-sided P=.006).
  • HR persisted with adjustment.
  • Shorter-term side effects were rash and low white blood cell count. 
  • Detection of Epstein-Barr virus DNA in 8 participants in treatment group, all eventually decreasing below detection levels. 
  • Some HLA types were linked to differential responses to the study drug. 

Study design

  • Phase 2, randomized, controlled, double-blind trial, 76 people with a relative who had T1D and who themselves were at high risk.
  • Funding: NIH, others.

Limitations

  • Relatively small cohort; applicability to people without relatives with T1D unknown.