World-first human trial finds arthritis drug can suppress progression of type 1 diabetes

Researchers at St Vincent’s Institute of Medical Research (SVI) in Melbourne have shown that a commonly prescribed rheumatoid arthritis drug can suppress the progression of type 1 diabetes. The world-first human trial, published in the New England Journal of Medicine and led by SVI’s Professor Thomas Kay, showed that a drug called baricitinib can safely and effectively 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. 

“When type 1 diabetes is first diagnosed there is a substantial number of insulin-producing cells still present. We wanted to see whether we could protect further destruction of these cells by the immune system. We showed that baricitinib is safe and effective at slowing the progression of type 1 diabetes in people who have been recently diagnosed,” said Professor Kay. “People with type 1 diabetes in the trial who were given the drug required significantly less insulin for treatment.” 

This ground-breaking research shows promise as the first disease-modifying treatment of its kind for type 1 diabetes that can be delivered as a tablet. “We are very optimistic that this treatment will become clinically available. This 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,” said Professor Helen Thomas, preclinical lead on the trial.

Baricitinib blocks an enzyme that normally helps to transmit signals that regulate the immune system and inflammation. The drug is currently prescribed for the treatment of rheumatoid arthritis, which is another autoimmune disease. It is thought that the drug similarly dampens down the immune response that is mounted against insulin-producing cells in people with newly diagnosed type 1 diabetes, thus delaying the onset of full-blown symptoms of the disease, improving glucose control and reducing potential for detrimental longer term health effects.

Source: St Vincent’s Institute of Medical Research, Medical Xpress, December 6, 2023; see source article