Hope for hundreds of thousands with type 1 diabetes as major study reveals arthritis drug can suppress the condition

• Researchers in Australia found that baricitinib can preserve insulin production
• Olumiant reduces amount of insulin patients need to control their blood sugar

A rheumatoid arthritis drug can suppress the progression of type 1 diabetes in newly diagnosed patients, scientists have said.

In a world-first clinical trial, researchers in Australia found that baricitinib can preserve the body’s own insulin production.

As a result, the anti-inflammatory drug, also known by its brand name Olumiant, reduces the amount of insulin patients need to inject to control their blood sugar.

The team said their finding marks a ‘huge step-change’ in how the condition is managed and treated and could improve ‘the ability to control type 1 diabetes’.

Professor Helen Thomas, head of immunology at St Vincent’s Institute of Medical Research in Melbourne and study author, said: ‘We are very optimistic that this treatment will become clinically available.’

Type 1 diabetes is an autoimmune disease in which the body’s immune system mistakenly attacks and kills the cells in the pancreas that produce insulin.

Therefore, sufferers have to inject insulin to control their blood sugar levels.

Around 430,000 Brits and 2million Americans have type 1 diabetes — around eight per cent of diabetes patients. Nine in 10 sufferers have type 2.

The researchers said there is ‘a substantial number’ of insulin-producing cells still present in the body when type 1 diabetes is first diagnosed.

Professor Thomas Kay, director of St Vincent’s Institute of Medical Research, who led the trial, said: ‘We wanted to see whether we could protect further destruction of these cells by the immune system.’

His team recruited 91 people, aged between 10 and 30 years old, to take part.

The trial was double-blind and randomised, meaning neither the researchers nor the volunteers knew who was taking baricitinib (60 people) and who was receiving a placebo (31 people).

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All patients taking part had been diagnosed with type 1 diabetes within the last 100 days and continued with their prescribed insulin therapy throughout the duration of 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, published in the New England Journal of Medicine, showed that 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, made by US pharma giant Eli Lilly, works by dampening down the immune response mounted against insulin-producing cells in people with type 1 diabetes.

While insulin can save lives, the researchers said the therapy itself is potentially dangerous if too much or too little is administered.

Professor Kay said: ‘It is tremendously exciting for us to be the first group anywhere in the world to test the efficacy of baricitinib as a potential type 1 diabetes treatment.

‘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.’

Commenting on the research Dr Faye Riley, research communications manager at Diabetes UK, said: ‘It’s incredibly exciting to see more positive results from clinical trials of immunotherapies to stop type 1 diabetes in its tracks.

‘For more than 100 years, people living with type 1 diabetes have relied solely on insulin, but 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.’