A drug for alopecia surprises in type 1 diabetes

A daily pill Baricitinibcommonly prescribed for rheumatoid arthritis and alopeciacould safely preserve the insulin production of the body itself and delay the progression of type 1 diabetes (DT1) in recently diagnosed people with the disease, according to the innovative Australian essay Bandit, carried out by the Institute of San Vicente Medical Research(Australia).

What is the baricitinib and how does it act in type 1 diabetes?

The monitoring of the blind Bandit essay, is presented in the Annual meeting this year of the European Association for Diabetes Study (EASD) which is celebrated in Vienna from September 15 to 19. This reveals that once the treatment with Baricitinib was interrupted, the diabetes of the participants progressed: They produced less insulin and had less stable blood sugar levels, that were not significantly different from those of the placebo group.

“Among the promising agents who have proven to preserve the function of beta cells in type 1 diabetes, the baricitinib stands out because it can be taken orally, it is well tolerated, even by young children, and it is clearly effective,” reports the author, the doctor Michalea Waibel, of the St. Vincent Medical Research Institute in Australia.

In addition, he adds: “These latest data support our previous clinical trial data by demonstrating that the therapeutic effect is lost when baricitinib is suspended and justify additional tests to determine whether the benefit of the treatment can be maintained for many years and whether to treat the early stages of the disease can prevent or delay the clinical diagnosis.”

Type 1 diabetes occurs when the immune system I attack the insulin producing cells of the pancreas by mistake. Over time, this entails the need for life insulin injections to control blood sugar levels.

The baricitinib, an inhibitor of the Janus kinase (JAK), acts blocking the signals in the body that cause the hyperactivity of the immune system and helps to protect the remaining insulin producing cells in people with recent diagnosis of type 1 diabetes, thus delaying the progression of the symptoms. It is already prescribed to treat various autoimmune diseases, such as rheumatoid arthritis, ulcerative colitis and alopecia.

The Bandit trial included 91 people between 10 and 30 years old with a diagnosis of type 1 diabetes in the previous 100 days. The participants They received a baricitinib pill (4 mg) or a placebo once a day for 48 weeks.

At the beginning of the trial and in weeks 12, 24 and 48, the researchers measured the C peptide levels (a marker of insulin secretion) of the participants to determine how much insulin they could produce themselves. They also used continuous glucose and HBA1C monitoring (a long -term blood glucose level marker) to assess the need for injected insulin and good control of blood glucose levels.

What happened after suspending baricitinib treatment

The findings revealed that taking a daily baricitinib pill for 48 weeks preserved the function of beta cells of insulin producersdecreased the fluctuations of blood glucose and reduced the need for insulin in people with a recent diagnosis of type 1 diabetes. The researchers also discovered that the baricitinib was safe and no side effects were attributed.

In this study, researchers report the findings of the monitoring period without medications, with evaluations carried out in weeks 72 and 96.

At 48 weeks, the C peptide level was 0.65 in the Baricitinib group and 0.43 in the placebo group. After suspending the treatment, the C peptide levels decreased to 0.49 in the Baricitinib group and 0.36 in the placebo group at 72 weeks, and subsequently at 0.37 and 0.26, respectively, at 96 weeks, which demonstrates a reduction in insulin production.

The fall in the function of beta cells of insulin producers after suspending the treatment with Baricitinib resulted in the need for greater insulin treatment, with insulin requirements in weeks 72 and 96 that were not significantly different among the groups.

The interruption of baricitinib treatment also caused a deterioration in glucose control, with differences in the time elapsed in the safe range of glucose and fluctuations of blood glucose between the groups in the first 48 weeks, which were no longer statistically significant in weeks 72 and 96.

Towards an early and preventive treatment of type 1 diabetes

Subsequent analysis did not allow identifying any characteristic at the beginning of the trial that predied the response to treatment, such as age, specific genes of the immune system known as human leukocyte antigens (HLA), the body mass index (BMI) or the number of autoantibodies. In addition, adherence to treatment (at least 80% of the drug of the administrated study) did not distinguish patients who responded to the treatment of those who did not. In general, around Two thirds of the participants who took Baricitinib completed the response criteria.

It should be noted that no additional security concerns arose during the monitoring period.

“For the first time, we have a modifier treatment of oral disease that can intervene sufficiently in advance to allow people with type 1 diabetes depending significantly less on insulin treatment and allow them to free themselves from the demands of the daily management of the disease, which could also reduce long -term complications rates,” says Waibel.

“If we identify people at high risk of developing type 1 diabetes through genetic tests and blood markers, we could offer them treatment even before to prevent the appearance of the disease,” he predicts.