Type 1 diabetes: Rheumatoid arthritis drug shows promise as treatment

Evan Walker
Evan Walker TheMediTary.Com |
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Researchers are hoping a rheumatoid arthritis drug may someday be prescribed to treat type 1 diabetes. mixetto/Getty Images
  • A commonly prescribed medication for rheumatoid arthritis might help prevent the progression of type 1 diabetes, according to new research.
  • Researchers said a few participants in the clinical trial did not need any insulin by the end of the study. The rest of the participants decreased the amount of insulin they needed daily.
  • Researchers reported that although the drug reduced the need for insulin, it did not cure the disease.

Researchers at St Vincent’s Institute of Medical Research in Melbourne, Australia, are reporting that a commonly prescribed rheumatoid arthritis drug can help suppress the progression of type 1 diabetes.

Their findings were revealed in a study published in the New England Journal of Medicine.

The medication, baricitinib (Olumiant), is an immunosuppressant used in the treatment of rheumatoid arthritis.

Baricitinib has also been approved by the Federal Drug Administration (FDA) for use in treating alopecia areata. Additionally, the results of clinical trials of baricitinib in combination with topical corticosteroids for treating atopic dermatitis have also been promising.

Like type 1 diabetes, rheumatoid arthritis, atopic dermatitis, and alopecia areata are autoimmune disorders.

In addition, the FDA granted emergency use authorization in 2020 to baricitinib to treat COVID-19 when combined with remdesivir for people needing a respirator.

The researchers noted that there was too much irreversible damage by the time of diagnosis to allow for the complete cessation of insulin therapy in participants.

“These are exciting findings since the only medication approved by the FDA to delay the onset of clinical type 1 diabetes is an infusion,” said Dr. Eliud Sifonte, an endocrinologist at NYU Langone Medical Associates — West Palm Beach in Florida who was not involved in the research. “I would like to see further studies showing similar or better efficacy.”

“It remains to be seen whether treating patients earlier in their process may lead to delaying the need for insulin. In this study, we saw decreased dosages, but patients had to continue using insulin nevertheless,” Sifonte told Medical News Today. “The study showed decreased needs for insulin but not resolution or ‘cure’ of diabetes. Patients treated with this agent should continue to monitor their blood glucose as indicated and as required based on their treatment regime.”

Dr. Caroline Messer, an endocrinologist at Northwell Lenox Hill Hospital in New York who also was not involved in the research, agreed.

“The class of JAK inhibitors, in general, shows promise for the preservation of beta cell function (the cells in the pancreas that produce insulin) in patients with type one diabetes,” she told Medical News Today. “There are similarities between this drug and teplizumab (TZIELD), which is already on the market for a similar indication.”

“The study clearly proves that baricitinib can decrease the amount of insulin required by patients with early type one diabetes and decrease the variability of blood sugars,” Messer added. “However, the Hemoglobin A1C (a measure of 3 months of average blood sugars) did not improve. As the authors noted, this trial may have been more successful if baricitinib had been initiated at an earlier stage in the disease process when there was less damage to the beta cells. One of the major advantages to this new medication is that it is administered in pill rather than IV form.”

“There is a higher risk of diabetic ketoacidosis (high acid in the bloodstream seen when insulin levels are low) in patients who are skipping insulin while taking this medication,” Messer noted.

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