We have entered a new phase of type 1 diabetes (T1D) research with disease-modifying therapies providing hope to alter the course of the condition.
But what are they, and which therapies are the front runners in the search for T1D cures? Read on to find out more...
Defining the problem
A “cure” for T1D means different things to different people.
For some it may mean allowing those who have been diagnosed with T1D to make insulin again. This could either be by regenerating the beta cells lost to the immune attack or by replacing them with healthy cells from an outside source.
For others it could mean preventing people at risk of T1D from developing the condition in the first place. It could also mean ensuring that any healthy beta cells that remain shortly after diagnosis can continue producing insulin, preserving their function.
All of these avenues could theoretically be achieved using drugs called disease-modifying therapies (DMTs).
What are disease-modifying therapies?
Disease-modifying therapies are drugs which can alter the course of a disease or condition. In T1D, DMTs aim to slow down or halt its progression, prevent its development or reverse it entirely.
DMTs are one pillar of JDRF’s strategy to accelerate cures for T1D.
DMTs aim to work on different stages of T1D, from those in the early stages to those in the later stages who require insulin (see JDRF’s publication: The stages of type 1 diabetes and why they’re important).
Of all therapy avenues, DMTs are the most advanced in terms of the development pipeline and will likely reach the hands of the T1D community the fastest.
Many of these therapies have been re-purposed from other autoimmune conditions such as rheumatoid arthritis where they have been successfully used to dampen the immune system and achieve remission.
Teplizumab: The first DMT available for T1D
Decades of research investment from JDRF have led to an explosion in DMT research and significant advances in this area.
We are now entering a new era where DMTs are becoming part of the therapeutic arsenal against T1D.
Notably, in 2022 teplizumab (Tzield ®) was approved by the FDA to delay the progression of the condition from its early stages (Stage 2) to clinical diagnosis (Stage 3) in those over 8 years of age.
Teplizumab is delivered by a daily infusion (into the vein) for approximately two weeks and can delay T1D clinical diagnosis by around two to three years.
Teplizumab was specifically developed for T1D and represents the first therapy to significantly change the course of the condition since insulin was developed over 100 years ago.
While teplizumab is currently only approved and available in the US, other regions and countries like the UK, Europe and Australia are considering the next stages of its approval.
Other DMTs on the horizon
Other DMTs are in the development pipeline with many at the advanced clinical trial stage.
One example is baricitinib which made headlines in 2023 through a world-first, JDRF-funded Australian clinical trial called BANDIT. In this trial, researchers showed that baricitinib was able to suppress the progression of T1D in Australians newly diagnosed with the condition.
Other DMTs being tested internationally include:
- Verapamil
- Abatacept
- Anti-thymocyte globulin (ATG)
- Golimumab
- Diamyd
- Rituximab
More information on current DMTs in the pipeline can be found here.
Our role in making DMTs a reality here in Australia
JDRF Australia aims to ensure that as many Australians with T1D as possible have access to clinical trials testing DMTs.
This is why we established the Australasian Type 1 Diabetes Immunotherapy Collaborative (ATIC), based at St Vincent’s Institute of Medical Research. This key piece of infrastructure allows cutting-edge T1D clinical trials to be undertaken right here in Australia.
ATIC currently has one T1D prevention study and four clinical trials operating within its network and was the hub for the BANDIT study.
Where next for DMTs?
The next stage of DMT research is to determine whether combining these therapies can drive a better therapeutic effect.
The idea is that because these therapies work in different ways to delay T1D, combining them may enhance their therapeutic effect.
How you can help
Your support can make a world of difference. By contributing to initiatives like Giving Day on 30 May, you help us put DMTs in the hands of the Australian T1D community faster by funding essential clinical trial infrastructure.
Donate to Giving Day and double your impact here.
Double your impact now!
Australia is at a turning point for type 1 diabetes (T1D) research. With new treatment options on the horizon and screening initiatives scaling faster than ever before, there’s never been a more exciting time to support local breakthroughs.
When you donate now, your investment in a world without T1D doubles – helping make the next big T1D breakthroughs a reality.
