Could a daily arthritis pill slow the development of type 1 diabetes?
According to a recent Australian study known as BANDIT (Baricitinib in New-onset Type 1 Diabetes), a widely used drug has shown promise in slowing the progression of type 1 diabetes. This drug, called Baricitinib, is prescribed to those with autoimmune diseases like rheumatoid arthritis, ulcerative colitis, and alopecia. The study suggests that Baricitinib, which works by suppressing overactive immune responses, can help preserve crucial insulin-producing cells when given early after diagnosis, potentially reducing a patient’s reliance on daily insulin injections.
The initial trial, conducted in 2023, involved 91 participants who had been diagnosed with type 1 diabetes within the past 100 days. Participants were randomly given either a 4mg Baricitinib pill or a placebo once daily for 48 weeks. Researchers observed C-peptide levels, an indicator of natural insulin production, along with blood sugar control markers such as HbA1c and glucose monitoring.
The findings revealed that Baricitinib helped preserve insulin production, stabilized blood sugar levels, and reduced the need for external insulin during the treatment period. However, after stopping the treatment, the benefits began to decline. C-peptide levels continued to fall in both groups, though they remained slightly higher in the Baricitinib group compared to placebo. By 96 weeks, the insulin production in both groups had significantly dropped, and the insulin requirements were no longer significantly different between the two groups. Despite this, the drug did not raise any new safety concerns, and researchers noted that it remained well-tolerated throughout the follow-up period.
The researchers are optimistic about the future of Baricitinib in the treatment of type 1 diabetes. They envision its use not just shortly after diagnosis, but potentially before symptoms appear in individuals identified as high-risk through genetic and blood markers. Dr. Michalea Waibel from St Vincent's Institute of Medical Research in Fitzroy, Australia, emphasized the potential for early intervention to delay or even prevent the onset of the disease. Plans for larger Phase III trials are underway, and if successful, Baricitinib could become a first-in-class oral treatment for type 1 diabetes within the next five years.
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