A drug once used to treat psoriasis has been shown be effective against Type 1 diabetes.
In a new study in The Lancet Diabetes and Endocrinology, researchers from Indiana University found alefacept (marketed as Amevive) — used for about a decade to treat the skin condition — effectively preserved diabetic's ability to produce insulin and helped to moderate blood glucose levels.
The medical investigators, led by Mark Rigby of Indiana University and the Riley Hospital for Children in Indianapolis, noted clinical trials in the 1980s and 1990s explored the possibility of using immune-suppressing drugs to treat Type 1 diabetes, but had mixed results.
But in recent years, new immune-suppressing drugs — such as alefacept — have been developed to have a specific effect on the immune system cells that cause problems in autoimmune disorders, such as psoriasis and diabetes, while preserving the immune cells essential for normal biological processes.
Clinical trials showed that the drug works to combat the skin condition by attacking specific types of T cells (white blood cells) — known as Tem and Tcm cells — involved in the body's mistaken attack against itself. Since Type 1 diabetes involves Tem cells and Tcm cells attacking insulin-producing cells in the pancreas, Rigby and colleagues sought to determine whether alefacept might benefit patients newly diagnosed with diabetes.
The study, partly funded by National Institutes of Health, enrolled 49 individuals from 14 medical centers in 2011 and 2012. The researchers gave 33 participants weekly injections of alefacept for a period of six months, while 16 received an inactive placebo. They then measured of how well the pancreas could secrete insulin in response to food, in those receiving the drug.
The results showed those given alefacept had marked improvements in insulin secretion four hours after eating, while insulin secretion in the placebo group decreased. The investigators also found that 12 months after starting treatment, insulin use in the placebo group was significantly higher than in those who received alefacept.
Rigby said the results suggest that treatment with alefacept can preserve diabetic's ability to produce their own insulin and also led to ad fewer episodes of hypoglycemia (low blood glucose levels) — a common and dangerous occurrence in patients requiring insulin shots.
He added alefacept appears to deplete disease-causing Tem cells and Tcm cells while leaving protective regulatory T cells unaffected.
"Alefacept is the first targeted biological drug assessed in patients with new-onset Type 1 diabetes that significantly depleted the T cells which attack the pancreas in type 1 diabetes, while preserving other immune cells which are important for pancreatic function," he explained.
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