By Amir Khan
A new treatment for type 1 diabetes may lie in an existing drug for other autoimmune diseases, according to a new study, published today in The Lancet. Researchers from the Riley Hospital for Children at Indiana University found that the drug alefacept, used to treat psoriasis for more than a decade, can also help treat type 1 diabetes and reduce the need for insulin injections. But with the drug manufacturer ceasing production, the finding may serve more as a proof-of-concept than a promising new treatment.
Researchers tested alefacept, sold under the brand name Amevive, on 33 people over the course of a year, and compared them to 16 people who were given a placebo. After 12 months, insulin use was much higher in the placebo group than in the group that was given alefacept, according to the study. But the drug didn’t reduce their need for insulin, researchers said, it simply stopped it from getting worse.
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"It 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,” study author Mark Rigby, MD, an assistant professor in the department of pediatrics at Indiana University, said in a statement.
But while the drug showed promise, it’s unclear just how effective it was, said Karin Hehenberger, MD, PhD, a diabetes specialist and executive vice president of scientific affairs for Coronado Biosciences.
“It’s great to see this mechanism, but just showing that insulin requirement is reduced is extremely difficult to prove,” Dr. Hehenberger said. ”There’s so much that drives insulin use. One person might start exercising or eating better, so controlling for this in a study is very difficult.”
Hehenberger said it would be more promising if the study showed consistent, reduced A1C levels, a biomarker that shows how well blood sugar is controlled.
In addition, while the drug showed promise, it was voluntarily taken off the market in December 2011, Hehenberger said.
“They took it off because it just didn’t really work well,” she said. “It wasn’t really effective for psoriasis.”
Previous studies have tried at least four other drugs similar to alefacept, Hehenberger, but have had mixed results.
“Some of these drugs that have failed may have an effect in certain patients, but when you look at the population as a whole, they’re so varied,” she said.
Type 1 diabetes causes the destruction of insulin-producing beta cells, and Hehenberger said focusing on identifying diabetes earlier would yield better results than trying to stop the destruction after it’s happened.
“When you’re diagnosed with diabetes, the cells you want to save are already gone,” she said. “You need to start treatment as early as possible so you can save as many as you can.”
“Insulin is a lifesaver, but it’s clearly not enough,” she added. “If we could effectively identify and treat this disease, we could save so many people.”
"Psoriasis Drug Shows Promise For Treating Type 1 Diabetes" originally appeared on Everyday Health.