Two-drug combination achieves remission in mice with type 1 diabetes

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A combination of two drugs has shown success in halting the development of type 1 diabetes in a mouse study by French and Danish researchers.
Type 1 diabetes develops when the body’s immune system sets itself to destroy the insulin producing cells (known as beta cells) in the pancreas. Researchers don’t understand why the immune system chooses to do this but they do know quite a lot about how the immune system goes about killing the cells.
Using this knowledge, the researchers were keen to test whether two drugs would be able to block the immune system from killing the pancreas’ beta cells. The drugs work in different ways and the researchers were keen to test which drug was more effective and how well they worked together.
One of the drugs chosen was givinostat, a histone deacetylase inhibitor drug that helps to preserve the working ability of the beta cells. The other drug was otelixizumab, an anti-CD3 monoclonal antibody that helps to hold back the immune attack on the beta cells.
The researchers tested each of the drugs against and also tested the two drugs in combination on another group of mice. The goal was to achieve stable remission, which is where the mice were able to maintain normal glucose levels without needing insulin. The mice were given the drugs shortly after developing a form of type 1 diabetes.
The results showed that givinostat alone was not able to achieve remission in any of the mice. Otelixizumab was more effective than givinostat alone and achieved remission in 47 per cent of the mice. The most effective treatment was the combination of both drugs which resulted in an 80 per cent remission rate in the mice.
The results bring hope that a combination treatment could be effective in treating humans with type 1 diabetes. So far, when otelixizumab has been tested in humans, on its own, the drug has proved to be ineffective. However, the drug may prove to be more successful if combined with one or more other drugs.
In 2015, a four-drug treatment showed a similar success rate in mice. In 2014, a two-drug combination showed success in a small group of humans with type 1 diabetes. Whilst all of these successes are encouraging, the same level of success is often hard to achieve in larger groups of humans; that is the ultimate challenge for a drug treatment.
The research team included researchers from the University Paris Descartes and the University of Copenhagen. The study is published in the Diabetologia journal.