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Combined Immune Therapy Examined for Early Type 1 Diabetes
· Confirmed
In Short: An experimental immune therapy called tegoprubart has enabled 11 people with type 1 diabetes to stop using insulin after receiving transplanted pancreatic islet cells.
Artist rendering of early O type main sequence star 1 1 1 1.
Developed by Eledon Pharmaceuticals, tegoprubart is an anti-CD40 ligand therapy designed to inhibit the immune response to transplanted cells, such as pancreatic islets, with fewer side effects.
Piotr Witkowski, director of the pancreas and islet transplant program at UChicago Medicine, noted in an early April LinkedIn post that an 11th participant also stopped using insulin.
Marlon Pragnell, VP of research and science at the American Diabetes Association, highlighted the potential of tegoprubart to address transplant-related immune toxicity, a common issue following islet transplantation.
The current trial has produced 'genuinely unprecedentedly good results,' but concerns remain about the long-term durability and safety of the therapy.
Another critical challenge is the shortage of islet cells, which limits broad-scale application of the therapy.
Despite these challenges, the potential of tegoprubart to provide a functional cure for type 1 diabetes is significant.
What this adds
This report adds details about the specific number of participants who stopped using insulin and the challenges faced in scaling up the therapy.
The BACKGROUND notes that tegoprubart is showing promise in helping beta cell transplants survive in people with type 1 diabetes.
Background
A new immune therapy called tegoprubart is showing promise in helping beta cell transplants survive in people with type 1 diabetes.
What's confirmed
- The FDA has approved the once-weekly injectable basal insulin drug insulin efsitora alfa-gobe (Onswik, Eli Lilly) for use as an adjunct with diet and exercise to help control blood sugar in adults with type 2 diabetes (T2D).
What's still developing
- If the more serious side effects can be prevented, a much larger population of people with T1D could have access to this therapy.
- "It's extremely unusual in a kid who presented like he did at his age, to now at almost 11 years old have such a robust C peptide with low insulin requirement and A1c in the low 5s. I will argue that's because of this combination therapy approach," Haller said.
- Specifically, Haller said, for individuals who still have some residual beta-cell function, one approach may be to use induction therapy with a potent immunomodulator such as teplizumab or the investigational human anti-thymocyte globulin SAB-142.
- "Most of us say that until we have a therapy that truly induces immune tolerance, which would be actually fixing the immune system entirely and permanently, we're going to need this sort of induction and maintenance therapy model. That's how almost all other autoimmune diseases are treated," said Haller.
- He subsequently received two courses of teplizumab infusion, followed by maintenance therapy with baricitinib (Olumiant, Lilly), a JAK inhibitor already approved for rheumatoid arthritis and alopecia areata and previously shown to preserve beta-cell function.
- In 2023, the groundbreaking Australian BANDIT (Baricitinib in New Onset Type 1 Diabetes) trial [1] reported that a daily pill of baricitinib, commonly prescribed for rheumatoid arthritis and alopecia, could safely preserve the body's own insulin production and slow the progression of type 1 diabetes (T1D) in people recently diagnosed with the condition.
- Now the follow-up of the blinded BANDIT trial, being presented at this year's Annual Meeting of The European Association for the Study of Diabetes (EASD), Vienna (15-19 Sept), reveals that once baricitinib treatment was stopped, participants' diabetes progressed-they produced less insulin and had less stable blood sugar levels, that were not significantly different to those on placebo.
- People taking GLP-1 receptor agonists reported substantially more nail, hair, and scalp problems than comparable adults with obesity or type 2 diabetes who had never used the drugs, according to two multinational studies presented at the European Academy of Dermatology and Venereology (EADV) Congress 2026.
- The nail study compared 575 people using GLP-1 receptor agonists with 1,329 people in France, the United States, Brazil, and Mexico who had type 2 diabetes and/or obesity but had never taken the drugs.
- The FDA approval decision was also informed by phase 3 data in two trials in adults with type 2 diabetes and CKD, FIDELIO-DKD and FIGARO-DKD.
- Two months after the This Is Us alum shared she had begun using a GLP-1—a Type II diabetes medication that can also be prescribed for weight loss—she reflected on the other health benefits she has experienced—namely, the strength to handle a four-month stint in Broadway’s & Juliet, which ended last month.
- New Kaiser Permanente research shows that a clinical pharmacist with diabetes management expertise who contacts patients to discuss hypoglycemia and alternative treatment options can effectively move patients on to safer treatment regimens.