In a ground-breaking Australian study, a commonly prescribed rheumatoid arthritis drug is showing promise to suppress the progression of type 1 diabetes in people newly diagnosed.

The world-first human trial involving 60 participants at St Vincent’s Institute of Medical Research is being led by Professors Thomas Kay and Helen Thomas. It has shown that a drug called baricitinib can effectively preserve the body’s own insulin production and suppress the progression of type 1 diabetes in people who initiated treatment within 100 days of diagnosis.   

The results of the study were published yesterday in the New England Journal of Medicine.

“When type 1 diabetes is first diagnosed there is a substantial number of insulin-producing cells still present. We wanted to see whether we could protect further destruction of these cells by the immune system. We showed that baricitinib is safe and effective at slowing the progression of type 1 diabetes in people who have been recently diagnosed,” said Professor Kay. 

This research shows promise as the first disease-modifying treatment of its kind for type 1 diabetes that can be delivered as a tablet. 

“It is tremendously exciting for us to be the first group anywhere in the world to test the efficacy of baricitinib as a potential type 1 diabetes treatment,” said Professor Kay. 

“Up until now, people with type 1 diabetes have been reliant on insulin delivered via injection or infusion pump. Our trial showed that, if started early enough after diagnosis, and while the participants remained on the medication, their production of insulin was maintained. People with type 1 diabetes in the trial who were given the drug required significantly less insulin for treatment.”  

Professor Thomas said her team is optimistic that this treatment will become clinically available.

“This would be a huge step-change in how type 1 diabetes is managed and we believe it shows promise as a fundamental improvement in the ability to control type 1 diabetes,” said Professor Thomas.

Professor Kay said in a Channel 7 interview that Australian regulators may ask that further research on a larger cohort of people is completed before baricitinib is approved for type 1 diabetes prevention. He said it may take three or more years before the drug was approved for diabetes prevention.

The baricitinib clinical trial was funded by JDRF. Professor Kay is an Australian Diabetes Society 2020 Kellion Award winner for his outstanding contribution to diabetes research, clinical or service areas in Australia. In 2003, he and his team received a Diabetes Australia Type 1 Diabetes Millennium Award. The $150,000 grant supported researchers undertaking long-term projects.