RESEARCHERS at Cardiff University have identified that Ustekinumab, a drug currently used to treat psoriasis, may effectively manage the early stages of Type 1 diabetes (T1D) in children and adolescents. T1D results from the immune system attacking and destroying insulin-producing cells, eventually leading to individuals dependent on insulin injection. Strategies that halt the immune system attack with minimal adverse effects are being developed to treat T1D. Ustekinumab, administered as a bimonthly injection, has been effectively used in over 100,000 patients with immune conditions such as psoriasis, arthritis, and inflammatory bowel disease, showing very few side effects. By binding to the p40 subunit of IL-12 and IL-23, Ustekinumab impacts T helper cell development, specifically Th17.1 cells that significantly destroy insulin-producing cells. Therefore, researchers from Cardiff University, in collaboration with King’s College London, Swansea University, and the University of Calgary, tested Ustekinumab in a controlled clinical trial for T1D to understand if it could help preserve the body’s ability to produce insulin.
The study, funded by the National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC), involved 72 young people aged 12 to 18 treated within 100 days of being diagnosed with T1D. These participants were recruited from hospitals in London, including Barts Health NHS Trust and University College London Hospital. Over 12 months, those treated with Ustekinumab had C-peptide levels—indicating the body’s insulin production—49% higher than those receiving a placebo. Notably, the treatment was very safe, with no more side effects than the placebo.
The authors emphasised the need for additional studies to confirm the study findings and to explore the potential of Ustekinumab in preventing the progression of T1D in at-risk children. Nevertheless, early identification of T1D in children by simple finger-prick antibody tests and application of Ustekinumab can potentially mean no need for insulin injections.
Laith Gergi, EMJ
Reference
Tatovic D et al. Ustekinumab for type 1 diabetes in adolescents: a multicenter, double-blind, randomized phase 2 trial. Nat Med. 2024;DOI:10.1038/s41591-024-03115-2.
