Eli Lilly’s rheumatoid arthritis medicine to slow progression of type 1 diabetes, say Aussie researchers

Pharma News: Australian researchers have shown that a commonly prescribed rheumatoid arthritis medicine can stop the progression of type 1 diabetes. 

The world-first human trial, BANDIT, was spearheaded by Professor Thomas Kay from the St Vincent’s Institute of Medical Research (SVI). It showcased the potential of Eli Lilly’s JAK inhibitor Olumiant (baricitinib) in safeguarding the body’s insulin production while impeding the advancement of type 1 diabetes, particularly in individuals who commenced treatment within 100 days of diagnosis.

“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 Olumiant (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 marks a pivotal moment as the first disease-modifying treatment for type 1 diabetes that can be administered in tablet form, potentially reshaping the landscape of diabetes care.

“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,” Professor Kay expressed.

Daily Olumiant maintained a significantly higher average mixed-meal-stimulated C-peptide level at week 48 compared with placebo (0.65 vs 0.43 nmol/L/min, p=0.001). Individuals on 4 mg/day Olumiant also required significantly less daily insulin at week 48 than placebo (0.41 vs 0.52 U/kg).

“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 Kay added.

Managing this lifelong autoimmune chronic disease demands meticulous glucose monitoring and continuous insulin administration, posing a significant burden on those diagnosed and their families.

Before the discovery of insulin over a century ago, type 1 diabetes was a fatal condition. Despite insulin’s life-saving role, its administration carries potential risks if dosages are incorrect. Moreover, the condition still leads to long-term complications such as heart attacks, strokes, vision impairment, kidney disease, and nerve damage.

“We are very 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,” commented Professor Helen Thomas, preclinical lead on the trial.

The pivotal clinical trial received funding from JDRF with collaborative partners including The Royal Melbourne Hospital, St Vincent’s Hospital Melbourne, The Royal Children’s Hospital, and The Women’s and Children’s Hospital in Adelaide.

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