Teplizumab therapy for type 1 diabetes.
BACKGROUND
Type 1 diabetes mellitus (T1D) is a T-cell mediated autoimmune disease with selective destruction of beta cells. Immunological interventions are directed at arresting the loss of beta-cell function with the promise that this will make it easier for patients to control their glucose levels.


METHODS
This review provides a summary of the preclinical and clinical research published between 1992 and 2009 using teplizumab and other anti-CD3 antibodies to arrest the loss of beta-cell function in new onset T1D. Data from animal and human studies on the probable mechanism of action of teplizumab are also reviewed.


RESULTS
A broad perspective on the use of teplizumab in inducing disease specific tolerance.


CONCLUSIONS
In Phase I/II randomized control trials, in patients with new onset T1D, teplizumab slowed the rate of loss of beta-cell function over 2 years of follow-up. Treated patients had better glycemic control and lower insulin requirements. Adverse events so far are mild and of limited duration. Phase III clinical trials are underway to confirm these results and to determine if two courses of drug have greater efficacy in arresting loss of beta-cell function.
Masharani
Umesh B
UB
Division of Endocrinology and Metabolism, Department of Medicine, University of California-San Francisco, 400 Parnassus Avenue, San Francisco, CA 94143, USA. umeshm@medicine.ucsf.edu
Becker
Joseph
J
D061067:Antibodies, Monoclonal, Humanized; D002986:Clinical Trials as Topic; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007167:Immunotherapy; D007515:Islets of Langerhans / Q000276:immunology; D016853:Muromonab-CD3 / Q000627:therapeutic use*
D061067:Antibodies, Monoclonal, Humanized; D016853:Muromonab-CD3; C502540:teplizumab