Healthcare (Commonwealth Union) – Type 1 diabetes is less common when compared to type 2 diabetes. It is an autoimmune condition not linked to lifestyle and can have serious consequences without treatment.
Teplizumab has been approved by the National Institute for Health and Care Excellence (NICE), following its earlier use under an early access scheme in the UK, including its first deployment in Birmingham. This gives hope to many with the condition.
Diabetes specialists at the University of Birmingham have welcomed the decision by NICE which confirms that the treatment—capable of slowing the onset of insulin-dependent type 1 diabetes in its early stages—will now be available through the National Health Service (NHS).
Teplizumab is an immunotherapy that can delay the progression to symptomatic type 1 diabetes in individuals diagnosed with stage 2 of the condition. It will now be accessible via the NHS for children aged eight and above, as well as adults with stage 2 type 1 diabetes.
The approval follows extensive work by researchers and clinicians focused on improving early identification and care for children and young people who may develop type 1 diabetes. At the University of Birmingham, alongside Birmingham Women’s and Children’s Hospitals and University Hospitals Birmingham NHS Foundation Trust, ongoing studies are exploring screening programmes aimed at detecting individuals at higher risk of developing the condition earlier.
The ELSA (Early Surveillance for Autoimmune diabetes) study, headed by Professor Parth Narendran, has screened thousands of young people for autoantibodies that indicate an increased risk of developing type 1 diabetes later in life, as reported in The Lancet Diabetes & Endocrinology. The latest announcement highlights the important role of screening initiatives such as ELSA in identifying individuals who may benefit from treatment with Teplizumab.
Through the ELSA programme, patients have already been able to access Teplizumab at an early stage, including the first UK recipient—a 14-year-old boy from Kings Norton named Sam—who received the treatment at Birmingham Children’s Hospital under the supervision of Dr Renuka Dias and her specialist team at the Clinical Research Facility. With NHS funding now approved, it is estimated that approximately 1,100 individuals could be eligible for Teplizumab in its first year, based on data from the ELSA study.
Professor Parth Narendran, Professor of Diabetes Medicine at the University of Birmingham, indicated that the NICE recommendation for Teplizumab represents a major milestone in the UK for people in the earliest stages of type 1 diabetes.
“As the first disease-modifying therapy shown to delay progression to clinical, insulin-requiring type 1 diabetes, teplizumab has the potential to transform the treatment paradigm from reacting to disease onset to intervening earlier in the disease process. This means that patients identified early, for example through the ELSA study led by the University of Birmingham, will have benefit from treatment that can give valuable additional years free from the daily burden of managing type 1 diabetes.
He further pointed out that the decision will move a long way to assist the formation of screening, monitoring and prevention pathways that has the ability to underpin the future of type 1 diabetes treatment.
Teplizumab works by acting on the immune system’s mistaken attack on the insulin-producing beta cells in the pancreas. By adjusting this immune response, it can postpone the development of clinical type 1 diabetes in individuals at stage 2 of the disease.
Clinical studies have demonstrated that one treatment course of teplizumab—given in hospital over 14 consecutive days—can reduce the rate of progression to symptomatic type 1 diabetes by around 50%.
Since the announcement has been made, the NHS will be required to establish new testing and treatment pathways to enable the delivery of teplizumab in clinical practice.
