What is teplizumab?
Teplizumab (Tzield®) is a pioneering new treatment and the world’s first immunotherapy for stage 2 type 1 diabetes.
For people identified with stage 2 type 1 diabetes, teplizumab can delay the need for insulin by an average of nearly three years.
Treatment is delivered in hospital by infusion into a vein once daily, over 14 consecutive days.
Who is teplizumab for?
Teplizumab is licenced in the UK for people aged 8 years and over who have been identified with stage 2 type 1 diabetes. People may be eligible if they:
- are confirmed to have two or more islet antibodies
- have blood sugar levels that can be higher than normal at times (dysglycaemia) but no symptoms
- do not need treatment with insulin
- are aged 8 or over
At this stage of diabetes, people do not experience any symptoms.
What is stage 2 type 1 diabetes?
Type 1 diabetes is an autoimmune condition that can affect anyone at any age. In type 1 diabetes, the immune system attacks the insulin-producing cells in the pancreas, eventually leaving the person dependent on insulin for life. There is currently no cure.
The condition develops in stages over time and blood tests show the presence of two or more autoantibodies. In stages 1 and two, a person has no symptoms, and this is why the condition is sometimes called ‘early stage’, ‘pre-symptomatic’ or ‘preclinical’ type 1 diabetes. The key difference between stages 1 and 2 is blood sugar levels. At stage 1, blood sugar is normal. At stage 2, blood sugar levels can be higher than normal at times but not enough to causes symptoms.
What this treatment means for people with stage 2 type 1 diabetes?
For people in England with stage 2 type 1 diabetes, and for the many more who may be at risk, this treatment is a genuine step change. Until now, type 1 diabetes has been a condition that is managed with insulin (once at stage 3), not one that can be slowed down.
This is the first time an immunotherapy for type 1 diabetes will be offered on the NHS, targeting the root cause of the condition – by helping to regulate the immune system. For people identified with stage 2 type 1 diabetes, before any symptoms appear, this treatment offers an average of nearly three years before reaching symptomatic stage, when blood sugar problems typically begin and lifelong insulin treatment becomes necessary, and for which there is currently no cure
What to do if approached by asymptomatic people asking for testing?
If people ask about whether they may have stage 2 type 1 diabetes or want to be tested please direct them to one of the current research trials that are screening for eligibility. The ELSA study screens children aged 2-17 years across the UK, and the T1DRA study screens adults between 18-70 years – noting that teplizumab is only licensed for use in those aged 8 and over.