Teplizumab: The Shield Against Diabetes

Diabetes is an autoimmune disease that effects nearly 1 in every 14 Indians. Most of us know people who suffer from diabetes, and we know that one of the few things that you can actually do for diabetes medically is administer insulin. So, what if I told you that around 2 years ago, the FDA approved a drug that can actually delay the onset of stage 3 type 1 diabetes (T1D)? Because that is exactly what happened. 

On November 2022, the FDA approved Teplizumab, as a first-in-class medication. This is one of the biggest developments in the mitigation of diabetes since the invention of synthetic insulin in 1978. Teplizumab, sold as Tzield, helps delay the onset of stage 3 of T1D in patients with stage 2 T1D. It can delay it for an average of 2 years, or sometimes, for DECADES. 

This is a monumental innovation because there is no known cure for T1D. T1D is an autoimmune condition in which the body’s own T-cells – which are a type of white blood cells - start to attack pancreatic β cells. These cells secrete insulin, the hormone that control blood glucose concentration. Teplizumab comes in during stage 3, which is when you start seeing the symptoms. If you get a diagnosis early, at around stage 2 when the disease starts accelerating, you can use Teplizumab to slow down the process and buy time for your pancreas to function, which can handle insulin better than any artificial means. 

The way Teplizumab works is that it identifies and binds CD3 protein that are attached to the CD8+ T-cells, a type of white blood cell. After binding, it partially deactivates these T-cells and promotes the production of regulatory T-Cells. The reason this drug is so innovative and smart is because it covers so many avenues. One common side effect of drugs that counter autoimmune responses is decreased immunity. But this combats that by promoting the development of regulatory T cells, maintaining immune tolerance by suppressing overactive immune responses. It induces partial inactivation in T cells, reducing their aggressive autoimmune response while ensuring that they can still fight infections.  

It is all of these functions together that makes this such an impressive drug. It successfully manages to preserve the functions of pancreatic beta cells, delays the progression of T1D, and maintains insulin production for a longer time. The PROTECT trial shows this. They were able to reduce their use of insulin, had a lowered risk of severe hyperglycaemia (low blood sugar), and were more like to spend more time in their target glucose range.  

To conclude, the innovation of Teplizumab shows that there is and will always be so much more to discover and create in the field of medical sciences. It is such a new and experimental drug, but has already shown so much promise. We hope that Teplizumab will be the first of many more innovations that make it easier for people, like diabetic patients, to live the life they deserve.  

Bibliography: 

• https://www.aamc.org/news/5-medical-advances-will-change-patient-care  

• https://www.mayoclinic.org/drugs-supplements/teplizumab-mzwv-intravenous-route/proper-use/drg-20542447#:~:text=A%20nurse%20or%20other%20trained,a%20day%20for%2014%20days. 

• https://go.drugbank.com/drugs/DB06606 

• https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011 

• https://www.yalemedicine.org/news/teplizumab-new-diabetes-drug#:~:text=The%20trial%20showed%20that%20the,in%20their%20target%20glucose%20range. 

• https://www.creativebiolabs.net/teplizumab-overview.htm#:~:text=Mechanism%20of%20Action%20of%20Teplizumab,activation%20signals%20upon%20recognizing%20antigens. 

• https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/pdi.2448  

• https://www.nejm.org/doi/full/10.1056/NEJMoa1902226