Teplizumab Preserves C-Peptide in Recent-Onset Type 1 Diabetes: Two-Year Results From the Randomized, Placebo-Controlled Protégé Trial

Protégé was a phase 3, randomized, double-blind, parallel, placebo-controlled 2-year study of three intravenous teplizumab dosing regimens, administered daily for 14 days at baseline and again after 26 weeks, in new-onset type 1 diabetes. We sought to determine efficacy and safety of teplizumab immu...

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Veröffentlicht in:Diabetes (New York, N.Y.) N.Y.), 2013-11, Vol.62 (11), p.3901-3908
Hauptverfasser: HAGOPIAN, William, FERRY, Robert J, LUDVIGSSON, Johnny, SHERRY, Nicole, CARLIN, David, BONVINI, Ezio, JOHNSON, Syd, STEIN, Kathryn E, KOENIG, Scott, DAIFOTIS, Anastasia G, HEROLD, Kevan C
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container_issue 11
container_start_page 3901
container_title Diabetes (New York, N.Y.)
container_volume 62
creator HAGOPIAN, William
FERRY, Robert J
LUDVIGSSON, Johnny
SHERRY, Nicole
CARLIN, David
BONVINI, Ezio
JOHNSON, Syd
STEIN, Kathryn E
KOENIG, Scott
DAIFOTIS, Anastasia G
HEROLD, Kevan C
description Protégé was a phase 3, randomized, double-blind, parallel, placebo-controlled 2-year study of three intravenous teplizumab dosing regimens, administered daily for 14 days at baseline and again after 26 weeks, in new-onset type 1 diabetes. We sought to determine efficacy and safety of teplizumab immunotherapy at 2 years and to identify characteristics associated with therapeutic response. Of 516 randomized patients, 513 were treated, and 462 completed 2 years of follow-up. Teplizumab (14-day full-dose) reduced the loss of C-peptide mean area under the curve (AUC), a prespecified secondary end point, at 2 years versus placebo. In analyses of prespecified and post hoc subsets at entry, U.S. residents, patients with C-peptide mean AUC >0.2 nmol/L, those randomized ≤6 weeks after diagnosis, HbA1c
doi_str_mv 10.2337/db13-0236
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We sought to determine efficacy and safety of teplizumab immunotherapy at 2 years and to identify characteristics associated with therapeutic response. Of 516 randomized patients, 513 were treated, and 462 completed 2 years of follow-up. Teplizumab (14-day full-dose) reduced the loss of C-peptide mean area under the curve (AUC), a prespecified secondary end point, at 2 years versus placebo. In analyses of prespecified and post hoc subsets at entry, U.S. residents, patients with C-peptide mean AUC &gt;0.2 nmol/L, those randomized ≤6 weeks after diagnosis, HbA1c &lt;7.5% (58 mmol/mol), insulin use &lt;0.4 units/kg/day, and 8-17 years of age each had greater teplizumab-associated C-peptide preservation than their counterparts. Exogenous insulin needs tended to be reduced versus placebo. Antidrug antibodies developed in some patients, without apparent change in drug efficacy. No new safety or tolerability issues were observed during year 2. 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Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Genetic aspects ; Glycated Hemoglobin A - metabolism ; Humans ; Hypoglycemic Agents - therapeutic use ; Immunotherapy ; Insulin ; Insulin - administration &amp; dosage ; Insulin - therapeutic use ; Medical diagnosis ; Medical sciences ; Monoclonal antibodies ; Original Research ; Peptides ; Physiological aspects ; Placebos ; Type 1 diabetes</subject><ispartof>Diabetes (New York, N.Y.), 2013-11, Vol.62 (11), p.3901-3908</ispartof><rights>2014 INIST-CNRS</rights><rights>COPYRIGHT 2013 American Diabetes Association</rights><rights>COPYRIGHT 2013 American Diabetes Association</rights><rights>Copyright American Diabetes Association Nov 2013</rights><rights>2013 by the American Diabetes Association. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3806608/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3806608/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=27894893$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23801579$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>HAGOPIAN, William</creatorcontrib><creatorcontrib>FERRY, Robert J</creatorcontrib><creatorcontrib>LUDVIGSSON, Johnny</creatorcontrib><creatorcontrib>SHERRY, Nicole</creatorcontrib><creatorcontrib>CARLIN, David</creatorcontrib><creatorcontrib>BONVINI, Ezio</creatorcontrib><creatorcontrib>JOHNSON, Syd</creatorcontrib><creatorcontrib>STEIN, Kathryn E</creatorcontrib><creatorcontrib>KOENIG, Scott</creatorcontrib><creatorcontrib>DAIFOTIS, Anastasia G</creatorcontrib><creatorcontrib>HEROLD, Kevan C</creatorcontrib><creatorcontrib>Protégé Trial Investigators</creatorcontrib><title>Teplizumab Preserves C-Peptide in Recent-Onset Type 1 Diabetes: Two-Year Results From the Randomized, Placebo-Controlled Protégé Trial</title><title>Diabetes (New York, N.Y.)</title><addtitle>Diabetes</addtitle><description>Protégé was a phase 3, randomized, double-blind, parallel, placebo-controlled 2-year study of three intravenous teplizumab dosing regimens, administered daily for 14 days at baseline and again after 26 weeks, in new-onset type 1 diabetes. 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Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Genetic aspects</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Immunotherapy</subject><subject>Insulin</subject><subject>Insulin - administration &amp; dosage</subject><subject>Insulin - therapeutic use</subject><subject>Medical diagnosis</subject><subject>Medical sciences</subject><subject>Monoclonal antibodies</subject><subject>Original Research</subject><subject>Peptides</subject><subject>Physiological aspects</subject><subject>Placebos</subject><subject>Type 1 diabetes</subject><issn>0012-1797</issn><issn>1939-327X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kt9qFDEUxgdR7LZ64QtIQLwQTE0m8yfTC6GMtgoLu5QV9CpkJmemKTPJmmRa2yfwVfocfTFTXLULi5yLQPI73znnO0mSF5QcpoyV71RDGSYpKx4lM1qxCrO0_Po4mRFCU0zLqtxL9r2_IIQUMZ4meynjhOZlNUt-rmA96JtplA1aOvDgLsGjGi9hHbQCpA06gxZMwAvjIaDV9RoQRR-0bCCAP0KrK4u_gXQR89MQPDpxdkThHNCZNMqO-gbUW7QcZAuNxbU1wdlhABWr2XB329_dopXTcniWPOnk4OH55jxIvpx8XNWf8Hxx-rk-nuM-o0XAWdcwWXKlAOK8VFJKScNKziDP8hbasiK8oYoXpKOMEq4yxgFI2uTQ8YKV7CB5_1t3PTUjqPvRnBzE2ulRumthpRbbL0afi95eimhZURAeBV5tBJz9PoEP4sJOzsSeBS3S6Csr8gdULwcQ2nQ2irWj9q04ZjlhLMvzKlJ4B9WDgVjZGuh0vN7iD3fwMRSMut2Z8GYrITIBfoReTt4Lfjr_XzMbtr1fVw8ibqFebPMvHzr518I_nysCrzeA9K0cOidNq_0_ruRVxivGfgGTMNsf</recordid><startdate>201311</startdate><enddate>201311</enddate><creator>HAGOPIAN, William</creator><creator>FERRY, Robert J</creator><creator>LUDVIGSSON, Johnny</creator><creator>SHERRY, Nicole</creator><creator>CARLIN, David</creator><creator>BONVINI, Ezio</creator><creator>JOHNSON, Syd</creator><creator>STEIN, Kathryn E</creator><creator>KOENIG, Scott</creator><creator>DAIFOTIS, Anastasia G</creator><creator>HEROLD, Kevan C</creator><general>American Diabetes Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>8GL</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>5PM</scope></search><sort><creationdate>201311</creationdate><title>Teplizumab Preserves C-Peptide in Recent-Onset Type 1 Diabetes: Two-Year Results From the Randomized, Placebo-Controlled Protégé Trial</title><author>HAGOPIAN, William ; FERRY, Robert J ; LUDVIGSSON, Johnny ; SHERRY, Nicole ; CARLIN, David ; BONVINI, Ezio ; JOHNSON, Syd ; STEIN, Kathryn E ; KOENIG, Scott ; DAIFOTIS, Anastasia G ; HEROLD, Kevan C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g416t-4fb3a78ddee2361a1110b3783e545cec7908b1d860f13108d438ee02b5ef86373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Antibodies, Monoclonal, Humanized - administration &amp; dosage</topic><topic>Antibodies, Monoclonal, Humanized - immunology</topic><topic>Antibodies, Monoclonal, Humanized - pharmacokinetics</topic><topic>Area Under Curve</topic><topic>Biological and medical sciences</topic><topic>C-Peptide - metabolism</topic><topic>C-reactive protein</topic><topic>Child</topic><topic>Complications and side effects</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 1 - physiopathology</topic><topic>Diabetes Mellitus, Type 1 - therapy</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Dosage and administration</topic><topic>Double-Blind Method</topic><topic>Drug Administration Schedule</topic><topic>Drug therapy</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. 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We sought to determine efficacy and safety of teplizumab immunotherapy at 2 years and to identify characteristics associated with therapeutic response. Of 516 randomized patients, 513 were treated, and 462 completed 2 years of follow-up. Teplizumab (14-day full-dose) reduced the loss of C-peptide mean area under the curve (AUC), a prespecified secondary end point, at 2 years versus placebo. In analyses of prespecified and post hoc subsets at entry, U.S. residents, patients with C-peptide mean AUC &gt;0.2 nmol/L, those randomized ≤6 weeks after diagnosis, HbA1c &lt;7.5% (58 mmol/mol), insulin use &lt;0.4 units/kg/day, and 8-17 years of age each had greater teplizumab-associated C-peptide preservation than their counterparts. Exogenous insulin needs tended to be reduced versus placebo. Antidrug antibodies developed in some patients, without apparent change in drug efficacy. No new safety or tolerability issues were observed during year 2. In summary, anti-CD3 therapy reduced C-peptide loss 2 years after diagnosis using a tolerable dose.</abstract><cop>Alexandria, VA</cop><pub>American Diabetes Association</pub><pmid>23801579</pmid><doi>10.2337/db13-0236</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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source Journals@Ovid Ovid Autoload; MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central
subjects Adolescent
Antibodies, Monoclonal, Humanized - administration & dosage
Antibodies, Monoclonal, Humanized - immunology
Antibodies, Monoclonal, Humanized - pharmacokinetics
Area Under Curve
Biological and medical sciences
C-Peptide - metabolism
C-reactive protein
Child
Complications and side effects
Diabetes
Diabetes Mellitus, Type 1 - physiopathology
Diabetes Mellitus, Type 1 - therapy
Diabetes. Impaired glucose tolerance
Dosage and administration
Double-Blind Method
Drug Administration Schedule
Drug therapy
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Genetic aspects
Glycated Hemoglobin A - metabolism
Humans
Hypoglycemic Agents - therapeutic use
Immunotherapy
Insulin
Insulin - administration & dosage
Insulin - therapeutic use
Medical diagnosis
Medical sciences
Monoclonal antibodies
Original Research
Peptides
Physiological aspects
Placebos
Type 1 diabetes
title Teplizumab Preserves C-Peptide in Recent-Onset Type 1 Diabetes: Two-Year Results From the Randomized, Placebo-Controlled Protégé Trial
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