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 |
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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 >0.2 nmol/L, those randomized ≤6 weeks after diagnosis, HbA1c <7.5% (58 mmol/mol), insulin use <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.</description><identifier>ISSN: 0012-1797</identifier><identifier>EISSN: 1939-327X</identifier><identifier>DOI: 10.2337/db13-0236</identifier><identifier>PMID: 23801579</identifier><identifier>CODEN: DIAEAZ</identifier><language>eng</language><publisher>Alexandria, VA: American Diabetes Association</publisher><subject>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</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&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. 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 <7.5% (58 mmol/mol), insulin use <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.</description><subject>Adolescent</subject><subject>Antibodies, Monoclonal, Humanized - administration & dosage</subject><subject>Antibodies, Monoclonal, Humanized - immunology</subject><subject>Antibodies, Monoclonal, Humanized - pharmacokinetics</subject><subject>Area Under Curve</subject><subject>Biological and medical sciences</subject><subject>C-Peptide - metabolism</subject><subject>C-reactive protein</subject><subject>Child</subject><subject>Complications and side effects</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 1 - physiopathology</subject><subject>Diabetes Mellitus, Type 1 - therapy</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Dosage and administration</subject><subject>Double-Blind Method</subject><subject>Drug Administration Schedule</subject><subject>Drug therapy</subject><subject>Endocrine pancreas. 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 & 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 & 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. Target tissue resistance</topic><topic>Genetic aspects</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Immunotherapy</topic><topic>Insulin</topic><topic>Insulin - administration & dosage</topic><topic>Insulin - therapeutic use</topic><topic>Medical diagnosis</topic><topic>Medical sciences</topic><topic>Monoclonal antibodies</topic><topic>Original Research</topic><topic>Peptides</topic><topic>Physiological aspects</topic><topic>Placebos</topic><topic>Type 1 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><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><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Gale In Context: High School</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetes (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>HAGOPIAN, William</au><au>FERRY, Robert J</au><au>LUDVIGSSON, Johnny</au><au>SHERRY, Nicole</au><au>CARLIN, David</au><au>BONVINI, Ezio</au><au>JOHNSON, Syd</au><au>STEIN, Kathryn E</au><au>KOENIG, Scott</au><au>DAIFOTIS, Anastasia G</au><au>HEROLD, Kevan C</au><aucorp>Protégé Trial Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Teplizumab Preserves C-Peptide in Recent-Onset Type 1 Diabetes: Two-Year Results From the Randomized, Placebo-Controlled Protégé Trial</atitle><jtitle>Diabetes (New York, N.Y.)</jtitle><addtitle>Diabetes</addtitle><date>2013-11</date><risdate>2013</risdate><volume>62</volume><issue>11</issue><spage>3901</spage><epage>3908</epage><pages>3901-3908</pages><issn>0012-1797</issn><eissn>1939-327X</eissn><coden>DIAEAZ</coden><abstract>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 <7.5% (58 mmol/mol), insulin use <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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