Antiviral Treatment Promising for preserving residual insulin production in children with new-onset T1D

In a recent study antiviral treatment has demonstrated its potential to preserve insulin production in children and adolescents with newly diagnosed type 1 diabetes (T1D). A phase 2 clinical trial, known as the Diabetes Virus Detection (DiViD) Intervention, has yielded promising results, paving the way for further exploration of antiviral strategies in T1D prevention and treatment. This study was published in Nature Medicine by Krogvold L and colleagues.

The DiViD Intervention trial, a phase 2 effort, was designed as a placebo-controlled, randomized, parallel-group, double-blind study. The study enrolled 96 children and adolescents aged 6 to 15 years, all diagnosed with new-onset T1D. These participants were divided into two groups, with one group receiving antiviral treatment consisting of pleconaril and ribavirin (47 participants) and the other group receiving a placebo (49 participants). The treatment duration spanned 6 months, with the primary goal of preserving β cell function.

The primary endpoint of the study was the mean stimulated C-peptide area under the curve (AUC) at 12 months from the initiation of treatment (which began less than 3 weeks after diagnosis). The analysis employed a mixed linear model using longitudinal log-transformed serum C-peptide AUCs at baseline, 3 months, 6 months, and 1 year.

The primary endpoint was met successfully, as the pleconaril and ribavirin treatment group exhibited a significantly higher serum C-peptide AUC at 12 months compared to the placebo group. The average marginal effect was calculated at 0.057 in the linear mixed model, with a 95% confidence interval ranging from 0.004 to 0.11 and a P-value of 0.037. Additionally, the treatment was well tolerated, indicating a favourable safety profile.

These findings represent a significant step forward in the fight against T1D, particularly in children and adolescents. The potential of antiviral treatment to preserve residual insulin production offers hope for improved diabetes management and quality of life for those affected by this condition.

This success in the DiViD Intervention trial underscores the need for further exploration and evaluation of antiviral strategies in both preventing and treating T1D. The study's results have opened a promising avenue for research and development in the quest to combat this chronic autoimmune disease.

Reference:

Krogvold, L., Mynarek, I. M., Ponzi, E., Mørk, F. B., Hessel, T. W., Roald, T., Lindblom, N., Westman, J., Barker, P., Hyöty, H., Ludvigsson, J., Hanssen, K. F., Johannesen, J., & Dahl-Jørgensen, K. Pleconaril and ribavirin in new-onset type 1 diabetes: a phase 2 randomized trial. Nature Medicine,2023:1–7. https://doi.org/10.1038/s41591-023-02576-1