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NEJM:替利珠单抗与1型糖尿病风险

2019-08-15 xing.T MedSci原创

由此可见,替利珠单抗可延迟高风险参与者进展为临床1型糖尿病。

1型糖尿病是一种慢性自身免疫性疾病,其导致产生胰岛素的β细胞的破坏和对外源性胰岛素的依赖性。一些干预措施延迟了1型糖尿病患者胰岛素分泌的减少,但需要在诊断前影响临床进展的干预措施。

近日,顶级医学期刊NEJM上发表了一篇研究文章,研究人员进行了一项替利珠单抗(一种Fc受体非结合抗CD3单克隆抗体)的2期、随机、安慰剂-对照双盲试验,该试验涉及1型糖尿病患者的亲属,他们没有糖尿病,但发病风险很高。临床疾病患者被随机分配到单一替利珠单抗或安慰剂治疗14天疗程中,并且在6个月后使用口服葡萄糖耐量试验进行随访以评估临床1型糖尿病进展情况。

该研究共有76名参与者(其中55名[72%]≤18岁)接受了随机分组,其中44名为替利珠单抗组,32名为安慰剂组。替利珠单抗组诊断1型糖尿病的中位时间为48.4个月,安慰剂组为24.4个月; 接受替利珠单抗治疗的患者中有19例(43%)被诊断为1型糖尿病,接受安慰剂治疗的患者中有23例(72%)被诊断为1型糖尿病。诊断1型糖尿病(替利珠单抗与安慰剂)的风险比为0.41(95%置信区间为0.22至0.78;通过调整后的Cox比例风险模型,P=0.006)。替利珠单抗的年度诊断率为14.9%,安慰剂组为35.9%。可预期的不良事件有皮疹和短暂淋巴细胞减少。KLRG1+TIGIT+CD8+T细胞在替利珠单抗组中比在安慰剂组中更常见。在HLA-DR3阴性、HLA-DR4阳性或抗锌转运蛋白8抗体阴性的参与者中,替利珠单抗治疗的参与者比安慰剂组参与者诊断出糖尿病的数量更少。 

由此可见,替利珠单抗可延迟高风险参与者进展为临床1型糖尿病。 

原始出处:

Kevan C. Herold,et al.An Anti-CD3 Antibody, Teplizumab, in Relatives at Risk for Type 1 Diabetes.NEJM.2019.https://www.nejm.org/doi/full/10.1056/NEJMoa1902226

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2083096, encodeId=20d7208309662, content=<a href='/topic/show?id=f1dc603355d' target=_blank style='color:#2F92EE;'>#替利珠单抗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60335, encryptionId=f1dc603355d, topicName=替利珠单抗)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/22AEC2EC4805C29C6E1DEE6D888DB41C/100, createdBy=7a322500193, createdName=ms1779634646866130, createdTime=Wed Jul 15 19:47:00 CST 2020, time=2020-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034923, encodeId=8247103492375, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Aug 15 11:47:00 CST 2019, time=2019-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042646, encodeId=2c441042646d4, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Thu Aug 15 11:47:00 CST 2019, time=2019-08-15, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2083096, encodeId=20d7208309662, content=<a href='/topic/show?id=f1dc603355d' target=_blank style='color:#2F92EE;'>#替利珠单抗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60335, encryptionId=f1dc603355d, topicName=替利珠单抗)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/22AEC2EC4805C29C6E1DEE6D888DB41C/100, createdBy=7a322500193, createdName=ms1779634646866130, createdTime=Wed Jul 15 19:47:00 CST 2020, time=2020-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034923, encodeId=8247103492375, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Aug 15 11:47:00 CST 2019, time=2019-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042646, encodeId=2c441042646d4, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Thu Aug 15 11:47:00 CST 2019, time=2019-08-15, status=1, ipAttribution=)]
    2019-08-15 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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  3. [GetPortalCommentsPageByObjectIdResponse(id=2083096, encodeId=20d7208309662, content=<a href='/topic/show?id=f1dc603355d' target=_blank style='color:#2F92EE;'>#替利珠单抗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60335, encryptionId=f1dc603355d, topicName=替利珠单抗)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/22AEC2EC4805C29C6E1DEE6D888DB41C/100, createdBy=7a322500193, createdName=ms1779634646866130, createdTime=Wed Jul 15 19:47:00 CST 2020, time=2020-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034923, encodeId=8247103492375, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Aug 15 11:47:00 CST 2019, time=2019-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042646, encodeId=2c441042646d4, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Thu Aug 15 11:47:00 CST 2019, time=2019-08-15, status=1, ipAttribution=)]
    2019-08-15 misszhang

    谢谢MedSci提供最新的资讯

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