Immunotherapies work by retraining the immune system, and scientists hope they could stop or prevent the immune attack behind type 1 diabetes. Clinical trials testing immunotherapies are going on right now, but we don’t have a good way of measuring how effective a treatments is. Professor Colin Dayan will combine different measurements to develop a score that indicates how successful the drugs are. This could speed up progress and help to make these treatments available for people with type 1 sooner.
Background to research
Type 1 diabetes happens when the immune system destroys insulin-producing beta cells in the pancreas. Treatments – called immunotherapies – hope to stop an immune attack and protect surviving beta cells, so they carry on producing insulin.
Immunotherapies are already being in trials. To see if they can protect beta cells, scientists typically measure how much insulin a person makes after having a glucose drink. They compare the results of this test at the start and the end of the study to see if the treatment has helped to preserve insulin production.
But participants need to spend around four hours in the clinic to have the test. And it takes a long time to find out if the treatment has had any benefit, making immunotherapy trials slow to run. This measure also fails to take into account important factors that matter to people with type 1 diabetes, like variations in their blood sugar levels or hypos.
Professor Dayan aims to develop a new way of finding out if immunotherapies successfully protect beta cells. He will use measurements collected from already completed immunotherapy trials, including blood sugar levels after an overnight fast, HbA1c, and insulin doses. The researchers will create a computerised ‘clinical trial simulation tool’ that predicts the performance of each measurement individually, and in different combinations. They’ll find the ones that best indicate how well a treatment works. This new score could be used consistently in all future trials.
Because the measurements that make up the score are simple to collect, scientists can test participants more often. This means trials would potentially need fewer participants and Professor Dayan believes it could halve the length of time trials take. It will also tell researchers what impact immunotherapies have on factors that matter most to people with type 1 diabetes.
Potential benefit to people with diabetes
By finding a better way to measure the success of immunotherapies, trials could become shorter and less expensive. This could allow more drugs and different drug doses to be tested, speeding up progress so we can reach the first immunotherapy for type 1 diabetes sooner than would otherwise be possible.