The world's first drug to delay the onset of type 1 diabetes has been approved for use on the NHS in England and Wales, marking the most significant breakthrough in treating the disease in over a century. The immunotherapy, teplizumab, does not cure type 1 diabetes but postpones its onset for up to three years, according to the National Institute for Health and Care Excellence (Nice), which gave the green light on Tuesday.
How teplizumab works
Teplizumab, also known as tzield and manufactured by Sanofi, trains the immune system to stop attacking pancreatic cells. It is administered through a drip into a vein once a day for 30 minutes over a 14-day period. The dose starts low and gradually increases. Once the course is complete, no further treatment is needed.
Impact on patients
The therapy is intended for adults and children aged eight and above with early, pre-symptomatic type 1 diabetes (stage 2). By delaying the onset of symptomatic stage 3 diabetes, patients gain years of freedom from the demanding lifelong management of the condition. Children and teenagers especially benefit from additional time to reach key developmental milestones before facing daily insulin therapy.
“Today’s landmark approval of teplizumab marks the start of a new age of type 1 diabetes treatment,” said Dr Elizabeth Robertson, director of research at Diabetes UK. “For the first time in 100 years, we are moving beyond insulin, with a medicine that targets the root cause of the condition. This is an extraordinary moment for celebration in the type 1 diabetes community, and represents a shift towards a future where type 1 diabetes can be prevented altogether.”
Expert and charity reactions
Karen Addington, chief executive of Breakthrough T1D, called the approval an “incredible moment.” She said: “For the first time, we have an immunotherapy that can delay the onset of symptomatic type 1 diabetes. If it were your child or someone you love, you would want to do everything possible to give them more years without the daily burden of managing this relentless condition. We now have a treatment that can help make that possible.”
Availability and cost
Sanofi has agreed a commercial arrangement with NHS England, ensuring teplizumab will be available at a confidential discounted price. Helen Knight, director of medicines evaluation at Nice, stated: “This is a genuinely exciting recommendation. For the first time, we have a treatment that can give people diagnosed at an early stage of type 1 diabetes precious extra time before they need to manage the full demands of the condition.”
The approval applies to England and Wales. The only other treatment for type 1 diabetes, insulin, was discovered 105 years ago and does not alter the disease's course but merely replaces what patients lack.
