The National Institute for Health and Care Excellence (NICE) has recommended teplizumab, a first-of-its-kind treatment that can delay the onset of type 1 diabetes by up to three years, for use on the NHS in England. Experts have hailed the decision as a "landmark" moment.
How Teplizumab Works
Teplizumab, also known as Tzield and manufactured by Sanofi, is a one-off course of treatment that trains the immune system to stop attacking pancreatic cells. It is administered through a drip into a vein once a day for 14 consecutive days, with each infusion lasting at least 30 minutes. The dose starts low and gradually increases over the first few days.
The drug is approved for children aged eight and over and adults who have type 1 diabetes in its early stage, before symptoms appear. According to NICE estimates, around 1,100 people could be eligible for teplizumab in the first year, dropping to approximately 820 patients in subsequent years.
Impact and Expert Reactions
Dr Elizabeth Robertson, director of research at Diabetes UK, said: "Today's landmark approval of teplizumab marks the start of a new age of type 1 diabetes treatment. For the first time in 100 years, we are moving beyond insulin, with a medicine that targets the root cause of the condition." She added: "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."
Helen Knight, director of medicines evaluation at NICE, commented: "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 evidence shows teplizumab can delay the onset of symptomatic diabetes by an average of nearly three years."
Early Detection and Screening
Detecting type 1 diabetes early, before symptoms appear, is crucial for accessing teplizumab. About 400,000 people in the UK have type 1 diabetes, a lifelong condition where the immune system attacks insulin-producing cells in the pancreas. Two UK studies are currently screening for type 1 diabetes: the Elsa study (funded by Diabetes UK and Breakthrough T1D), which screens children aged two to 17, and the T1DRA study, which screens adults aged 18 to 70.
Dr Robertson emphasized: "We want a future where everyone with early-stage type 1 diabetes can benefit from immunotherapies. Through our long-term investment in world-class research, and partnership with the NHS and industry, we are working to make a national type 1 diabetes screening programme a reality."
Patient Perspective
Elena Boichak, from Newbury, discovered her son Dima had stage 2 type 1 diabetes after enrolling him in the Elsa screening study when he was nine. She said: "As a mother, the most valuable thing teplizumab has given us is time. Every month and every year that Dima can continue being a child without insulin injections, carb counting and the daily burden of type 1 diabetes is incredibly precious. This recommendation means that other families across the UK may now have access to that same opportunity. Early screening and access to treatment can change the way families experience this diagnosis and help them feel prepared rather than overwhelmed."
