Immunotherapeutic agents in type 1 diabetes: a systematic review and meta-analysis of randomized trials

Clinical Endocrinology
Gunjan Y GandhiYogish C Kudva

Abstract

Although recent trial results of anti-CD3 therapy are promising, there have been conflicting results of various immunotherapeutic agents used in patients with type 1 diabetes. We conducted a systematic review and meta-analysis to determine the efficacy of nonantigen-based immunotherapeutic approaches for preservation of beta-cell function in patients with type 1 diabetes. We searched MEDLINE, EMBASE, Cochrane CENTRAL, reference lists, and content expert files up to September 2006. Eligible studies were randomized controlled trials (RCTs) of antiproliferative agents (methotrexate, azathioprine), monoclonal antibodies (CD3, CD4), T-cell inhibitors (cyclosporin) and other immunotherapeutic agents (photopheresis, linomide, fusidin, buffy coat, intravenous immunoglobulin, BCG, nicotinamide) in patients with newly diagnosed type 1 diabetes followed for > or = 6 months. Pairs of reviewers working independently and with adequate reliability assessed the trials' methodological quality, collected data, and conducted random-effects meta-analyses on measures of preservation of beta-cell function (e.g. C-peptide secretion, insulin independence). Of the 299 potentially relevant articles identified after an initial search, 20 trials met selec...Continue Reading

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Aug 19, 2011·Indian Journal of Endocrinology and Metabolism·Vishvas Garg
Sep 15, 2011·Expert Opinion on Biological Therapy·Shannon A Miller, Erin St Onge
Jun 23, 2012·Diabetes·Govindarajan RajagopalanChella S David
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