A new drug that delays type 1 diabetes: Let's learn about Tzield (Teplizumab)

Does anyone in your family have type 1 diabetes? Or has a doctor told you that you are at risk of developing the disease? If so, today we are talking about a new drug that can delay the onset of diabetes symptoms by several years. This is something that has really brought great hope to many people. Let's see what this drug is and how it works.

Type 1 diabetes and the role of Tzield's drug

First, let's simply understand what type 1 diabetes is. It is actually an autoimmune disease . Simply put, the immune system, which is like an 'army' that protects our body from disease, mistakenly starts attacking our own good cells. In type 1 diabetes, this 'attack' occurs on the beta cells in our pancreas.

Think of these beta cells as little factories that produce a hormone called insulin, which is essential for our bodies. Insulin helps cells convert the sugar (glucose) in the food we eat into energy. So, when the immune system destroys these beta cells, insulin production gradually decreases.

This destruction will not happen all at once. It will happen in three stages.

• Stage 1: The immune system begins to attack the beta cells, but they still produce enough insulin.
• Stage 2: Beta cell damage increases, blood sugar levels start to become slightly abnormal, but there are still no outward symptoms.
• Stage 3: Most of the beta cells are destroyed, and the body is unable to produce enough insulin. Blood sugar levels rise significantly. This is when symptoms of diabetes, such as excessive thirst and frequent urination, appear.

This is where a drug called Tzield (teplizumab-mzwv) comes in. Tzield is a biologic medicine. It can slow down the rate at which the immune system attacks the beta cells of people with stage 2 type 1 diabetes. This means that it can delay the progression of the disease to stage 3, when symptoms appear and daily insulin shots are required.

This is a medication given through a vein (intravenous infusion, or IV) . This treatment course is given once a day for 14 consecutive days.

Is this Tzield treatment suitable for me?

Type 1 diabetes can affect anyone at any age and with any lifestyle. Tzield treatment may be right for you if you meet these criteria:

• If you have stage 2 type 1 diabetes .
• If you don't have type 2 diabetes .
• If you are 8 years old or older .

To confirm whether you have type 1 diabetes in the second stage, your doctor will do some special blood tests. The most important of these are a test to check for autoantibodies against beta cells and an oral sugar tolerance test . They will also check your blood cell counts and liver enzymes to see if this medicine is safe for you.

How were the effects of the Tzield drug studied?

A special clinical study called TN-10 was conducted to investigate the benefits and risks of this drug. The main question it asked was, "Can Tzield stop or delay the progression of type 1 diabetes to stage 3 in people at high risk?"

The participants were divided into two groups. One group was given the Tzield drug. The other group was given a placebo . That is, a saline solution that looked like the drug but didn't contain any medicine. Neither the patients nor the doctors knew who was getting what.

You can easily see what the eligibility and disqualifications are for participating in the study from the table below.

What are the results of the study?

After 14 days of treatment, these people were followed for about 5 years. The results are really encouraging.

Simply put, it took about 4 years for those taking Tzield to develop symptoms, while those taking placebo developed symptoms in about 2 years. Especially within the first year of treatment, only a very small number of those taking Tzield experienced a worsening of their disease. At the end of the study, 57% of those taking Tzield were still healthy and free of any diabetes symptoms. But only 28% of those taking placebo did.

What are the side effects of Tzield?

Like any medication, Tzield can have side effects. But don't worry, most of these can be managed.

Common side effects:

• Skin rash: This can usually be a sign of an allergy. Most of the time, it is not serious and will go away on its own. Keep the skin moist and avoid scratching. Things like washing with cold water or bathing in oatmeal can help. Talk to your doctor about this. He or she will prescribe medication if necessary. However , if the rash is accompanied by swelling of the tongue or throat, or if you have difficulty breathing, go to the emergency room (ETU) of a hospital immediately.

• Low white blood cells (Lymphopenia): Your white blood cell count may temporarily decrease during the first few days of treatment. This may not affect you, but it may make you more likely to get infections. This will return to normal within a few weeks. Your doctor will monitor you regularly for this.

• Headache: A mild headache may occur. It often goes away on its own. If the headache persists or becomes severe, let your doctor know.

Serious side effects to watch out for:

• Cytokine Release Syndrome: Because of medications that affect the immune system, such as Tzildagliptin, sometimes a large amount of immune substances called cytokines can be released into the blood at once. This happens in the early days of treatment. Symptoms such as fever, nausea, body aches, and extreme fatigue may occur. Your doctor will give you other medications (such as paracetamol) before treatment to reduce these. If you have any of these symptoms, tell your doctor immediately.

• Severe white blood cell count decrease: If this condition becomes severe, it can lead to serious infections. If you have symptoms of infection such as fever, chills, cough, and extreme fatigue , tell your doctor immediately.

These are not all the possible side effects of Tzield. If you have any symptoms that are bothering you, be sure to see your doctor for medical advice.

How do you know if the medicine is working?

The purpose of Tzield is to delay the onset of symptoms. Therefore, you may not notice much difference after taking the treatment. This is a one-time 14-day treatment. After that, your doctor will check your diabetes regularly to see how it is. Never stop taking the treatment or change the schedule without your doctor's advice.

Are there any problems with other medications?

Before you start Tzield treatment, it is very important to tell your doctor about all other medications you are taking (including vitamins, supplements, Ayurvedic or herbal medicines).

In particular, you should be careful about getting vaccines while taking Tzield. Some vaccines may be less effective, and some may be unsafe. Therefore , before receiving any vaccine, tell your doctor that you are taking Tzield.