Verapamil and beta cell function in adults with recent-onset type 1 diabetes.
Fernando OvalleTiffany GrimesGuanlan XuAnish J PatelTruman B GraysonLance A ThielenTanja DudenbostelAnath ShalevPublished in: Nature medicine (2018)
Pancreatic beta cell loss is a key factor in the pathogenesis of type 1 diabetes (T1D), but therapies to halt this process are lacking. We previously reported that the approved antihypertensive calcium-channel blocker verapamil, by decreasing the expression of thioredoxin-interacting protein, promotes the survival of insulin-producing beta cells and reverses diabetes in mouse models1. To translate these findings into humans, we conducted a randomized double-blind placebo-controlled phase 2 clinical trial ( NCT02372253 ) to assess the efficacy and safety of oral verapamil added for 12 months to a standard insulin regimen in adult subjects with recent-onset T1D. Verapamil treatment, compared with placebo was well tolerated and associated with an improved mixed-meal-stimulated C-peptide area under the curve, a measure of endogenous beta cell function, at 3 and 12 months (prespecified primary endpoint), as well as with a lower increase in insulin requirements, fewer hypoglycemic events and on-target glycemic control (secondary endpoints). Thus, addition of once-daily oral verapamil may be a safe and effective novel approach to promote endogenous beta cell function and reduce insulin requirements and hypoglycemic episodes in adult individuals with recent-onset T1D.
Keyphrases
- glycemic control
- type diabetes
- double blind
- placebo controlled
- blood glucose
- clinical trial
- weight loss
- phase iii
- insulin resistance
- study protocol
- phase ii
- cardiovascular disease
- blood pressure
- induced apoptosis
- physical activity
- squamous cell carcinoma
- single cell
- binding protein
- cell death
- open label
- oxidative stress
- cell cycle arrest
- skeletal muscle
- replacement therapy
- metabolic syndrome
- free survival
- angiotensin converting enzyme
- smoking cessation
- radiation therapy
- signaling pathway
- bone marrow