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Low-Dose Antithymocyte Globulin in Type 1 Diabetes: Real-World Exploratory Observation of C-Peptide by Modified
David Weber1, Joshua Modeste1, Sarah Peeling1
1Diabetes Institute, University of Florida, Gainesville, FL.
Objective:
To evaluate the real-world feasibility and efficacy of low-dose antithymocyte globulin (ATG) by an exploratory modified quantitative response (mQR) of C-peptide in type 1 diabetes.
Research Design And Methods:
Individuals with stage 2 (n = 6) or stage 3 (n = 33) diabetes were treated clinically with low-dose ATG (2.5 mg/kg) and asked to obtain C-peptide via a commercial laboratory 90 min postconsumption of 6 mL/kg Boost. Thirty individuals (77%) completed 1 year of follow-up, with 22 (73% of those) providing pre-ATG and 1-year-post-ATG C-peptides. Area under the curve C-peptide was estimated from 90-min values to calculate mQR.
Results:
In the 22 evaluable patients, average mQR at 1 year was 0.072. Average HbA1c decreased from 7.1% (54 mmol/mol) to 6.0% (42 mmol/mol). There were 15 responders (+mQR) and 7 nonresponders (-mQR). There were no unexpected side effects.
Conclusions:
C-peptide mQR was feasible and produced expected responder frequencies following low-dose ATG in a clinical practice setting.
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