FDA Approves First Cellular Therapy for Type 1 Diabetes
Clinicians should consider the adverse effects when recommending Lantidra to patients
The U.S. Food and Drug Administration recently approved Lantidra, the first allogeneic (donor) pancreatic islet cellular therapy made from deceased donor pancreatic cells for the treatment of type 1 diabetes (T1D). Lantidra is approved for the treatment of adults with T1D who are unable to approach target glycated hemoglobin (average blood glucose levels) because of current repeated episodes of severe hypoglycemia (low blood sugar) despite intensive diabetes management and education.
“Severe hypoglycemia is a dangerous condition that can lead to injuries resulting from loss of consciousness or seizures,” said Peter Marks, MD, PhD, director of the FDA’s Center for Biologics Evaluation and Research. “Today’s approval, the first-ever cell therapy to treat patients with type 1 diabetes, provides individuals living with type 1 diabetes and recurrent severe hypoglycemia an additional treatment option to help achieve target blood glucose levels.”
What is type 1 diabetes (T1D)?
T1D is a chronic autoimmune disease that requires lifelong care including requiring insulin, either through multiple daily injections or continuous infusion using a pump, every day to live. People with T1D also perform blood glucose checks several times a day to guide the management of their diabetes.
Some people with T1D have trouble managing the amount of insulin needed every day to prevent hyperglycemia (high blood sugar) without causing hypoglycemia. They may also develop hypoglycemia unawareness, where they are unable to detect their blood glucose dropping and may not have a chance to treat themselves to prevent their blood glucose from further dropping. This makes it difficult to dose insulin. Lantidra provides a potential treatment option for these patients.
How does Lantidra work? How safe is it?
The primary mechanism of action of Lantidra is believed to be the secretion of insulin by the infused allogeneic islet beta cells. In some patients with T1D, these infused cells can produce enough insulin, so the patient no longer needs to take insulin (by injections or pump) to control their blood sugar levels.
Lantidra is administered as a single infusion into the hepatic (liver) portal vein. An additional infusion of Lantidra may be performed depending on the patient’s response to the initial dose.
The safety and effectiveness of Lantidra was evaluated in two nonrandomized, single-arm studies in which a total of 30 participants with T1D and hypoglycemic unawareness received at least one infusion and a maximum of three infusions. Overall, 21 participants did not need to take insulin for a year or more, with 11 participants not needing insulin for one to five years and 10 participants not needing insulin for more than five years. Five participants did not achieve any days of insulin independence.
Adverse reactions associated with Lantidra varied with each participant depending on the number of infusions they received and the length of time they were followed and this may not reflect the rates observed in practice. The most common adverse reactions included nausea, fatigue, anemia, diarrhea, and abdominal pain.
A majority of participants experienced at least one serious adverse reaction related to the procedure for infusing Lantidra into the hepatic portal vein and the use of immunosuppressive medications needed to maintain the islet cell viability. Some serious adverse reactions required discontinuation of immunosuppressive medications, which resulted in the loss of islet cell function and insulin independence.
Lantidra is approved with patient-directed labeling to inform patients with T1D about the benefits and risks of Lantidra. The FDA granted approval for Lantidra to CellTrans Inc.
- This press release was originally published on the U.S. Food and Drug Administration website