OBJECTIVE In the TrialNet 10 Anti-CD3 Prevention (TN-10) trial, teplizumab delayed onset of stage 3 type 1 diabetes in U.S. and Canadian individuals with stage 2 disease who had a relative with type 1 diabetes. Here, the generalizability of the population risk in TN-10 to a European population with or without first-degree relatives (FDRs) with type 1 diabetes was investigated. RESEARCH DESIGN AND METHODS This retrospective study used data from participants with stage 2 type 1 diabetes from the TN-10 placebo arm and the Fr1da population-based screening program in Germany (Fr1da group) to investigate time to progression from stages 2–3 type 1 diabetes. The study only had sufficient power to detect large differences. RESULTS Risk of progression to stage 3 type 1 diabetes was comparable between the TN-10 placebo arm (n = 32) and the Fr1da group (n = 152; hazard ratio HR = 1.3 95% CI 0.8–2.1). Once prognostic factors significantly associated with progression in this study (anti–IA-2 antibodies, HbA1c 5.7%, and 120-min oral glucose tolerance test) were included in the model, the adjusted HR was 1.1 (95% CI 0.6–2.1). Fr1da group participants with (n = 45) and without (n = 107) FDRs with type 1 diabetes had similar time to progression to stage 3. Age-based subanalysis demonstrated minimal impact of age on progression time. CONCLUSIONS Time to progression to stage 3 appeared similar between the TN-10 placebo arm and the Fr1da group and between participants with and without FDRs with disease. Results suggest progression risk from the TN-10 trial may be generalizable to European populations with or without FDRs with type 1 diabetes.
Koeger et al. (Tue,) studied this question.
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