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Photopheresis has a mild effect on the disease process of type 1 diabetes

המידע מתוך medicontext.co.il

LONDON (Reuters Health) – Photopheresis has a mild but significant effect on the disease process of recent-onset type 1 diabetes mellitus, according to a report published in the August issue of the Archives of Disease in Childhood.

Photopheresis–reinfusion of leucocytes after exposure to ultraviolet light in the presence of psoralen–has shown promising results in the treatment of various autoimmune disorders. However, a well-controlled randomized study has never been done to investigate its role as a treatment for type 1 diabetes, Dr. J. Ludvigsson, from Linkצping University in Sweden, and colleagues note.

Dr. Ludvigsson's team assessed the diabetes-related outcomes of 40 children, diagnosed at 10 to 18 years of age, who were randomized to receive photopheresis or sham pheresis. Children in both groups received five 2-day apheresis sessions within 3 months of diagnosis. They were followed for 3 years.

Actively treated children had significantly higher urine peptide C levels than sham-treated children, the authors note. While the groups did not differ in their HbA1c values, actively treated subjects did require lower insulin doses than sham-treated subjects to maintain adequate values.

Both groups experienced a similar number of infections during followup, the researchers state. Overall, treatment was well tolerated, but three actively treated subjects experienced nausea and one actively treated subject developed urticaria.

"A tempting possibility would be to use photopheresis for prevention of diabetes in high-risk groups as defined by autoantibodies and genetic markers," the authors state. However, the current findings indicate that its "effect on the disease process at the onset of type 1 diabetes is very weak and more knowledge is needed before it can be considered as a treatment modality of newly diagnosed type 1 diabetes," they add.

"An advantage with photopheresis treatment is the low frequency of side effects," the researchers point out. However, "the practical efforts and the high treatment cost are obvious disadvantages," they note.

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