Will Stelera to treat psoriasis increase Type 1s residual beta cell function?

Stelera is a newer injectable drug that is approved to help treat psoriasis. Psoriasis is another autoimmune condition that I have. It causes annoying scales on my legs and elbows. It is a minor annoyance and much much less demanding than T1.

From what I can tell Stelera works by reducing the body’s immune response to cause psoriasis (http://www.stelarainfo.com/pdf/PrescribingInformation.pdf). One precaution statement for the drug even indicate, “You should not receive the BCG vaccine during
the one year before taking STELARA® or one year after
you stop taking STELARA.”

Could this drug be similar the Dr. Faustman’s BCG Type 1 research and lead to an increase in my residual beta cell function? (If I have any). Could taking this drug lead to beter control of my T1 through increased endogenous insulin production?

My psoriasis is classified as moderate to severe, but it is a minor issue for me. If I were to take this drug it would be nice to not have noticable psoriasis, but I would be more interested on its impact on my T1. Is this too unethical? Let me know what you think.

Interleukin-12 (part of Stelera) has been shown to be disruptive (to some degree) to the autoimmune reaction in nonobese diabetic mice. It does this by messing with T cell receptors. The BCG in Faustmans research affects another path (TNF), but also serves to disrupt the autoimmune reaction. They both disrupt the autoimmune reaction, but that is about all they have in common.

I really doubt you would fine much "evidence" for this, certainly you are unlikely convince a doctor to prescribe Stelera for this as "off-label." But as long as you don't care about taking part in Faustmans work it is not "unethical" to take Stelera. After all, you have the condition for the approved use.

Thanks for the link. Nice to get a better understanding of the drug’s action. The article makes it sound plausible that Stelera may increase some T1s endogenous insulin prodution. I am of the opinion that every little bit of endogenous insulin helps.

I am starting to have wild fantasies of eating a biscuit or rice without a PP spike in the 200s! We can all dream right?

Numerous immune suppressive drugs, such as those prescribed for rheumatoid arthritis,
have been tested to see if they help slow or stop the autoimmune attack in T1... especially in the newly diagnosed, so it is possible it will have an effect

In fact JDRF funded a trial to test Ustekinumab, the name of the drug in Stellera,
to see if it has an effect on beta cell preservation in mice, and then design
a trial to see its effect on people.

http://onlineapps.jdfcure.org/AbstractReport.cfm?grant_id=34461&...

The JDRF funded study above is at Indiana University, and bears some similarityto the trial that Brian linked above, which was in Italy.

I would agree that every little bit of endogenous insulin helps. That's because I DO have some, and while I can't stay alive without injected insulin (already tried that), I do have a little wiggle room that others don't have. For example, if my pump runs out of insulin, I can go several hours before refilling, admittedly with a rise in BGs but I don't immediately go into DKA. That alone is a blessing, because I HAVE run out of insulin in situations where I couldn't immediately refill my pump. Or like last week, when my infusion set fell out.

I wouldn't recommend that experiment to anyone else, but I feel lucky that I do have the little bit of freedom, and less worry!

thanks HPNPilot! That abstract sums up my thoughts pretty well and shows that the idea is reasonable, but unfortunately not novel. Has there been any preliminary results published?

In a quick search, I have been unable to find any published results, even though according to the abstract, the mouse study was to complete in March of 2012.

The professor's contact info is here:
http://www.iupui.edu/~islets/team.html

It might be interesting for you to contact him and find out what is happening.
The fact that you may be taking Stellera for psoriasis and also have T1 would no doubt be of great interest to him, given that the 2nd phase of his study was to see what happens in humans.

I met with my dermatologist today and found out that I am not a canidate for Stelera or a similar drug. They cost approximately $30,000 a year and, as such, it is prudent to exhaust other therapy options first.