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GAD vaccine reduces insulin loss in recently diagnosed type 1 diabetes: findings from a Bayesian meta-analysis
Western Michigan University, MI 49008 USA.
Western Michigan University, MI 49008 USA.
Yale University, CT USA; Yale University, CT USA.
Hospital Sick Children, Canada; University of Toronto, Canada.
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2017 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 60, no 1, 43-49 p.Article in journal (Refereed) Published
Abstract [en]

GAD is a major target of the autoimmune response that occurs in type 1 diabetes mellitus. Randomised controlled clinical trials of a GAD + alum vaccine in human participants have so far given conflicting results. In this study, we sought to see whether a clearer answer to the question of whether GAD65 has an effect on C-peptide could be reached by combining individual-level data from the randomised controlled trials using Bayesian meta-analysis to estimate the probability of a positive biological effect (a reduction in C-peptide loss compared with placebo approximately 1 year after the GAD vaccine). We estimate that there is a 98% probability that 20 mu g GAD with alum administered twice yields a positive biological effect. The effect is probably a 15-20% reduction in the loss of C-peptide at approximately 1 year after treatment. This translates to an annual expected loss of between -0.250 and -0.235 pmol/ml in treated patients compared with an expected 2 h AUC loss of -0.294 pmol/ml at 1 year for untreated newly diagnosed patients. The biological effect of this vaccination should be developed further in order to reach clinically desirable reductions in insulin loss in patients recently diagnosed with type 1 diabetes.

Place, publisher, year, edition, pages
SPRINGER , 2017. Vol. 60, no 1, 43-49 p.
Keyword [en]
Bayes methods; Glutamic acid decarboxylase (GAD); Meta-analysis; Type 1 diabetes; Vaccine
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:liu:diva-133724DOI: 10.1007/s00125-016-4122-1ISI: 000389634000007PubMedID: 27704166OAI: oai:DiVA.org:liu-133724DiVA: diva2:1063914
Note

Funding Agencies|JDRF [1-INO-20140170-A-V]

Available from: 2017-01-11 Created: 2017-01-09 Last updated: 2017-01-11

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Ludvigsson, Johnny
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Division of Clinical SciencesFaculty of Medicine and Health SciencesDepartment of Paediatrics in Linköping
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CiteExportLink to record
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