Three-Year Follow-up After Antiviral Treatment in New-Onset Type 1 Diabetes: Results From the Diabetes Virus Detection and Intervention Trial
Abstract
Objective In the Diabetes Virus Detection and Intervention trial, antiviral treatment with pleconaril and ribavirin decreased the decline, compared with placebo, in endogenous C-peptide 1 year after diagnosis of type 1 diabetes (T1D) in children and adolescents. This article reports the results 2 and 3 years after diagnosis. Research design and methods This was a multicenter, randomized, placebo-controlled (1:1) trial of 96 children and adolescents aged 6-15.9 years newly diagnosed with T1D. Antiviral treatment (pleconaril and ribavirin) or placebo was given for 6 months from diagnosis, and participants were followed for 3 years. The primary outcome was residual C-peptide secretion, reported as the area under the curve (AUC), assessed by 2-h mixed-meal tolerance test. Secondary outcomes included insulin doses and HbA1c. Results At the 3-year follow-up, 75 participants attended. At 2 years, the mean ± SD AUC for C-peptide in the placebo group was 0.27 ± 0.33 compared with 0.34 ± 0.37 in the pleconaril and ribavirin group. After 3 years, the AUC had decreased to 0.17 ± 0.23 and 0.25 ± 0.34, respectively. There was no statistically significant difference between the groups. The groups were also comparable with regard to secondary end points. Conclusions The decreased reduction in C-peptide levels after antiviral treatment is no longer present after 2 or 3 years. Further investigations are needed to explore options to use antiviral treatment in the prevention and treatment of T1D…
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Treatment with pleconaril together with ribavirin temporarily preserves β-cell function more effectively than placebo; however, the benefit was not found to be present after 2 years and after 3 years.
“Treatment with the viral clearing agent pleconaril, together with the broadspectrum antiviral drug ribavirin, temporarily preserves βcell function more effectively than placebo (table 1); 29 however, the benefit was not found to be present after 2 years and after 3 years.30”
From The future of type 1 diabetes therapy (2025) · cites this paper as [30]
Cites
Hayden, F. G., Coats, T., Kim, K., Hassman, H. A., Blatter, M. M., Zhang, B., & Liu, S. (2002) · Antiviral Therapy · doi:10.1177/135965350200700107 · Cited by 72 · see citing works
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The future of type 1 diabetes therapy
Ziegler, A.-G., Cengiz, E., & Kay, T. W. H. (2025) · The Lancet · doi:10.1016/s0140-6736(25)01438-2 · Cited by 42 · see citing works
de Groen, P., Blok, L. C. H. M., Snethlage, C. M. F., Hanssen, N. M. J., Rampanelli, E., & Nieuwdorp, M. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms262110788 · Cited by 6 · see citing works
“However, longer-term follow-up studies (up to three years) indicate that the protective effect on insulin production may diminish over time, with no statistically significant difference between treated and placebo groups at two and three years [125].”
Haber, L. S. D. A., Laurindo, L. F., de Melo, R. F. D., Carneiro, D. P., Biteli, P., Chagas, H. V., Mellem, L. J., Haber, J. F. D. S., Sloan, L. A., Sloan, K. P., et al. (2025) · Endocrines · doi:10.3390/endocrines6030035
“In children and adolescents, treatment presents a significant challenge since it involves not only insulin therapy and blood glucose monitoring but also drastic lifestyle changes [49,50].”
- Authors
- Mynarek, I. M., Krogvold, L., Mørk, F. B., Lawaetz, T. W. H., Roald, T., Fagerland, M. W., Lindblom, N., Westman, J., Barker, P., Hyöty, H., Ludvigsson, J., Hanssen, K. F., Johannesen, J., & Dahl-Jørgensen, K.
- Affiliations
- Oslo University Hospital (NO)
- University of Copenhagen (DK)
- Apodemus (Sweden) (SE)
- NIHR Cambridge Biomedical Research Centre (GB)
- Tampere University (FI)
- Linköping University (SE)
- 1Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2025-01-13
- Volume
- 48
- Issue
- 3
- Pages
- 481-488
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W4406310550
- Cited by
- 4
- References
- 0
- Citations by year
- 2026: 1 · 2025: 3
- FWCI
- 2.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Helse Sør-Øst RHF (2016119)
- JDRF (2-SRA-2019-810-M-B)
- Innovative Medicines Initiative (115797, 945268)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
- Keywords
- type 1 diabetes, antiviral therapy, pleconaril, ribavirin, newly diagnosed type 1 diabetes, children and adolescents, long-term follow-up, insulin dose, HbA1c, mixed meal tolerance test
- MeSH terms
- Adolescent, Antiviral Agents, C-Peptide, Child, Diabetes Mellitus, Type 1, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Male, Ribavirin
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