Interesting Studies

1

Verapamil and beta cell function in adults with recent-onset type 1 diabetes

Fascinating study reported in Nature Medicine. Authors built on their previous molecular understanding (decreasing the expression of thioredoxin-interacting protein by antihypertensive calcium-channel blocker verapamil promotes the survival of insulin-producing beta cells and reverses diabetes in mouse models1) and conduct an RCT to illustrate that once-daily oral verapamil added to a standard insulin regimen may provide a safe and effective novel approach to promote and preserve an individual’s own beta cell function, delay beta cell loss and disease progression for at least 1 year and reduce insulin requirements and hypoglycemic episodes in adults with recent-onset T1D.

Full text here http://www.nature.com.stanford.idm.oclc.org/articles/s41591-018-0089-4

One of the best example of drug repurposing - Starting from Cell Biology, to Mouse model to an RCT in Homo Sapiens.

I think this is an interesting study to conduct at population scale given OHDSI tools stack of Population Level Effect Estimation.

Regards
-Rohit Vashisht

2

Yes, this is interesting topic, indeed.

When I’d seen this article before you mentioned, I’d ignored this article because I thought it would be hard to conduct comparative effectiveness study for verapamil in type 1 DM.

To my knowledge number 1 indication of verapamil is atrial fibrillation (verapamil is not good for controlling BP, though some doctors still keep prescribing this medication for hypertension). Atrial fibrillation mainly affects senior population, whereas type 1 DM usually affects much younger population.

Because the onset of disease is so different in life time, I don’t know how to design the study for validate effectiveness of verapamil in patients with type 1 DM in real-world.

I made simple cohort who used verapamil and had a history of type 1 diabetes mellitus.
http://www.ohdsi.org/web/atlas/#/cohortdefinition/1769408

@rohitv , do you have any idea for actual study design?
One possible design can be comparing glucose level before and after verapamil prescription on type 1 DM.