Evidence map›Paper›PMID 27252867›Full record

ArticleEndocrinology, diabetes & metabolism case reports2016

Pancreas-protective effect of rituximab for acute-onset type 1 diabetes in the honeymoon period: a case report.

Akira Kurozumi, Yosuke Okada, Tadashi Arao, Yusuke Miyazaki, Maiko Yoshikawa, Keiichi Torimoto, Satoshi Kubo, Shingo Nakayamada, Yoshiya Tanaka

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Endocrinology, diabetes & metabolism case reports, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Akira KurozumiFirst Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Japan, Kitakyushu , Japan.
Yosuke OkadaFirst Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Japan, Kitakyushu , Japan.
Tadashi AraoFirst Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan; Department of Internal Medicine, Japan Labour Health and Welfare Organization, Kyushu Rosai Hospital, Moji Medical Center, Kyushu, Japan.
Yusuke MiyazakiFirst Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Japan, Kitakyushu , Japan.
Maiko YoshikawaFirst Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Japan, Kitakyushu , Japan.
Keiichi TorimotoFirst Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Japan, Kitakyushu , Japan.
Satoshi KuboFirst Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Japan, Kitakyushu , Japan.
Shingo NakayamadaFirst Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Japan, Kitakyushu , Japan.
Yoshiya TanakaFirst Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Japan, Kitakyushu , Japan.
University of Occupational and Environmental Health Japan · JPKyushu Rosai Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

unlabelledA randomized controlled study of rituximab demonstrated that the drug protects pancreatic function in patients with acute-onset type 1 diabetes mellitus (AOT1DM). However, the mechanism of this protective effect is poorly understood. We examined the effects of rituximab in two patients with AOT1DM in the honeymoon period and the mechanism of these effects. Case 1 was a 40-year-old man and Case 2 was a 45-year-old man, both diagnosed with AOT1DM. Various tests indicated intact capacity for endogenous insulin secretion and that they were in the honeymoon phase of AOT1DM. Treatment with rituximab protected against pancreatic β-cell damage and maintained somewhat the endogenous insulin secretion. In Case 2, HbA1c level was maintained below 6.5% up to 24 months after treatment. However, in Case 1, the patient showed a gradual increase in HbA1c level starting around 9 months but fell at 12 months to >9.0% and required an insulin dose about twice greater than that of Case 2. High spleen tyrosine kinase (Syk) levels were recorded in the two patients before rituximab administration and after the treatment, the levels were further increased in Case 1, but decreased in Case 2. Both patients require continuous careful follow-up for glycemic control, insulin secretion capacity, and adverse reactions in the future. Although the clinical relevance of high Syk levels in AOT1DM patients remains unclear, the difference in the change in Syk level between the two patients may explain the different clinical courses. LEARNING POINTS: We described the pancreas-protective effect of rituximab in two patients with acute-onset type 1 diabetes mellitus in the honeymoon period and investigated the possible mechanism of action.The present study demonstrated that treatment with rituximab maintained endogenous insulin secretion capacity for 2 years in the two patients.The phosphorylated-spleen tyrosine kinase (p-Syk) data suggest that the differences in HbA1c level and the required insulin dose between the two patients could be due to reactivation or nonreactivation of β-cells.

Identifiers

PMID27252867
PMCPMC4870497
OpenAlexW2397750222

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.