for people ages 6-17 (full criteria)
at San Francisco, California and other locations
study started
estimated completion
Stephen Gitelman



Type 1 diabetes mellitus (T1DM) is an autoimmune disease. Based on previous research, study doctors think that giving medicines to affect the immune system soon after diabetes is diagnosed may stop, delay or decrease the destruction of beta cells, resulting in better glucose control. Researchers believe that tocilizumab could have some effect on the cells in the immune system that are thought to be involved in the development of type 1 diabetes. This study will test whether tocilizumab can help preserve or delay destruction of remaining beta cells in people recently diagnosed type 1 diabetes.

Official Title

Preserving Beta-Cell Function With Tocilizumab in New-onset Type 1 Diabetes (ITN058AI)


Staggered enrollment is planned for this trial.

Prior to initiating the study in the pediatric age group (6-17 years old), 30-99 eligible adults (ages 18-45 years) will be randomized 2:1 to tocilizumab or placebo, respectively. Once the first thirty adult participants have completed 12 weeks of treatment, the FDA and Data and Safety Monitoring Board (DSMB) will review available data (e.g., interim analysis) to weigh potential risks and benefits before opening the trial to pediatric participants.

As of ≥ May 15, 2017: Study enrollment limited to participants ages 6 to 17 years inclusive.


Type 1 Diabetes Mellitus New-onset Type 1 Diabetes Mellitus T1DM T1D interleukin-6 (IL-6) receptor inhibitor Diabetes Mellitus Diabetes Mellitus, Type 1 Tocilizumab (TCZ)


You can join if…

Open to people ages 6-17

  1. Male or female aged 6-45 years*

-*Current Institutional Review Board (IRB)-approved age eligibility criteria is restricted to subjects 6 to 17 years of age at time of study enrollment

  1. Diagnosis of type 1 diabetes mellitus (T1DM), using the American Diabetes Association T1DM criteria, within 100 days of study enrollment
  2. Positive for at least one diabetes-related autoantibody, including but not limited to:
  3. Glutamate decarboxylase (GAD-65)
  4. Insulin, if obtained within 10 days of the onset of exogenous insulin therapy
  5. Insulinoma antigen-2 (IA-2)
  6. Zinc transporter-8 (ZnT8)
  7. Peak stimulated C-peptide level ≥ 0.2 pmol/mL following a mixed-meal tolerance test (MMTT) conducted at least 21 days from diagnosis and within 37 days of randomization (V0)
  8. Signed informed consent (and informed assent of minor, if applicable).

You CAN'T join if...

  1. Severe reaction or anaphylaxis to human, humanized or murine monoclonal antibodies
  2. History of malignancy or serious uncontrolled cardiovascular, nervous system, pulmonary, renal, or gastrointestinal disease, or significant dyslipidemia
  3. Any history of recent serious bacterial, viral, fungal, or other opportunistic infections
  4. Have serologic evidence of current or past HIV (Human immunodeficiency virus), Hepatitis B, or Hepatitis C
  5. Positive QuantiFERON Tuberculosis (TB) test, history of TB, or active TB infection
  6. Active infection with Epstein-Barr virus (EBV) as defined by EBV viral load ≥10,000 copies per mL of whole blood
  7. Active infection with Cytomegalovirus (CMV) as defined by CMV viral load ≥10,000 copies per mL of whole blood
  8. Diagnosis of liver disease or elevated hepatic enzymes, as defined by Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), or both > 1.5 x the upper limit of age-determined normal (ULN) or total bilirubin > ULN
  9. Current or prior treatment that is known to cause a significant, ongoing change in the course of T1D or immunologic status
  10. . Current or prior (within last 30 days) use of drugs other than insulin to treat hyperglycemia (e.g. metformin, sulfonylureas, glinides, thiazolidinediones, exenatide, liraglutide, Dipeptidyl peptidase-4 Intravenous (DPP-IV) inhibitors, or amylin)
  11. . Current use of any medication known to significantly influence glucose tolerance (e.g., atypical antipsychotics, diphenylhydantoin, niacin)
  12. . Any of the following hematologic abnormalities, confirmed by repeat tests:
  13. White blood count <3,000/microL or >14,000/microL
  14. Lymphocyte count <500/microL
  15. Platelet count <150,000 /microL
  16. Hemoglobin <8.5 g/dL
  17. . Neutrophil count <2,000 cells/microL.
  18. . Females who are pregnant, lactating, or planning on pregnancy during the 2- year study period
  19. . History or diagnoses of other autoimmune diseases with the exception of stable thyroid or celiac disease
  20. . History of alcohol, drug or chemical abuse within 1 year prior to study eligibility screening evaluation
  21. . Any medical or psychological condition that in the opinion of the principal investigator would interfere with safe completion of the trial
  22. . Prior participation in a clinical trial that could increase risks associated with this clinical trial
  23. . Receipt of live vaccine (e.g. varicella, measles, mumps, rubella, cold-attenuated intranasal influenza vaccine, bacillus Calmette-Guérin, and small pox) in the 6 weeks before randomization
  24. . High lipid levels (fasting Low-density lipoprotein (LDL) cholesterol ≥160 mg/dL)
  25. . History of significant allergy (e.g. anaphylaxis) to milk or soy proteins.


  • University of California San Francisco
    San Francisco California 94143 United States
  • Stanford University
    Stanford California 94305 United States

Lead Scientist

  • Stephen Gitelman
    I am involved in a variety of different translational and clinical research projects, most related to diabetes. A number of the on-going studies are attempts to alter the course of autoimmune-mediated type 1 diabetes, often via immunomodulation, in order to preserve endogenous beta cell function. Some of the recent and on-going projects are described below.


in progress, not accepting new patients
Start Date
Completion Date
National Institute of Allergy and Infectious Diseases (NIAID)
National Institute of Allergy and Infectious Diseases (NIAID) website
Division of Allergy, Immunology, and Transplantation (DAIT) website
Immune Tolerance Network (ITN) website
EXTEND's study-specific ITN website
American Diabetes Association information on Type 1 Diabetes
Phase 2
Study Type
Last Updated