Understanding Lantidra: A Cell Therapy, Not a Medication
Lantidra (donislecel) is an allogeneic pancreatic islet cellular therapy derived from deceased donor pancreases, providing insulin-producing beta cells. It is administered as an infusion into the hepatic portal vein of the liver, with the goal of the transplanted cells producing and secreting insulin to reduce or potentially eliminate the need for daily insulin injections in eligible patients.
Lantidra is not a cure for Type 1 diabetes and is specifically approved for adults with a severe, hard-to-manage form known as 'brittle' diabetes.
The Strict Eligibility Requirements
To get Lantidra, potential candidates must meet strict eligibility criteria, often initiated by an intake form. These criteria focus on those with difficult-to-control Type 1 diabetes and issues with severe hypoglycemia awareness.
Specific requirements include being an adult (18+) with confirmed Type 1 diabetes for over five years, experiencing repeated episodes of severe hypoglycemia or hypoglycemia unawareness despite intensive management, having no other serious health issues, active infections, or a BMI over 27, and requiring a negative T- and B-cell crossmatch with donor lymphocytes.
The Lantidra Application and Treatment Process
The path to receiving Lantidra is a multistep process handled at a single specialized center. This involves submitting a patient intake form, review by the UI Health clinical team, comprehensive screening, donor matching (dependent on limited deceased donor supply), the infusion procedure requiring hospitalization, and lifelong immunosuppression and monitoring.
Access and Limitations of Lantidra
Restricted Availability
As of late 2024, Lantidra is exclusively available at the University of Illinois Chicago (UI Health), where the supporting clinical trials took place. This necessitates evaluation and treatment at this single location.
Comparison: Lantidra vs. Traditional Insulin Therapy
| Feature | Lantidra (Cell Therapy) | Intensive Insulin Therapy | Key Difference | |
|---|---|---|---|---|
| Mechanism | Infused donor islet cells produce endogenous insulin. | External administration of synthetic insulin. | Source of Insulin | Native vs. external |
| Ideal Patient | Adults with severe, recurrent hypoglycemia and/or unawareness, despite best efforts. | All patients with Type 1 diabetes, especially those who can manage glucose levels effectively. | Target Population | Severe cases vs. all T1D |
| Administration | One or more surgical infusions into the hepatic portal vein. | Daily injections or use of an insulin pump. | Method | Infusion vs. injection |
| Insulin Dependence | May achieve insulin independence for periods of time; not guaranteed or permanent. | Continuous dependence on external insulin source. | Reliability | Potential independence vs. ongoing need |
| Major Risks | Surgical procedure risks (e.g., liver injury), lifelong immunosuppression risks (infection, cancer). | Standard risks associated with insulin use (e.g., hypoglycemia, weight gain), no long-term immunosuppression. | Risk Profile | Surgical and immunosuppressive vs. metabolic |
| Cost & Access | High cost, limited availability, complex insurance coverage, dependent on donor supply. | Wide availability, standard insulin coverage, not reliant on donors. | Barrier to Entry | High vs. low |
Considerations for the Patient
Considering Lantidra involves weighing potential benefits against significant long-term health risks and lifestyle changes. Lifelong immunosuppressive drugs are required to prevent rejection of the donor cells, increasing susceptibility to serious infections and certain cancers. Procedural risks like hemorrhage or liver injury are also a factor. While insulin independence is possible, it's not guaranteed or always permanent. Prospective patients must engage in a thorough discussion with medical professionals about these trade-offs.
Conclusion
Addressing the question, 'Can I get lantidra?', the answer is yes, but only for a highly specific and small group of adults with Type 1 diabetes meeting strict criteria related to severe, repeated hypoglycemia and unawareness. Treatment is currently exclusive to UI Health, requires lifelong immunosuppression, and involves notable risks. It's a specialized treatment offering potential, not a cure. A detailed discussion with an endocrinologist and transplant team is crucial. Further information is available on the {Link: diatribe.org https://diatribe.org/diabetes-research/first-fda-approved-islet-cell-transplant-performed}.
