Immunosuppressive agents in diabetes treatment: Hope or despair?

Table 1 Immunosuppressive agents in diabetes treatment

Immunosuppressive agent class	Representative drugs in diabetes treatment	Target cell	Diabetes-specific studies or approvals
CD3 inhibitors	Teplizumab, otelixizumab	T-cells	Teplizumab: FDA-approved for delaying T1DM onset in specific populations; Otelixizumab: T1DM
CTLA4-Ig	Abatacept, belatacept	T-cells	Abatacept: T1DM; belatacept: T1DM, T2DM, islet or pancreas transplantation, prevention of PTDM
JAK inhibitors	Baricitinib, ruxolitinib, tofacitinib, upadacitinib	Various immune cells	Baricitinib: T1DM, T2DM; ruxolitinib: T1DM; tofacitinib: T1DM, T2DM; upadacitinib: T1DM
Immune globulin	ATG	T-cells	T1DM, islet or pancreas transplantation
TNF-α inhibitors	Adalimumab, Etanercept, Golimumab, Infliximab	Various immune cells	Adalimumab: T1DM, T2DM; etanercept: T1DM, T2DM, islet or pancreas transplantation; golimumab: T1DM; Infliximab: T1DM, T2DM
CD20 inhibitors	Rituximab	B cells	Rituximab: T1DM, T2DM; ofatumumab: T1DM
LFA-3/Ig	Alefacept	T cells	T1DM
Anti-CD52 antibody	Alemtuzumab	B and T cells	Islet or pancreas transplantation

FDA: Food and Drug Administration; T1DM: Type 1 diabetes mellitus; T2DM: Type 2 diabetes mellitus; PTDM: Post-transplantation diabetes mellitus; ATG: Anti-thymocyte globulin; JAK: Janus kinase; TNF-α: Tumor necrosis factor α; CTLA4: Cytotoxic T-lymphocyte-associated protein 4; IgG: Immunoglobulin G; ATG: Anti-thymocyte globulin.