The MELD-ATG trial is the first adaptive, dose-ranging, placebo-controlled study to evaluate antithymocyte globulin (ATG) in recent-onset type 1 diabetes among youth aged 5-25 years.
Both 2.5 mg/kg and 0.5 mg/kg doses of ATG significantly preserved beta-cell function at 12 months compared to placebo, measured by stimulated C-peptide levels.
Lower doses of ATG were associated with fewer adverse immune reactions such as serum sickness and cytokine release syndrome, supporting a safer, effective minimal dose.
Findings suggest ATG as a promising repurposed immunomodulatory agent with disease-modifying potential in new-onset type 1 diabetes.
