Short steroid treatment may help manage teplizumab CRS without stopping therapy
Last updated May 6, 2026
Key finding
In one adolescent with new-onset type 1 diabetes, short courses of glucocorticoids appeared to control teplizumab-related cytokine release syndrome and allowed both teplizumab courses to be completed.
This paper describes one teenager with new-onset type 1 diabetes who developed cytokine release syndrome during two teplizumab treatment courses. Short steroid treatment appeared to control the reaction, and she completed therapy with ongoing partial remission over the next 30 months, but this was only a single-patient report.
Quick read
Study at a glance
The essential study design details in one scan.
EvidenceScore™
Low
Study type
non-randomized clinical trial (non-RCT or NRCT)
Follow-up
Long-Term (> 12 mo)
Risk of bias
High Risk
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Plain-language summary
What this paper says
A plain-language read of the study’s main message and where it applies.
Study focus
In one adolescent with new-onset type 1 diabetes, short courses of glucocorticoids appeared to control teplizumab-related cytokine release syndrome and allowed both teplizumab courses to be completed.
Published in
Journal Reference
Publication details and source links for this paper.
Khine A, Sanda S, Torok C, Quandt Z, Gitelman SE. Glucocorticoids to Manage Cytokine Release Syndrome During Teplizumab Therapy for New-Onset Type 1 Diabetes. Diabetes Care. 2026;49(3):e46-e48. doi:10.2337/dc25-2494
Main Effects
Cytokine release syndrome symptoms ↓ after short glucocorticoid treatment
Teplizumab treatment completion ↑ because both infusion courses were finished
HbA1c ↔ remained fairly low through follow-up in this one patient
Total daily insulin dose ↓ stayed relatively modest during partial remission
Evidence Suggest
- Intravenous methylprednisolone and oral prednisone were used during the first CRS episode, and prednisone was used again during the second course.
- The patient completed both 12-day teplizumab courses without interruption after glucocorticoid treatment.
- Reported HbA1c values were 6.3% at 6 months, 6.4% at 15 months, 6.1% at 24 months, and 5.4% at 30 months.
- The authors reported ongoing low-dose basal insulin use and preserved mixed-meal C-peptide trends, which they interpreted as sustained partial remission.
Who this applies to
These findings apply most directly to adolescents or young people with new-onset type 1 diabetes receiving teplizumab who develop clinically significant cytokine release syndrome during treatment. Even then, the report reflects only one patient managed at a single center.
Keep in Mind
This paper mainly addresses adverse-event management, not a definitive test of teplizumab efficacy. The apparent benefit of glucocorticoids was limited to allowing treatment completion and symptom control in one patient. Because there was no formal comparison and many later outcomes reflect the broader effect of teplizumab itself, the case should be viewed as hypothesis-generating rather than practice-changing.
Between the Lines
- This was a single-patient case report.
- There was no direct control comparison for steroid use during CRS management.
- The patient was excluded from the parent trial analysis because glucocorticoids were prohibited.
- The report cannot show whether the same outcome would happen in other patients.
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