On May 5, 2025, Health Canada approved Teplizumab (brand name Tzield), the first-ever treatment that can delay the onset of type 1 diabetes (T1D) in individuals at high risk of developing the disease.

Already authorized in the United States since 2022, this medication marks a major breakthrough—it is the first therapy to modify the course of T1D. However, it is still too early to know the cost or reimbursement conditions in Canada.

What is Teplizumab?

Teplizumab is a treatment that targets the immune system. It acts on T cells, which play a key role in the autoimmune process that destroys insulin-producing beta cells in the pancreas. By slowing this process, the drug helps delay the progression toward a diabetes diagnosis.

The treatment is administered in a clinical setting through 14 daily injections over two weeks. It does not cure diabetes, but it can delay its onset by several months or even years, allowing time to prepare, postpone the need for insulin, and better adjust to the diagnosis.

Reported side effects are generally mild and temporary, such as fever or a skin rash.

Who is this treatment for?

Tzield is intended for people at high risk of developing T1D in the near future. This includes individuals:

  • who have at least two autoantibodies associated with T1D (these are markers that can be detected through a blood test),

  • who show abnormal glucose levels during an oral glucose tolerance test, and

  • who have not yet received a formal diagnosis of diabetes.

A clinical study published in 2019 showed that this treatment could delay the onset of T1D by an average of two years in people meeting these criteria.

In Quebec, it’s important to note that only one autoantibody test is currently available, and there is no structured screening program in place yet. In addition, reimbursement criteria have not been announced, and the price of the drug remains to be confirmed.

Why is this treatment important?

For people at risk, Tzield could offer several benefits, including:

  • gaining more time without insulin;

  • reducing the emotional impact of the diagnosis;

  • allowing individuals and families to better prepare for living with T1D;

  • lowering the risk of early complications.

In the future, it may also be possible to administer a second course of treatment to extend the delay even further, or to use the drug shortly after diagnosis to help preserve remaining insulin production.

A step toward prevention

The approval of Teplizumab in Canada marks a milestone in the prevention of T1D. Research continues on other promising therapies, including potential vaccines that could stop the autoimmune process altogether.

But to take action, we must first identify those at risk. That’s why autoantibody screening will play a central role in the years ahead.

What are your thoughts on early screening for T1D?

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(First published: July 2021. Updated: May 2025)

References:

  • Sanofi Canada. (May 5, 2025). Health Canada has granted approval for Tzield®, the first and only disease-modifying therapy in autoimmune type 1 diabetes in Canada [Press release]. https://sanoficanada.mediaroom.com/2025-05-05-Health-Canada-has-granted-approval-for-Tzield-R-,-the-first-and-only-disease-modifying-therapy-in-autoimmune-type-1-diabetes-in-Canada
  • Herold KC, Bundy BN, Long SA, et al. (2019). An Anti-CD3 Antibody, Teplizumab, in Relatives at Risk for Type 1 Diabetes. The New England Journal of Medicine. 381(7):603-613. 
  • FDA Advisory Committee Recommends that Teplizumab Receives Approval, 14 juin 2021, https://www.jdrf.org/blog/2021/05/27/fda-advisory-committee-recommends-teplizumab-receives-approval/
  • Teplizumab : ce nouveau médicament passionnant pour prévenir le diabète de type 1, 14 juin 2021, https://infosante24.com/teplizumab-ce-nouveau-medicament-passionnant-pour-prevenir-le-diabete-de-type-1/
  • FDA Approves First Drug That Can Delay Onset of Type 1 Diabetes, consulté le 23 novembre 2022, https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-can-delay-onset-type-1-diabetes?fbclid=IwAR0vQ84mVXCe2-VQp14wkA-dtwJFUEwigR7TULwGtmCFiaKoIe5l_3JPSNE