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How to screen

Screening can help identify at-risk patients before symptoms arise.1,2

A woman laughing and looking to the side
A woman laughing and looking to the side

The ADA recommends proactively screening at-risk patients for the following 4 islet autoantibodies (AAbs)2,3*

GADA

Glutamic acid decarboxylase 65 AAb


IAA

Insulin AAb


IA-2A

Insulinoma-associated antigen 2 AAb


ZnT8A

Zinc transporter-8 AAb


When tested together, these 4 AAbs have been found to have a 98% autoimmunity detection rate at disease onset.5

8 out of 10

commercially insured patients
pay less than

$20

for T1D AAb screening


Costs for AAb screening vary by health plan, benefit design, and test. Please check with the health plan to confirm costs for patients.

Consensus guidance on when to screen and monitor

Adult Patients

Initially screen for T1D risk during yearly visits to help improve feasibility7§​
  • Rescreen patients with increased risk in 1 year7

  • For high-risk patients, monitor metabolic status annually4
  • For all other patients, repeat screen every 3 years4

  • Collaborate and/or refer to a specialist based on stage4
  • Perform glycemic assessment and metabolic monitoring as needed in collaboration4,7

  • Rescreen patients with increased risk in 1 year7

  • For high-risk patients, monitor metabolic status annually4
  • For all other patients, repeat screen every 3 years4

  • Collaborate and/or refer to a specialist based on stage4
  • Perform glycemic assessment and metabolic monitoring as needed in collaboration4,7


Pediatric Patients

Screen during recommended well-child visits (1-2 years, 4-6 years and 11-13 years)7§​
  • Rescreen patients with increased risk in 1 year7
  • For all other patients, rescreen around 6 years and 9-11 years of age7
Screening for islet AAbs and close monitoring can reduce DKA risk in children by ~88%.9
  • Consider collaborating with a specialist4
  • If <3 years: rescreen every 6 months for 3 years, then annually for 3 more years4
  • If ≥3 years: rescreen annually for 3 years4
Screening for islet AAbs and close monitoring can reduce DKA risk in children by ~88%.9
  • Collaborate and/or refer to a specialist based on stage4
  • Perform glycemic assessment and metabolic monitoring as needed in collaboration4,7
Screening for islet AAbs and close monitoring can reduce DKA risk in children by ~88%.9

  • Rescreen patients with increased risk in 1 year7
  • For all other patients, rescreen around 6 years and 9-11 years of age7
Screening for islet AAbs and close monitoring can reduce DKA risk in children by ~88%.9

  • Consider collaborating with a specialist4
  • If <3 years: rescreen every 6 months for 3 years, then annually for 3 more years4
  • If ≥3 years: rescreen annually for 3 years4
Screening for islet AAbs and close monitoring can reduce DKA risk in children by ~88%.9

  • Collaborate and/or refer to a specialist based on stage4
  • Perform glycemic assessment and metabolic monitoring as needed in collaboration4,7
Screening for islet AAbs and close monitoring can reduce DKA risk in children by ~88%.9

Important Safety Information Anchor

INDICATION

TZIELD is a CD3-directed monoclonal antibody indicated to delay the onset of Stage 3 type 1 diabetes (T1D) in adults and pediatric patients aged 8 years and older with Stage 2 T1D.

IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS

  • Cytokine Release Syndrome (CRS): CRS occurred in TZIELD-treated patients during the treatment period and through 28 days after the last drug administration. Prior to TZIELD treatment, premedicate with antipyretics, antihistamines and/or antiemetics, and treat similarly if symptoms occur during treatment. If severe CRS develops, consider pausing dosing for 1 day to 2 days and administering the remaining doses to complete the full 14-day course on consecutive days; or discontinue treatment. Monitor liver enzymes during treatment. Discontinue TZIELD treatment in patients who develop elevated alanine aminotransferase or aspartate aminotransferase more than 5 times the upper limit of normal (ULN) or bilirubin more than 3 times ULN.
  • Serious Infections: Use of TZIELD is not recommended in patients with active serious infection or chronic infection other than localized skin infections. Monitor patients for signs and symptoms of infection during and after TZIELD administration. If serious infection develops, treat appropriately, and discontinue TZIELD.
  • Lymphopenia: Lymphopenia occurred in most TZIELD-treated patients. For most patients, lymphocyte levels began to recover after the fifth day of treatment and returned to pretreatment values within two weeks after treatment completion and without dose interruption. Monitor white blood cell counts during the treatment period. If prolonged severe lymphopenia develops (<500 cells per mcL lasting 1 week or longer), discontinue TZIELD.
  • Hypersensitivity Reactions: Acute hypersensitivity reactions including serum sickness, angioedema, urticaria, rash, vomiting and bronchospasm occurred in TZIELD-treated patients. If severe hypersensitivity reactions occur, discontinue TZIELD and treat promptly.
  • Vaccinations: The safety of immunization with live-attenuated (live) vaccines with TZIELD-treated patients has not been studied. TZIELD may interfere with immune response to vaccination and decrease vaccine efficacy. Administer all age-appropriate vaccinations prior to starting TZIELD.
    • Administer live vaccines at least 8 weeks prior to treatment. Live vaccines are not recommended during treatment, or up to 52 weeks after treatment.
    • Administer inactivated (killed) vaccines or mRNA vaccines at least 2 weeks prior to treatment. Inactivated vaccines are not recommended during treatment or 6 weeks after completion of treatment.

Most common adverse reactions (>10%) were lymphopenia, rash, leukopenia, and headache.

  • Pregnancy: May cause fetal harm.
  • Lactation: A lactating woman may consider pumping and discarding breast milk during and for 20 days after TZIELD administration.

Please see full Prescribing Information, including patient selection criteria, and Medication Guide. View Important Safety Information page.

REFERENCES

  1. Scheiner G, Weiner S, Kruger DF, Pettus J. Screening for type 1 diabetes: Role of the diabetes care and education specialist. ADCES Pract. 2022;10(5):20-25.
  2. American Diabetes Association Professional Practice Committee. Diagnosis and classification of diabetes: standards of care in diabetes—2025. Diabetes Care. 2025;(48)(Suppl 1):S27-S49.
  3. TZIELD Prescribing Information. Provention Bio, Inc; 2023.
  4. Phillip M, Achenbach P, Addala A, et al. Consensus guidance for monitoring individuals with islet autoantibody‑positive pre‑stage 3 type 1 diabetes. Diabetes Care. 2024;47(8):1276-1298.
  5. Wenzlau JM, Juhl K, Yu L, et al. The cation efflux transporter ZnT8 (Slc30A8) is a major autoantigen in human type 1 diabetes. Proc Natl Acad Sci U S A. 2007;104(43):17040-17045.
  6. Data on file. IQVIA. Data as of April 2024.
  7. Simmons KMW, Frohnert BI, O’Donnell HK, et al. Historical insights and current perspectives on the diagnosis and management of presymptomatic type 1 diabetes. Diabetes Technol Ther. 2023;25(11):790-799.
  8. American Diabetes Association. Blood glucose & A1C diagnosis. Accessed January 18, 2024. https://diabetes.org/about-diabetes/diagnosis
  9. Winkler C, Schober E, Ziegler A-G, et al. Markedly reduced rate of diabetic ketoacidosis at onset of type 1 diabetes in relatives screened for islet autoantibodies. Pediatr Diabetes. 2012;13(4):308-313.

INDICATION

IMPORTANT SAFETY INFORMATION

INDICATION

TZIELD is a CD3-directed monoclonal antibody indicated to delay the onset of Stage 3 type 1 diabetes (T1D) in adults and pediatric patients aged 8 years and older with Stage 2 T1D.

IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS

  • Cytokine Release Syndrome (CRS): CRS occurred in TZIELD-treated patients during the treatment period and through 28 days after the last drug administration. Prior to TZIELD treatment, premedicate with antipyretics, antihistamines and/or antiemetics, and treat similarly if symptoms occur during treatment. If severe CRS develops, consider pausing dosing for 1 day to 2 days and administering the remaining doses to complete the full 14-day course on consecutive days; or discontinue treatment. Monitor liver enzymes during treatment. Discontinue TZIELD treatment in patients who develop elevated alanine aminotransferase or aspartate aminotransferase more than 5 times the upper limit of normal (ULN) or bilirubin more than 3 times ULN.
  • Serious Infections: Use of TZIELD is not recommended in patients with active serious infection or chronic infection other than localized skin infections. Monitor patients for signs and symptoms of infection during and after TZIELD administration. If serious infection develops, treat appropriately, and discontinue TZIELD.
  • Lymphopenia: Lymphopenia occurred in most TZIELD-treated patients. For most patients, lymphocyte levels began to recover after the fifth day of treatment and returned to pretreatment values within two weeks after treatment completion and without dose interruption. Monitor white blood cell counts during the treatment period. If prolonged severe lymphopenia develops (<500 cells per mcL lasting 1 week or longer), discontinue TZIELD.
  • Hypersensitivity Reactions: Acute hypersensitivity reactions including serum sickness, angioedema, urticaria, rash, vomiting and bronchospasm occurred in TZIELD-treated patients. If severe hypersensitivity reactions occur, discontinue TZIELD and treat promptly.
  • Vaccinations: The safety of immunization with live-attenuated (live) vaccines with TZIELD-treated patients has not been studied. TZIELD may interfere with immune response to vaccination and decrease vaccine efficacy. Administer all age-appropriate vaccinations prior to starting TZIELD.
    • Administer live vaccines at least 8 weeks prior to treatment. Live vaccines are not recommended during treatment, or up to 52 weeks after treatment.
    • Administer inactivated (killed) vaccines or mRNA vaccines at least 2 weeks prior to treatment. Inactivated vaccines are not recommended during treatment or 6 weeks after completion of treatment.

Most common adverse reactions (>10%) were lymphopenia, rash, leukopenia, and headache.

  • Pregnancy: May cause fetal harm.
  • Lactation: A lactating woman may consider pumping and discarding breast milk during and for 20 days after TZIELD administration.

Please see full Prescribing Information, including patient selection criteria, and Medication Guide. View Important Safety Information page.