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Rheumatoid Arthritis Treatment May Reduce Diabetes Risk

Control of RA-related inflammation with TNFα antagonists may improve insulin sensitivity

MONDAY, April 11 (HealthDay News) -- Extended use of tumor necrosis factor α (TNFα) antagonists in patients with rheumatoid arthritis (RA) may reduce the risk of developing insulin resistance (IR), according to a review published in the April issue of Arthritis Care & Research.

Mary Chester Wasko, M.D., from the University of Pittsburgh School of Nursing, and colleagues evaluated the association between molecular markers of inflammation, alterations in body composition, and IR. They identified studies published between 1949 and 2010 detailing IR and body habitus in patients with RA. They also evaluated the role of TNFα in the pathophysiology of type 2 diabetes mellitus and RA, and the impact of antirheumatic drugs on glycemic control.

The investigators found that patients with RA had factors putting them at increased risk for IR and type 2 diabetes, and studies suggest they have increased likelihood of IR and cardiovascular disease (CVD) risk. Compared to the general population, there was no clear increase in incidence or prevalence of type 2 diabetes. RA-related inflammation was rapidly and effectively controlled by TNFα antagonists, and evidence suggested these may also be beneficial in improving insulin sensitivity if used for an extended period. Overall risk of type 2 diabetes and CVD in patients with RA may be reduced by treatment-related changes.

"Patients with chronic inflammatory diseases such as RA are at higher risk of developing impaired glucose metabolism that may eventually progress to type 2 diabetes mellitus," the authors write. "Patients with RA in whom disease activity is effectively controlled may experience the additional clinical benefit of improved insulin sensitivity."

All the study authors disclosed financial ties to the pharmaceutical industry. Two authors disclosed a financial relationship with Centocor Ortho Biotech Inc., which supported the study.

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