Insulin-Sensiting Effects of Tumor Necrosis Factor Alpha Inhibitors in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.

Abstract

BACKGROUND:

Rheumatoid Arthritis (RA) has been associated with insulin resistance (IR), a well-established pathophysiological feature of Type 2 Diabetes (T2DM). Inconsistent literature evidence suggests that IR could be ameliorated by biological medications targeting TNFα.

OBJECTIVE:

The aim of this systematic review was to evaluate the effect of TNFα inhibitors (TNFi) on IR in RA patients.

METHODS:

We performed a systematic review in order to identify the available data on the effect of anti- TNFα medications on IR in RA patients. For this purpose, MedLine (via PubMed), Cochrane Central Register of Controlled Trials (CENTRAL) and SCOPUS were searched up to December 2016.

RESULTS:

The search strategy retrieved 209 individual records. Of these, only 12 articles were included in the systematic review. The pooled analysis under a random-effects model demonstrated a significant improvement of IR after treatment with TNFi quantified with the HOmeostasis Model Assessment of Insulin Resistance (HOMA-IR), with a standardized difference in means (SDM) of -0.847 (95%CI: -1.278 - 0.417, p < 0.0001). Heterogeneity across studies was high (Q = 65.00 with df = 9, p < 0.001, I2 = 89.15%).

CONCLUSION:

Our meta-analysis suggests that TNFα blockade might improve IR in RA patients.

• Authors: Christian Leporini, Emilio Russo, Salvatore D Angelo, Franco Arturi, Giovanni Tripepi, Rosario Peluso, Rosa Daniela Grembiale, Ignazio Olivieri, Giovambattista De Sarro, Francesco Ursini
• Journal: Reviews on recent clinical trials (Rev Recent Clin Trials) 2018 Vol. 13 Issue 3 Pg. 184-191 ISSN: 1876-1038 [Electronic] United Arab Emirates
• PMID: 29542420 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: Copyright© Bentham Science Publishers; For any queries, please email at [email protected].

Chemical References

• Antirheumatic Agents
• Tumor Necrosis Factor-alpha

Topics

• Antirheumatic Agents (therapeutic use)
• Arthritis, Rheumatoid (complications, drug therapy, metabolism)
• Humans
• Insulin Resistance
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)