Vol 8, No 3 (2022)
Review paper
Published online: 2022-09-30

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Antidiabetic effect of disease-modifying antirheumatic drugs

Bożena Targońska-Stępniak1
Rheumatology Forum 2022;8(3):122-128.

Abstract

Disease-modifying antirheumatic drugs (DMARDs) form the mainstay of treatment for chronic arthritis, slow down progression of the disease and can lead to a state of remission. Most of these drugs are immunosuppressive preparations and biologics. There are reports on effects of these preparations in addition to their anti-inflammatory effect, including antidiabetic effect. This paper aims to present the currently available results of studies and clinical observations indicating the potential for multidirectional effects of DMARDs, particularly a risk-reducing effect on the development of diabetes and diabetes-dependent complications.

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References

  1. Mantravadi S, George M, Brensinger C, et al. Impact of tumor necrosis factor inhibitors and methotrexate on diabetes mellitus among patients with inflammatory arthritis. BMC Rheumatol. 2020; 4: 39.
  2. Infante M, Padilla N, Alejandro R, et al. Diabetes-modifying antirheumatic drugs: the roles of DMARDs as glucose-lowering agents. Medicina (Kaunas). 2022; 58(5): 571.
  3. Ozen G, Pedro S, Holmqvist ME, et al. Risk of diabetes mellitus associated with disease-modifying antirheumatic drugs and statins in rheumatoid arthritis. Ann Rheum Dis. 2017; 76(5): 848–854.
  4. Wasko MC, Hubert HB, Lingala VB, et al. Hydroxychloroquine and risk of diabetes in patients with rheumatoid arthritis. JAMA. 2007; 298(2): 187–193.
  5. Gonzalez-Gay MA, De Matias JM, Gonzalez-Juanatey C, et al. Anti-tumor necrosis factor-alpha blockade improves insulin resistance in patients with rheumatoid arthritis. Clin Exp Rheumatol. 2006; 24(1): 83–86.
  6. Kiortsis DN, Mavridis AK, Vasakos S, et al. Effects of infliximab treatment on insulin resistance in patients with rheumatoid arthritis and ankylosing spondylitis. Ann Rheum Dis. 2005; 64(5): 765–766.
  7. Solomon DH, Massarotti E, Garg R, et al. Association between disease-modifying antirheumatic drugs and diabetes risk in patients with rheumatoid arthritis and psoriasis. JAMA. 2011; 305(24): 2525–2531.
  8. Chen HH, Chen DY, Lin CC, et al. Association between use of disease-modifying antirheumatic drugs and diabetes in patients with ankylosing spondylitis, rheumatoid arthritis, or psoriasis/psoriatic arthritis: a nationwide, population-based cohort study of 84,989 patients. Ther Clin Risk Manag. 2017; 13: 583–592.
  9. Desai RJ, Dejene S, Jin Y, et al. Comparative risk of diabetes mellitus in patients with rheumatoid arthritis treated with biologic or targeted synthetic disease-modifying drugs: a cohort study. ACR Open Rheumatol. 2020; 2(4): 222–231.
  10. Jin Y, Chen SK, Lee H, et al. Use of biologic or targeted-synthetic disease-modifying anti-rheumatic drugs and risk of diabetes treatment intensification in patients with rheumatoid arthritis and diabetes mellitus. Rheumatol Adv Pract. 2020; 4(2): rkaa027.
  11. Nam SoH, Kim M, Kim YJ, et al. Risk of new-onset diabetes mellitus associated with antirheumatic drugs in patients with rheumatoid arthritis: a nationwide population study. J Clin Med. 2022; 11(8): 2109.
  12. Infante M, Ricordi C, Fabbri A. Antihyperglycemic properties of hydroxychloroquine in patients with diabetes: Risks and benefits at the time of COVID-19 pandemic. J Diabetes. 2020; 12(9): 659–667.
  13. Rekedal LR, Massarotti E, Garg R, et al. Changes in glycosylated hemoglobin after initiation of hydroxychloroquine or methotrexate treatment in diabetes patients with rheumatic diseases. Arthritis Rheum. 2010; 62(12): 3569–3573.
  14. Simental-Mendía LE, Simental-Mendía M, Sánchez-García A, et al. Effect of hydroxychloroquine on glucose control in patients with and without diabetes: a systematic review and meta-analysis of randomized controlled clinical trials. Eur J Clin Pharmacol. 2021; 77(11): 1705–1712.
  15. Gupta A. Real-world clinical effectiveness and tolerability of hydroxychloroquine 400 mg in uncontrolled type 2 diabetes subjects who are not willing to initiate insulin therapy (HYQ-real-world study). Curr Diabetes Rev. 2019; 15(6): 510–519.
  16. Wasko MC, McClure CK, Kelsey SF, et al. Antidiabetogenic effects of hydroxychloroquine on insulin sensitivity and beta cell function: a randomised trial. Diabetologia. 2015; 58(10): 2336–2343.
  17. Wondafrash DZ, Desalegn TZ, Yimer EM, et al. Potential effect of hydroxychloroquine in diabetes mellitus: a systematic review on preclinical and clinical trial studies. J Diabetes Res. 2020; 2020: 5214751.
  18. Powrie JK, Shojaee-Moradie F, Watts GF, et al. Mode of action of chloroquine in patients with non-insulin-dependent diabetes mellitus. Am J Physiol. 1991; 260(6 Pt 1): E897–E904.
  19. Halaby MJ, Kastein BK, Yang DQ. Chloroquine stimulates glucose uptake and glycogen synthase in muscle cells through activation of Akt. Biochem Biophys Res Commun. 2013; 435(4): 708–713.
  20. Baghdadi LR, Baghdadi LR. Effect of methotrexate use on the development of type 2 diabetes in rheumatoid arthritis patients: A systematic review and meta-analysis. PLoS One. 2020; 15(7): e0235637.
  21. N'Dow SMS, Donnelly LA, Pearson ER, et al. In a cohort of individuals with type 2 diabetes using the drug sulfasalazine, HbA lowering is associated with haematological changes. Diabet Med. 2021; 38(9): e14463.
  22. Stanley TL, Zanni MV, Johnsen S, et al. TNF-alpha antagonism with etanercept decreases glucose and increases the proportion of high molecular weight adiponectin in obese subjects with features of the metabolic syndrome. J Clin Endocrinol Metab. 2011; 96(1): E146–E150.
  23. Otsuka Y, Kiyohara C, Kashiwado Y, et al. Effects of tumor necrosis factor inhibitors and tocilizumab on the glycosylated hemoglobin levels in patients with rheumatoid arthritis; an observational study. PLoS One. 2018; 13(4): e0196368.