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

[ Vol. 13 , Issue. 3 ]

Author(s):

Christian Leporini*, Emilio Russo, Salvatore D`Angelo, Franco Arturi, Giovanni Tripepi, Rosario Peluso, Rosa Daniela Grembiale, Ignazio Olivieri, Giovambattista De Sarro and Francesco Ursini   Pages 184 - 191 ( 8 )

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.

Keywords:

Anti-TNFα, insulin resistance, rheumatoid arthritis, type 2 diabetes, RA patients, meta-analysis.

Affiliation:

Department of Health Sciences, University of Catanzaro , Department of Health Sciences, University of Catanzaro , Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Department of Health Sciences, University of Catanzaro , CNRIBIM, National Research Council-Institute of Biomedicine, Reggio Calabria, Department of Clinical Medicine and Surgery - Rheumatology Research Unit – Federico II University, Naples, Department of Health Sciences, University of Catanzaro , Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Department of Health Sciences, University of Catanzaro , Department of Health Sciences, University of Catanzaro

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