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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 "Magna Graecia", Catanzaro, Department of Health Sciences, University of Catanzaro "Magna Graecia", 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 "Magna Graecia", 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 "Magna Graecia", 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 "Magna Graecia", Catanzaro, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro

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