Hydroxychloroquine Use and Decreased Risk of Diabetes in Rheumatoid Arthritis Patients

Bili, Androniki; Sartorius, Jennifer; Kirchner, H. Lester; Morris, Stephanie J.; Ledwich, Lindsay J.; Antohe, Jana L.; Dancea, Sorina; Newman, Eric D.; Wasko, Mary Chester

doi:10.1097/rhu.0b013e318214b6b5

Cited by 83 publications

(62 citation statements)

References 28 publications

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“…Notably, sevelamer carbonate reduced intracellular serum AGEs, well established proinflammatory compounds (4). The fact that sevelamer carbonate, but not calcium carbonate, reproduced the findings of dietary AGE restriction constitutes a potentially important new finding that could have therapeutic implications for the metabolic syndrome and other chronic conditions associated with increased oxidant stress and inflammation (43,44). The fact that reducing AGEs by two independent methods results in improvements in glucose metabolism and reactive oxygen species/inflammation adds credibility to the hypothesis that this action of sevelamer carbonate was due to the binding of AGEs in the intestinal contents and elimination of AGEs, rather than an effect on bile-acid acids and phosphate uptake.…”

Section: Discussionmentioning

confidence: 95%

Effects of Sevelamer on HbA1c, Inflammation, and Advanced Glycation End Products in Diabetic Kidney Disease

Vlassara

Uribarri

Cai

et al. 2012

Clinical Journal of the American Society of Nephrology

129

105

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SummaryBackground and objectives Increased inflammation and oxidative stress may be caused by proteins and lipids modified by cytotoxic advanced glycation end products (AGEs) in food. Restricting food containing elevated AGEs improves these risk factors in diabetic CKD. Because diet adherence can be problematic, this study aimed to remove cytotoxic AGEs from food already ingested and to determine whether sevelamer carbonate sequesters cytotoxic AGEs in the gut, preventing their uptake and thereby reducing AGE-induced abnormalities.Design, setting, participants, & measurements This single-center, randomized, 2-month, open-label, intention-totreat, crossover study compared sevelamer carbonate with calcium carbonate treatment in stage 2-4 diabetic CKD. Participants received 2 months of treatment with one drug, had a 1-week washout, and then received the opposite drug for 2 months.Results Sevelamer carbonate reduced HbA1c, serum methylglyoxal, serum « N-carboxymethyl-lysine, triglycerides, and 8-isoprostanes. Total cholesterol and fibroblast growth factor 23 were reduced by sevelamer carbonate, relative to calcium carbonate. AGE receptor 1 and sirtuin 1 mRNA were increased and PMNC TNFa levels were decreased by sevelamer carbonate, but not calcium carbonate. Medications and caloric and AGE intake remained unchanged. Sevelamer carbonate reversibly bound AGE-BSA at intestinal, but not stomach, pH.Conclusions Sevelamer carbonate significantly reduces HbA1c, fibroblast growth factor 23, lipids, and markers of inflammation and oxidative stress, and markedly increases antioxidant markers, independently of phosphorus in patients with diabetes and early kidney disease. These novel actions of sevelamer carbonate on metabolic and inflammatory abnormalities in type 2 diabetes mellitus may affect progression of early diabetic CKD.

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Section: Discussionmentioning

confidence: 95%

Effects of Sevelamer on HbA1c, Inflammation, and Advanced Glycation End Products in Diabetic Kidney Disease

Vlassara

Uribarri

Cai

et al. 2012

Clinical Journal of the American Society of Nephrology

129

105

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“…Más frecuentemente se la utiliza como coadyuvante con otros FAME, como metotrexate (MTX), leflunomida (LFN) o sulfasalazina 32 . Además, recientemente se han descrito beneficios de este medicamento vinculados a su acción sobre el metabolismo lipídico y la insulinoresistencia en pacientes con AR, semejante a lo descripto en el LES 33 . Por otro lado, el uso de HCQ en combinación con otros FAME está bien documentado en la literatura.…”

Section: Hidroxicloroquina Y Artritis Reumatoideunclassified

Hidroxicloroquina en el tratamiento de las enfermedades autoinmunes sistémicas

et al. 2016

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“…26 In addition, the treatment of the systemic infl ammation of RA is known to be benefi cial, especially with the use of hydroxychloroquine and anti-TNF. [27][28][29] Some studies have also shown that the prevalence of type 1 DM is higher in patients with RA, especially in the subgroup positive for the anti-cyclic citrullinated peptide (anti-CCP) antibody. That risk can be attributed to an allele shared by both diseases, acting like a common risk factor in the pathogenesis of both diseases.…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Consenso 2012 da Sociedade Brasileira de Reumatologia sobre o manejo de comorbidades em pacientes com artrite reumatoide

Pereira¹,

Mota²,

Cruz³

et al. 2012

Rev. Bras. Reumatol.

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Objective: To elaborate recommendations of the Rheumatoid Arthritis Committee of the Brazilian Society of Rheumatology (SBR) to manage comorbidities in rheumatoid arthritis (RA). Methods: To review the literature and the opinions of the SBR RA Committee experts. Results and conclusions: Recommendations: 1) Early diagnosis and proper treatment of comorbidities are recommended; 2) The specifi c treatment of RA should be adapted to the presence of comorbidities; 3) Angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers are preferred to treat systemic arterial hypertension; 4) In patients diagnosed with rheumatoid arthritis and diabetes mellitus, the continuous use of a high cumulative dose of corticoids should be avoided; 5) Statins should be used to maintain LDL cholesterol levels under 100 mg/dL and the atherosclerotic index lower than 3.5 in patients with RA who have other comorbidities; 6) Metabolic syndrome should be treated; 7) Performing non-invasive tests to investigate subclinical atherosclerosis is recommended; 8) Greater surveillance for the early diagnosis of occult malignancy is recommended; 9) Preventive measures of venous thrombosis are suggested; 10) Bone densitometry is recommended in RA patients over the age of 50 years and in younger patients on corticoid therapy at a dose greater than 7.5 mg for over three months; 11) Patients with RA and osteoporosis should be instructed to avoid falls, to increase their dietary calcium intake and sun exposure, and to exercise; 12) Calcium and vitamin D supplementation is suggested. Bisphosphonates are suggested for patients with T score < -2.5 on bone densitometry; 13) A multidisciplinary team, with the active participation of a rheumatologist, is recommended to treat comorbidities.

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Hydroxychloroquine Use and Decreased Risk of Diabetes in Rheumatoid Arthritis Patients

Abstract: Our findings support the potential benefit of hydroxychloroquine in attenuating the risk of diabetes in rheumatoid arthritis patients. Further work is needed to determine its potential preventive role in other groups at high risk for diabetes.

Cited by 83 publications

References 28 publications

Effects of Sevelamer on HbA1c, Inflammation, and Advanced Glycation End Products in Diabetic Kidney Disease

Effects of Sevelamer on HbA1c, Inflammation, and Advanced Glycation End Products in Diabetic Kidney Disease

Hidroxicloroquina en el tratamiento de las enfermedades autoinmunes sistémicas

Consenso 2012 da Sociedade Brasileira de Reumatologia sobre o manejo de comorbidades em pacientes com artrite reumatoide

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