Improvement in insulin resistance is greater when infliximab is added to methotrexate during intensive treatment of early rheumatoid arthritis—results from the IDEA study

Bissell, Lesley-Anne; Hensor, Elizabeth M A; Kozera, Łukasz; McDermott, Michael; Burska, Agata; Nam, J.; Keen, Helen; Villeneuve, Édith; Donica, Helena; Buch, Maya H; Conaghan, Philip G.; Andrews, Jacqueline; Emery, Paul; Morgan, Ann W

doi:10.1093/rheumatology/kew306

Cited by 25 publications

(21 citation statements)

References 45 publications

(12 reference statements)

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“…Data on patients with RA treated with infliximab were obtained from four RCTs (three full-length articles [ 54 – 56 ] and two conference abstracts [ 57 , 58 ]), 11 PCs (11 full-length articles [ 35 , 59 – 68 ] and one conference abstract [ 69 ]), and five RCs (four full-length articles [ 38 , 49 , 51 , 70 ] and one conference abstract [ 19 ]). Data from several studies showed that treatment with infliximab resulted in significant increase in TC [ 54 , 57 – 63 , 65 , 67 , 68 , 70 ], HDL-C [ 57 – 65 ], and TG [ 61 , 63 , 65 , 70 ]. Results with LDL-C and atherogenic index were mixed.…”

Section: Resultsmentioning

confidence: 99%

The Impact of Biologics and Tofacitinib on Cardiovascular Risk Factors and Outcomes in Patients with Rheumatic Disease: A Systematic Literature Review

et al. 2018

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IntroductionRheumatic diseases are autoimmune, inflammatory diseases often associated with cardiovascular (CV) disease, a major cause of mortality in these patients. In recent years, treatment with biologic and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs), either as monotherapy or in combination with other drugs, have become the standard of treatment. In this systematic literature review, we evaluated the effect of treatment with biologic or tofacitinib on the CV risk and outcomes in these patients.MethodsA systematic search was performed in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews for articles reporting on CV risk and events in patients with rheumatic disease treated with a biologic agent or tofacitinib. Articles identified were subjected to two levels of screening. Articles that passed the first level based on title and abstract were assessed on full-text evaluation. The quality of randomized clinical trials was assessed by Jadad scoring system and the quality of the other studies and abstracts was assessed using the Downs and Black instrument. The data extracted included study design, baseline patient characteristics, and measurements of CV risk and events.ResultsOf the 5722 articles identified in the initial search, screening yielded 105 unique publications from 90 unique studies (33 clinical trials, 39 prospective cohort studies, and an additional 18 retrospective studies) that reported CV risk outcomes. A risk of bias analysis for each type of report indicated that they were of good or excellent quality. Importantly, despite some limitations in data reported, there were no indications of significant increase in adverse CV events or risk in response to treatment with the agents evaluated.ConclusionsTreatment with biologic or tofacitinib appears to be well-tolerated with respect to CV outcomes in these patients.Electronic supplementary materialThe online version of this article (10.1007/s40264-017-0628-9) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

The Impact of Biologics and Tofacitinib on Cardiovascular Risk Factors and Outcomes in Patients with Rheumatic Disease: A Systematic Literature Review

et al. 2018

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“…Some of the studies reported the improvement of the glycosylated hemoglobin (HbA1c) level and the insulin secretion rate in type 2 DM patients, while others showed no significant changes. Some studies have shown that the administration of tumor necrosis factor (TNF)-α inhibitors (TNFi), such as infliximab (IFX), etanercept (ETN) and adalimumab (ADA) improves insulin resistance in patients with rheumatic disease [ 17 – 21 ], while others have reported contradictory findings [ 22 , 23 ]. One retrospective cohort study shows that TNFi and methotrexate (MTX) therapy versus MTX therapy alone was slightly—but not significantly—associated with changes in HbA1c levels among psoriasis and RA patients [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of tumor necrosis factor inhibitors and tocilizumab on the glycosylated hemoglobin levels in patients with rheumatoid arthritis; an observational study

et al. 2018

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Rheumatoid arthritis (RA) and diabetes mellitus (DM) are associated with inflammation. We tried to investigate the influence of tumor necrosis factor inhibitors (TNFi) and tocilizumab (TCZ) on the glucose metabolism of RA patients. RA patients in whom treatment with TNFi or TCZ was initiated from 2008 to 2015 were studied based on their medical records. We analyzed patients whose glycosylated hemoglobin (HbA1c) levels were measured both before and 3 months after the initiation of these biologic agents. The association between HbA1c reduction and the treatment was evaluated. From 971 cases treated with these biologic agents, 221 cases whose medical records of HbA1c were available, were included (TNFi, n = 154; TCZ, n = 67). Both the TNFi and TCZ groups had significantly lower HbA1c values at 1 month and 3 months after the initiation of treatment (TNFi, p<0.001; TCZ, p<0.001). Although the pretreatment HbA1c values did not differ (TNFi, 6.2%; TCZ, 6.2%; p = 0.532), the 3-month treatment HbA1c values were lower (TNFi, 6.1%; TCZ, 5.8%; p = 0.010) and the changes in HbA1c (ΔHbA1c) were greater (TNFi, 0.1%; TCZ, 0.4%; p<0.001) in the TCZ group. The reduction of HbA1c—defined by the achievement of a ΔHbA1c of ≥0.5%—was associated with baseline diagnosis of diabetes mellitus, baseline diabetes treatment, hospitalization, medical change during the observation period, and TCZ. In the multivariate logistic regression analysis, TCZ was associated with the reduction of HbA1c in comparison to TNFi (adjusted OR = 5.59, 95% CI = 2.56–12.2; p<0.001). The HbA1c levels in RA patients were significantly lower after the initiation of TNFi or TCZ. Our study suggests that TCZ decreases the HbA1c levels in RA patients to a greater extent than TNFi.

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“…В ряде исследований у больных РА, получающих БПВП и ГИБП, также была обнаружена связь между биомаркерами сердечной недостаточности (NT-proBNP, тропонина Т) и СРБ [6,15] и продемонстрировано снижение концентрации NT-proBNP у пациентов на фоне противоревматической терапии, особенно значимое в случае применения комбинированной терапии метотрексатом + ГИБП и при достижении ремиссии заболевания [38][39][40].…”

Section: Discussionunclassified

Time course of changes in the level of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with rheumatoid arthritis during therapy with an interleukin-6 receptor inhibitor

Gerasimova¹,

Попкова²,

Martynova³

et al. 2019

Naučno-praktičeskaâ revmatologiâ

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Improvement in insulin resistance is greater when infliximab is added to methotrexate during intensive treatment of early rheumatoid arthritis—results from the IDEA study

Cited by 25 publications

References 45 publications

The Impact of Biologics and Tofacitinib on Cardiovascular Risk Factors and Outcomes in Patients with Rheumatic Disease: A Systematic Literature Review

The Impact of Biologics and Tofacitinib on Cardiovascular Risk Factors and Outcomes in Patients with Rheumatic Disease: A Systematic Literature Review

Effects of tumor necrosis factor inhibitors and tocilizumab on the glycosylated hemoglobin levels in patients with rheumatoid arthritis; an observational study

Time course of changes in the level of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with rheumatoid arthritis during therapy with an interleukin-6 receptor inhibitor

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