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

Author(s): Christian Leporini*, Emilio Russo, Salvatore D`Angelo, Franco Arturi, Giovanni Tripepi, Rosario Peluso, Rosa Daniela Grembiale, Ignazio Olivieri, Giovambattista De Sarro, Francesco Ursini

Journal Name: Reviews on Recent Clinical Trials

Volume 13 , Issue 3 , 2018

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Graphical 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.

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Article Details

Year: 2018
Page: [184 - 191]
Pages: 8
DOI: 10.2174/1574887113666180314100340
Price: $65

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