Insulin resistance in rheumatoid arthritis: the impact of the anti-TNF-α therapy

Increased prevalence of insulin resistance has been observed in patients with rheumatoid arthritis (RA). High‐grade systemic inflammation is implicated in the development of insulin resistance in these patients. Tumor necrosis factor (TNF)‐α is a potent proinflammatory cytokine that plays a role in...

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Bibliographic Details
Published in:Annals of the New York Academy of Sciences 2010-04, Vol.1193 (1), p.153-159
Main Authors: Gonzalez-Gay, Miguel A., Gonzalez-Juanatey, Carlos, Vazquez-Rodriguez, Tomas R., Miranda-Filloy, Jose A., Llorca, Javier
Format: Article
Language:English
Subjects:
anti-TNF-α therapy
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - drug therapy
Humans
inflammation
Insulin Resistance
rheumatoid arthritis
TNF-α
Tumor Necrosis Factor-alpha - antagonists & inhibitors
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Summary:Increased prevalence of insulin resistance has been observed in patients with rheumatoid arthritis (RA). High‐grade systemic inflammation is implicated in the development of insulin resistance in these patients. Tumor necrosis factor (TNF)‐α is a potent proinflammatory cytokine that plays a role in the initiation and progression of inflammation and the mechanisms associated with accelerated atherosclerosis in RA. In assessing data immediately prior to and after intravenous infusion of the anti‐TNF‐α monoclonal antibody‐infliximab in RA patients on period treatment with this drug attributable to disease refractory to conventional disease‐modifying antirheumatic drugs, a dramatic improvement of insulin resistance and insulin sensitivity was observed. A long‐term positive effect of TNF‐α antagonists infliximab and etanercept on insulin resistance in RA patients with severe disease was also reported. These results highlight the importance of therapies that act blocking TNF‐α function to reduce the mechanisms implicated in the development of the metabolic syndrome observed in RA.
ISSN:0077-8923
1749-6632
DOI:10.1111/j.1749-6632.2009.05287.x