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

• Published in: Annals of the New York Academy of Sciences Vol. 1193; no. 1; pp. 153 - 159
• Main Authors: Gonzalez-Gay, Miguel A., Gonzalez-Juanatey, Carlos, Vazquez-Rodriguez, Tomas R., Miranda-Filloy, Jose A., Llorca, Javier
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.04.2010
• 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
• ISSN: 0077-8923; 1749-6632
• DOI: 10.1111/j.1749-6632.2009.05287.x

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.