Improvement of HbA1c in Patients with Type 2 Diabetes Mellitus and Rheumatoid Arthritis Treated with bDMARDs

Alfredomaria Lurati,1 Antonella Laria,1 Daniela Mazzocchi,1 Katia Angela Re,1 Maria Grazia Marrazza,1 Paola Maria Faggioli,2 Antonino Mazzone2 1Rheumatology Unit, Fornaroli Hospital Magenta Italy, Milan, Italy; 2Internal Medicine Unit, Legnano Hospital, Milan, ItalyCorrespondence: Alfredomaria Lurat...

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Autores principales:	Lurati A, Laria A, Mazzocchi D, Re KA, Marrazza MG, Faggioli PM, Mazzone A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	diabetes mellitus rheumatoid arthritis bdmards Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/25b05d17f5b84971bc43f6a35f853242
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spelling	oai:doaj.org-article:25b05d17f5b84971bc43f6a35f8532422021-12-02T14:51:56ZImprovement of HbA1c in Patients with Type 2 Diabetes Mellitus and Rheumatoid Arthritis Treated with bDMARDs1179-156Xhttps://doaj.org/article/25b05d17f5b84971bc43f6a35f8532422021-04-01T00:00:00Zhttps://www.dovepress.com/improvement-of-hba1c-in-patients-with-type-2-diabetes-mellitus-and-rhe-peer-reviewed-fulltext-article-OARRRhttps://doaj.org/toc/1179-156XAlfredomaria Lurati,1 Antonella Laria,1 Daniela Mazzocchi,1 Katia Angela Re,1 Maria Grazia Marrazza,1 Paola Maria Faggioli,2 Antonino Mazzone2 1Rheumatology Unit, Fornaroli Hospital Magenta Italy, Milan, Italy; 2Internal Medicine Unit, Legnano Hospital, Milan, ItalyCorrespondence: Alfredomaria LuratiRheumatology Unit Fornaroli Hospital Magenta Italy, Via Donatore Sangue 50, Milan, 22100, ItalyEmail alfredomaria.lurati@asst-ovestmi.itObjective: The aim of our study was to evaluate the possible role of biological treatments for rheumatoid arthritis (RA) in improving the glycemic profile in patients affected not only by RA but also by type 2 diabetes mellitus (2TDM).Methods: An observational retrospective study was conducted using data from patients referred to our Rheumatology Unit. Patients with active RA despite standard DMARDs therapy and concomitant 2TDM were selected into one of five exposure groups to first-line bDMARDs (adalimumab, golimumab, etanercept, tocilizumab, sarilumab) and observed for the outcome of CRP, ESR, DAS28CRP and glycated hemoglobin (HbA1c) variations.Results: After the start of treatment, there was a significant reduction in the values of acute phase reactants ESR and CRP (p< 0.01), DAS28-CRP (p< 0.01) and HbA1C (p< 0.05), in the absence of any confounding factors such as a reduction in BMI or a change in steroid doses. There was no statistically significant difference between the various treatments. Anti-IL6 drugs appear to be associated with a slightly greater reduction in HbA1c values, bordering on statistical significance (p=0.047).Conclusion: Initiation of a bDMARD appears to be associated with an improvement in concomitant 2TDM in patients with active RA, which, in the first hypothesis, is linked with a reduction of the inflammatory milieu.Keywords: diabetes mellitus, rheumatoid arthritis, bDMARDsLurati ALaria AMazzocchi DRe KAMarrazza MGFaggioli PMMazzone ADove Medical Pressarticlediabetes mellitusrheumatoid arthritisbdmardsDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol Volume 13, Pp 73-78 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetes mellitus rheumatoid arthritis bdmards Diseases of the musculoskeletal system RC925-935
spellingShingle	diabetes mellitus rheumatoid arthritis bdmards Diseases of the musculoskeletal system RC925-935 Lurati A Laria A Mazzocchi D Re KA Marrazza MG Faggioli PM Mazzone A Improvement of HbA1c in Patients with Type 2 Diabetes Mellitus and Rheumatoid Arthritis Treated with bDMARDs
description	Alfredomaria Lurati,1 Antonella Laria,1 Daniela Mazzocchi,1 Katia Angela Re,1 Maria Grazia Marrazza,1 Paola Maria Faggioli,2 Antonino Mazzone2 1Rheumatology Unit, Fornaroli Hospital Magenta Italy, Milan, Italy; 2Internal Medicine Unit, Legnano Hospital, Milan, ItalyCorrespondence: Alfredomaria LuratiRheumatology Unit Fornaroli Hospital Magenta Italy, Via Donatore Sangue 50, Milan, 22100, ItalyEmail alfredomaria.lurati@asst-ovestmi.itObjective: The aim of our study was to evaluate the possible role of biological treatments for rheumatoid arthritis (RA) in improving the glycemic profile in patients affected not only by RA but also by type 2 diabetes mellitus (2TDM).Methods: An observational retrospective study was conducted using data from patients referred to our Rheumatology Unit. Patients with active RA despite standard DMARDs therapy and concomitant 2TDM were selected into one of five exposure groups to first-line bDMARDs (adalimumab, golimumab, etanercept, tocilizumab, sarilumab) and observed for the outcome of CRP, ESR, DAS28CRP and glycated hemoglobin (HbA1c) variations.Results: After the start of treatment, there was a significant reduction in the values of acute phase reactants ESR and CRP (p< 0.01), DAS28-CRP (p< 0.01) and HbA1C (p< 0.05), in the absence of any confounding factors such as a reduction in BMI or a change in steroid doses. There was no statistically significant difference between the various treatments. Anti-IL6 drugs appear to be associated with a slightly greater reduction in HbA1c values, bordering on statistical significance (p=0.047).Conclusion: Initiation of a bDMARD appears to be associated with an improvement in concomitant 2TDM in patients with active RA, which, in the first hypothesis, is linked with a reduction of the inflammatory milieu.Keywords: diabetes mellitus, rheumatoid arthritis, bDMARDs
format	article
author	Lurati A Laria A Mazzocchi D Re KA Marrazza MG Faggioli PM Mazzone A
author_facet	Lurati A Laria A Mazzocchi D Re KA Marrazza MG Faggioli PM Mazzone A
author_sort	Lurati A
title	Improvement of HbA1c in Patients with Type 2 Diabetes Mellitus and Rheumatoid Arthritis Treated with bDMARDs
title_short	Improvement of HbA1c in Patients with Type 2 Diabetes Mellitus and Rheumatoid Arthritis Treated with bDMARDs
title_full	Improvement of HbA1c in Patients with Type 2 Diabetes Mellitus and Rheumatoid Arthritis Treated with bDMARDs
title_fullStr	Improvement of HbA1c in Patients with Type 2 Diabetes Mellitus and Rheumatoid Arthritis Treated with bDMARDs
title_full_unstemmed	Improvement of HbA1c in Patients with Type 2 Diabetes Mellitus and Rheumatoid Arthritis Treated with bDMARDs
title_sort	improvement of hba1c in patients with type 2 diabetes mellitus and rheumatoid arthritis treated with bdmards
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/25b05d17f5b84971bc43f6a35f853242
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Improvement of HbA1c in Patients with Type 2 Diabetes Mellitus and Rheumatoid Arthritis Treated with bDMARDs

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