Featured Research

from universities, journals, and other organizations

Certain drugs lower risk of diabetes for patients with rheumatoid arthritis or psoriasis

Date:
June 21, 2011
Source:
JAMA and Archives Journals
Summary:
In a study that included nearly 14,000 patients with rheumatoid arthritis or psoriasis, the use of certain disease-modifying anti-rheumatic drugs was found to lower the risk of diabetes.

In a study that included nearly 14,000 patients with rheumatoid arthritis or psoriasis, the use of certain disease-modifying antirheumatic drugs was found to lower the risk of diabetes, according to a study in the June 22/29 issue of JAMA.

Two common systemic inflammatory conditions, rheumatoid arthritis (RA) and psoriasis, predispose patients to insulin resistance and may place patients at risk for diabetes mellitus (DM). The treatment of psoriasis and RA includes disease-modifying antirheumatic drugs (DMARDs) such as tumor necrosis factor (TNF) inhibitors, which are directed against the inflammatory response, according to background information in the article. The relationship between these conditions and DM suggests that systemic immunosuppression may also reduce the risk for DM.

Daniel H. Solomon, M.D., M.P.H., of Brigham and Women's Hospital, Boston, and colleagues examined the relationship between DMARD medications and the risk of newly diagnosed DM among participants with RA or psoriasis. The researchers conducted a retrospective cohort study among 121,280 patients with a diagnosis of either RA or psoriasis on at least 2 visits. The analyses were conducted in the context of 2 large health insurance programs, 1 in Canada and 1 in the United States, using administrative data. The average follow-up was 5.8 months and began with the first prescription for a DMARD after study eligibility was met. Drug regimens were categorized into 4 mutually exclusive groups: (1) TNF inhibitors with or without other DMARDs; (2) methotrexate without TNF inhibitors or hydroxychloroquine; (3) hydroxychloroquine without TNF inhibitors or methotrexate; or (4) other nonbiologic DMARDs without TNF inhibitors, methotrexate, or hydroxychloroquine.

The final study cohort consisted of 13,905 participants with 22,493 new treatment episodes starting 1 of the categories of DMARD regimens between January 1996 and June 2008. The researchers found 267 newly diagnosed cases of DM: 55 cases among 3,993 treatment episodes with nonbiologic DMARD users; 80 cases among 4,623 treatment episodes with TNF inhibitor users; 82 cases among 8,195 treatment episodes with methotrexate users; and 50 cases among 5,682 treatment episodes with hydroxychloroquine users. The incidence rates for DM were highest for individuals who switched to other nonbiologic DMARDs and lowest for TNF inhibitor users. "The fully adjusted models suggest a reduced relative risk of DM for TNF inhibitor and hydroxychloroquine compared with other nonbiologic DMARDs," the authors write.

According to the authors, "The findings from this epidemiologic study should be considered hypothesis-generating. However, considering these results in light of prior findings regarding improved insulin and glucose metabolism and reduced DM risk with hydroxychloroquine and TNF inhibitors, there is evidence suggesting a possible role for DMARDs and immunosuppression in DM prevention. A randomized controlled trial testing the ability of these agents to prevent DM among participants with systemic inflammatory disorders should be considered."

Editorial: Can Treatment of Chronic Inflammatory Diseases Reduce the Risk of Diabetes Mellitus?

In an accompanying editorial, Tim Bongartz, M.D., M.S., and Yogish Kudva, M.D., of the Mayo Clinic College of Medicine, Rochester, Minn., comment on the findings of this study.

"Prospective trials are needed to confirm the observational data and clarify which patients may benefit from these possible [multiple] effects of specific anti-inflammatories. If hydroxychloroquine and anti-TNF agents should truly enable 2 complex disease processes to be addressed with a single intervention, it will be crucial to investigate how much of their potential antidiabetic effects would add to good disease control, the durability of these effects, and the timing of treatment. Because even if treatment of chronic inflammatory disease can reduce the risk of diabetes, clinicians still will have to learn how to use specific anti-inflammatory agents to achieve optimal outcomes for both conditions."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. D. H. Solomon, E. Massarotti, R. Garg, J. Liu, C. Canning, S. Schneeweiss. Association Between Disease-Modifying Antirheumatic Drugs and Diabetes Risk in Patients With Rheumatoid Arthritis and Psoriasis. JAMA: The Journal of the American Medical Association, 2011; 305 (24): 2525 DOI: 10.1001/jama.2011.878

Cite This Page:

JAMA and Archives Journals. "Certain drugs lower risk of diabetes for patients with rheumatoid arthritis or psoriasis." ScienceDaily. ScienceDaily, 21 June 2011. <www.sciencedaily.com/releases/2011/06/110621164716.htm>.
JAMA and Archives Journals. (2011, June 21). Certain drugs lower risk of diabetes for patients with rheumatoid arthritis or psoriasis. ScienceDaily. Retrieved April 16, 2014 from www.sciencedaily.com/releases/2011/06/110621164716.htm
JAMA and Archives Journals. "Certain drugs lower risk of diabetes for patients with rheumatoid arthritis or psoriasis." ScienceDaily. www.sciencedaily.com/releases/2011/06/110621164716.htm (accessed April 16, 2014).

Share This



More Health & Medicine News

Wednesday, April 16, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Outbreak Now Linked To 121 Deaths

Ebola Outbreak Now Linked To 121 Deaths

Newsy (Apr. 15, 2014) The ebola virus outbreak in West Africa is now linked to 121 deaths. Health officials fear the virus will continue to spread in urban areas. Video provided by Newsy
Powered by NewsLook.com
Cognitive Function: Is It All Downhill From Age 24?

Cognitive Function: Is It All Downhill From Age 24?

Newsy (Apr. 15, 2014) A new study out of Canada says cognitive motor performance begins deteriorating around age 24. Video provided by Newsy
Powered by NewsLook.com
How Mt. Everest Helped Scientists Research Diabetes

How Mt. Everest Helped Scientists Research Diabetes

Newsy (Apr. 15, 2014) British researchers were able to use Mount Everest's low altitudes to study insulin resistance. They hope to find ways to treat diabetes. Video provided by Newsy
Powered by NewsLook.com
Carpenter's Injury Leads To Hundreds Of 3-D-Printed Hands

Carpenter's Injury Leads To Hundreds Of 3-D-Printed Hands

Newsy (Apr. 14, 2014) Richard van As lost all fingers on his right hand in a woodworking accident. Now, he's used the incident to create a prosthetic to help hundreds. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins