Interleukin-6 receptor blockade or TNFa inhibition for reducing glycaemia in patients with RA and diabetes: post hoc analyses of three randomised, controlled trials.

Abstract

Diabetes is common in patients with rheumatoid arthritis (RA). Interleukin (IL)-6 is implicated in both the pathogenesis of RA and in glucose homeostasis; this post hoc analysis investigated the effects of IL-6 receptor vs. tumour necrosis factor inhibition on glycosylated haemoglobin (HbA1c) in patients with RA with or without diabetes.Data were from two placebo-controlled phase III studies of subcutaneous sarilumab 150/200?mg q2w?+?methotrexate or conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and a phase III monotherapy study of sarilumab 200?mg q2w vs. adalimumab 40?mg q2w. Patients with diabetes were identified by medical history or use of antidiabetic medication (patients with HbA1c =?9% were excluded from all three studies). HbA1c was measured at baseline and weeks 12/24. Safety and efficacy were assessed in RA patients with or without diabetes.Patients with diabetes (n?=?184) were older, weighed more and exhibited higher RA disease activity than patients without diabetes (n?=?1928). Regardless of diabetes status, in patients on background csDMARDs, least squares (LS) mean difference (95% CI) in change from baseline in HbA1c for sarilumab 150?mg/200?mg vs. placebo at week 24 was -?0.28 (-?0.40, -?0.16; nominal p?

View details for DOI 10.1186/s13075-020-02229-5

View details for PubMedID 32907617