RESEARCH - Effects of Remicade treatment on insulin resistance

October 11, 2004

Ann Rheum Dis. 2004 Sep 30 [Epub ahead of print]

Effects of infliximab treatment on insulin resistance in patients with

rheumatoid arthritis and ankylosing spondylitis.

Kiortsis DN, Mavridis AK, Vasakos S, Nikas SN, Drosos AA.

Laboratory of Physiology, Medical School, University of Ioannina,

Ioannina, Greece.

OBJECTIVE: Tumor necrosis factor alpha (TNF- alpha) might be an

important mediator of insulin resistance. Infliximab is a chimeric

monoclonal, high- affinity antibody against the soluble and

trans-membrane TNF-alpha. It can reduce significantly the biological

activity of circulating and tissue TNF-alpha and is used in the

treatment of various autoimmune disorders. The purpose of the study was

to assess the effects of infliximab infusions on insulin sensitivity in

patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS).

METHODS: Forty-five patients (28 with RA and 17 with AS) aged 19 to 74

years were studied. All patients were treated with intravenous

infliximab. A complete biochemical profile was performed before and

after 6 months of treatment with infliximab. As a measure of insulin

resistance the Homeostasis Model Assessment (HOMA) index was used and as

a measure of insulin sensitivity the Quantitative Insulin Sensitivity

Check Index (QUICKI) index was used. RESULTS: In the whole study

population group, no significant changes of HOMA index or of QUICKI

index were observed. However, in the tertile of patients with the

highest insulin resistance, a significant decrease of HOMA index and

increase of QUICKI index was found (p<0.01 for both parameters).

CONCLUSIONS: The results of the present study may indicate that

infliximab treatment might have beneficial effects on insulin

sensitivity in the most insulin resistant patients with RA and AS.

PMID: 15458960

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Mayo Clinic in Rochester

s Hopkins Medicine

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