Patients using Remicade, Humira or Amgen Inc. (AMGN)’s Enbrel had a 38 percent lower risk of developing diabetes, according to the report in the Journal of the American Medical Association. Those on hydroxychloroquine, a generic drug for rheumatoid arthritis and malaria, had a 46 percent lower risk, the study found.
Rheumatoid arthritis, which damages joints, and psoriasis, marked by thick, itchy skin patches, are inflammatory ailments. Their treatments may fight diabetes by suppressing the immune system or slowing the body’s metabolism of insulin, said Daniel Solomon, a researcher at Brigham and Women’s Hospital in Boston. The results provide added information on diabetes and may one day help prevent and control it, the investigators said.
“It may be that certain medicines are more beneficial for reducing” the risk of diabetes, said Solomon, a rheumatologist and associate professor at Harvard Medical School in Boston, in a telephone interview. “There are many targets here” for ongoing research into the condition.
Researchers analyzed the health-care records of 13,906 patients with rheumatoid arthritis or psoriasis looking for new diagnoses of diabetes to come up with their finding. The data must be confirmed in studies that pit the therapies against each other, Solomon said. The researchers are working on a study of hydroxychloroquine in arthritis patients to evaluate its effect on blood sugar and insulin, he said.
If the results hold, doctors may use a patient’s diabetes risk to tailor treatment for rheumatoid arthritis and psoriasis, the researchers said. It is unclear if the risks of the potent drugs, such as infections, will outweigh the diabetes prevention benefits in patients who don’t have a condition like rheumatoid arthritis or psoriasis, the researchers said.
The study results build on earlier research and add to the biological plausibility that treatment of chronic inflammatory diseases may reduce the risk of diabetes, said Tim Bongartz and Yogish Kudva, from the Mayo Clinic in Rochester, Minnesota, in an editorial that accompanies the study.
“Specific anti-inflammatory agents may exert beneficial effects on insulin resistance,” they wrote. “Especially for a chronic disease such as rheumatoid arthritis, which is associated with an increased risk of cardiovascular disease, it appears attractive to take advantage” of multiple benefits from a specific drug that would already be used, they said.
If the dual effect is found, patients may be able to cut back on diabetes treatment or prevent it from developing, they said. Additional work would be needed to determine how the drugs should be used, when they should be started and how long the benefit lasts, they said.
“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,” they said.
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