Wang CR, Tsai HW. Immediate-release tofacitinib reduces insulin resistance in non-diabetic active rheumatoid arthritis patients: A single-center retrospective study. World J Diabetes 2022; 13(6): 454-465 [PMID: 35800413 DOI: 10.4239/wjd.v13.i6.454]
Corresponding Author of This Article
Chrong-Reen Wang, MD, PhD, Full Professor, Department of Internal Medicine, National Cheng Kung University Hospital, No. 138 Sheng-Li Road, Tainan 70403, Taiwan. wangcr@mail.ncku.edu.tw
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Jun 15, 2022; 13(6): 454-465 Published online Jun 15, 2022. doi: 10.4239/wjd.v13.i6.454
Immediate-release tofacitinib reduces insulin resistance in non-diabetic active rheumatoid arthritis patients: A single-center retrospective study
Chrong-Reen Wang, Hung-Wen Tsai
Chrong-Reen Wang, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 70403, Taiwan
Hung-Wen Tsai, Department of Pathology, National Cheng Kung University Hospital, Tainan 70403, Taiwan
Author contributions: Wang CR designed the report, collected the clinical data, and wrote the paper; Wang CR and Tsai HW analyzed the clinical data.
Institutional review board statement: This study was approved by the Ethics Committee of National Cheng Kung University Hospital, No. B-ER-105-108.
Informed consent statement: The Institutional Review Board waived the requirement of informed consent from each patient due to the study being classified as a retrospective review of medical records.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data of this study can be provided to researchers by the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chrong-Reen Wang, MD, PhD, Full Professor, Department of Internal Medicine, National Cheng Kung University Hospital, No. 138 Sheng-Li Road, Tainan 70403, Taiwan. wangcr@mail.ncku.edu.tw
Received: January 14, 2022 Peer-review started: January 14, 2022 First decision: April 18, 2022 Revised: April 18, 2022 Accepted: May 28, 2022 Article in press: May 28, 2022 Published online: June 15, 2022
ARTICLE HIGHLIGHTS
Research background
An increased risk of insulin resistance (IR) has been identified in rheumatoid arthritis (RA), a chronic inflammatory disorder with elevated levels of pathogenic cytokines. Biologics targeting proinflammatory cytokines can control the disease and improve insulin sensitivity in RA.
Research motivation
Although Janus kinase (JAK) signaling can regulate cytokine receptors and participate in RA pathogenesis, it remains to be elucidated whether there is a reduction of IR in such patients under JAK inhibitor (JAKi) therapy.
Research objectives
This study examined the effect of JAKi treatment on the reduction of IR in RA with active disease.
Research methods
A retrospective study was carried out in non-diabetic active RA patients under tofacitinib (TOF) therapy with 5 mg twice-daily immediate-release formulation from 2017 to 2021.
Research results
Fifty-six RA patients aged 30 years to 75 years (52.3 ± 11.1) with DAS 28 values 4.54 to 7.37 (5.82 ± 0.74), were classified into high- and low-IR groups based on the baseline homeostatic model assessment (HOMA)-IR levels. For the 30 patients naive to biologics, after a 24-wk therapeutic period, reduced levels of HOMA-IR were observed in the high-IR group (3.331 ± 1.036 vs 2.292 ± 0.707, P < 0.001). In another 26 patients exposed to tumor necrosis factor-α or interleukin-6 blockers, despite showing a decrease with lower magnitude than that observed in the naïve patients, reduced HOMA-IR levels were also identified in the high-IR group (2.924 ± 0.790 vs 2.545 ± 1.080, P = 0.018).
Research conclusions
In this retrospective study, our results demonstrated reduced IR following 24-wk TOF therapy in non-diabetic active RA patients.
Research perspectives
Further prospective studies can be performed in both non-diabetic patients and those with comorbid diabetes to clearly elucidate the effect of TOF on IR in active RA.
