Infliximab Improves Insulin Sensitivity in Rheumatoid Arthritis Patients

Treatment with infliximab (Remicade) appears to reduce the insulin resistance that is common among patients with autoimmune connective tissue diseases. However, this benefit may only apply to patients with high levels of insulin resistance.

The results of animal research support a role for tumor necrosis factor alpha in the pathogenesis of insulin resistance, Dr. A. A. Drosos and colleagues, from the University of Ioannina, note. As such, treatment with an anti-TNF-alpha agent, like infliximab, may improve insulin sensitivity in rheumatoid arthritis and ankylosing spondylitis patients.

To investigate, the authors used two standard indices to assess insulin resistance in 28 rheumatoid arthritis patients and 17 ankylosing spondylitis patients before and after 6 months’ of treatment with infliximab.

In the overall analysis, infliximab therapy was not associated with any significant changes in insulin resistance. By contrast, when the analysis was confined to the one third of patients with the greatest insulin resistance, both indices showed a significant improvement in insulin sensitivity (p < 0.01).

"The improvement in insulin sensitivity may decrease the cardiovascular disease risk in these patients," the authors point out. Still, further studies with greater patient numbers and longer follow-up are needed to determine if infliximab does reduce this risk.
Ann Rheum Dis 2005;64:765-766.