In a post hoc analysis of two phase 3 trials, therapy with Sarilumab lowered HbA1c concentrations in diabetic and nondiabetic rheumatoid arthritis (RA) patients.
Patients with rheumatoid arthritis have a higher risk of diabetes of up to 25%. IL-6 can play a role in this, as it is involved in glucose metabolisms and has been identified as an independent risk factor for diabetes. “With this in mind we conducted a post hoc analysis of two phase 3 trials, ‘mobility’ and ‘target’”, said Professor Mark Genovese from the Stanford School of Medicine, USA.
Patients with baseline and at least one post-baseline blood sample were included in this analysis and categorized as diabetic or non-diabetics based on a medical history of diabetes or prior use of antidiabetic medication. Changes from baseline in fasting glucose, HbA1c, and weight were analyzed with a linear regression model.
Mean fasting glucose and HbA1c at baseline were similar across treatment groups, but higher in the diabetes group than in the non-diabetes group. Decreases in HbA1c occurred in all patients treated with Sarilumab. “In diabetic patients, curves diverged at week 12, but interestingly, we see the same trend in non-diabetics”, said Prof. Genovese. Changes of HbA1c were independent of baseline oral glucocorticoid use or clinical response to treatment with Sarilumab. “We do see improvements and I think they have clinical relevance: IL-6 signaling interruption might be the cause”, concluded Prof. Genovese.
Therefore, a fully designed diabetic study might be of interest to fully understand the effect of Sarilumab in these patients.
Source:
Genovese, M.C. et al. Combination with DMARDs on Fasting Glucose and Glycosylated Hemoglobin in Patients with Rheumatoid Arthritis With and Without Diabetes. Abstract No 1822, 2017 ACR/ARHP Annual Meeting, November 3- 8 2017, San Diego (CA/USA).