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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.
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).