Effects of tumor necrosis factor inhibitors and tocilizumab on the glycosylated hemoglobin levels in patients with rheumatoid arthritis; an observational study.
Effects of tumor necrosis factor inhibitors and tocilizumab on the glycosylated hemoglobin levels in patients with rheumatoid arthritis; an observational study.
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DOI：
10.1371/journal.pone.0196368
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Horiuchi T
中科院分区：
文献类型：
--
作者：
Otsuka Y;Kiyohara C;Kashiwado Y;Sawabe T;Nagano S;Kimoto Y;Ayano M;Mitoma H;Akahoshi M;Arinobu Y;Niiro H;Akashi K;Horiuchi T
类风湿性关节炎(RA)和糖尿病(DM)与炎症有关。本研究旨在探讨肿瘤坏死因子抑制物(TNFi)和托西珠单抗(TCZ)对RA患者糖代谢的影响。对2008-2015年间开始使用TNFi或TCZ治疗的RA患者进行了基于他们的医疗记录的研究。我们分析了患者的糖化血红蛋白(HbA1c)水平在这些生物制剂开始使用前和3个月后进行了测量。评估HbA1c降低与治疗之间的关系。在这些生物制剂治疗的971例患者中，221例有HbA1c的病史记录(TNFi，n=154；TCZ，n=67)。在治疗开始后1个月和3个月，TnFi组和TCZ组的HbA1c值均显著降低(TnFi，P<；0.001；TCZ，P<；0.001)。治疗前HbA1c无显著差异(TnFi，6.2%；TCZ，6.2%；p=0.532)，但治疗3个月时HbA1c值较低(TnFi，6.1%；TCZ，5.8%；p=0.010)，HbA1c(ΔHbA1c)变化较大(TnFi，0.1%；TCZ，0.4%；p<；0.001)。糖化血红蛋白的降低--定义为Δ糖化血红蛋白≥为0.5%--与糖尿病的基线诊断、基线糖尿病治疗、住院治疗、观察期内的内科变化以及曲克西平有关。在多因素Logistic回归分析中，糖化血红蛋白与糖化血红蛋白的降低有关(调整后OR=5.59，95%CI=2.56~12.2；p<；0.001)。应用TNFi或TCZ后，RA患者的HbA1c水平显著降低。我们的研究表明，TCZ对RA患者HbA1c水平的降低幅度大于TNFi。
Rheumatoid arthritis (RA) and diabetes mellitus (DM) are associated with inflammation. We tried to investigate the influence of tumor necrosis factor inhibitors (TNFi) and tocilizumab (TCZ) on the glucose metabolism of RA patients. RA patients in whom treatment with TNFi or TCZ was initiated from 2008 to 2015 were studied based on their medical records. We analyzed patients whose glycosylated hemoglobin (HbA1c) levels were measured both before and 3 months after the initiation of these biologic agents. The association between HbA1c reduction and the treatment was evaluated. From 971 cases treated with these biologic agents, 221 cases whose medical records of HbA1c were available, were included (TNFi, n = 154; TCZ, n = 67). Both the TNFi and TCZ groups had significantly lower HbA1c values at 1 month and 3 months after the initiation of treatment (TNFi, p<0.001; TCZ, p<0.001). Although the pretreatment HbA1c values did not differ (TNFi, 6.2%; TCZ, 6.2%; p = 0.532), the 3-month treatment HbA1c values were lower (TNFi, 6.1%; TCZ, 5.8%; p = 0.010) and the changes in HbA1c (ΔHbA1c) were greater (TNFi, 0.1%; TCZ, 0.4%; p<0.001) in the TCZ group. The reduction of HbA1c—defined by the achievement of a ΔHbA1c of ≥0.5%—was associated with baseline diagnosis of diabetes mellitus, baseline diabetes treatment, hospitalization, medical change during the observation period, and TCZ. In the multivariate logistic regression analysis, TCZ was associated with the reduction of HbA1c in comparison to TNFi (adjusted OR = 5.59, 95% CI = 2.56–12.2; p<0.001). The HbA1c levels in RA patients were significantly lower after the initiation of TNFi or TCZ. Our study suggests that TCZ decreases the HbA1c levels in RA patients to a greater extent than TNFi.
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影响因子：
13.3
作者：
Kim, Seoyoung C.;Solomon, Daniel H.;Schneeweiss, Sebastian
通讯作者：
Schneeweiss, Sebastian
影响因子：
16.2
作者：
Herder C;Brunner EJ;Rathmann W;Strassburger K;Tabák AG;Schloot NC;Witte DR
通讯作者：
Witte DR
影响因子：
27.4
作者：
Listing J;Kekow J;Manger B;Burmester GR;Pattloch D;Zink A;Strangfeld A
通讯作者：
Strangfeld A
影响因子：
4.7
作者：
Bili, Androniki;Tang, Xiaoqin;Wasko, Mary Chester M.
通讯作者：
Wasko, Mary Chester M.
DOI：
10.1093/rheumatology/keq031
发表时间：
2010-07
期刊：
Rheumatology (Oxford, England)
影响因子：
--
作者：
Horiuchi T;Mitoma H;Harashima S;Tsukamoto H;Shimoda T
通讯作者：
Shimoda T