Effects of Tumour Necrosis Factor Antagonists on Insulin Sensitivity/Resistance in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

摘要: Objective Beyond the joints, TNFi (tumour necrosis factor inhibitor) therapy may confer systemic benefits in rheumatoid arthritis (RA). Several studies have investigated role of on insulin resistance/sensitivity (IR/IS). This question is general interest given emerging evidence linking inflammation and resistance. The main aim this review was to summarise published data determine effects IR/IS. Methods We searched PubMed ISI Web Knowledge databases for which examined IR/IS. were assessed independently by two reviewers according a pre-specified protocol. Homeostatic Model Assessment Insulin resistance (HOMA) Quantitative Sensitivity Check Index (QUICKI) pooled reported as standard difference means (SDM) with 95% confidence interval (CI) using random-effects model. Results A total eight 260 subjects met selection criteria. duration from 8 weeks 12 months. There statistically significant reduction HOMA index six out four increment QUICKI. analysis revealed [SDM-0.148, 95%CI[-0.278 -0.017], p=0.026] QUICKI [SDM 0.312, 95%CI[0.019 0.606], p=0.037] TNFi. Conclusion There support that improves IS reduces IR RA. Further, well conducted trials are needed if such translate lower incidence diabetes RA or other autoimmune conditions biologic therapy.