Journal
NEUROENDOCRINE IMMUNOLOGY IN RHEUMATIC DISEASES: TRANSLATION FROM BASICS TO CLINICS
Volume 1193, Issue -, Pages 153-159Publisher
WILEY-BLACKWELL
DOI: 10.1111/j.1749-6632.2009.05287.x
Keywords
rheumatoid arthritis; insulin resistance; inflammation; TNF-alpha; anti-TNF-alpha therapy
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Increased prevalence of insulin resistance has been observed in patients with rheumatoid arthritis (RA). High-grade systemic inflammation is implicated in the development of insulin resistance in these patients. Tumor necrosis factor (TNF)-alpha is a potent proinflammatory cytokine that plays a role in the initiation and progression of inflammation and the mechanisms associated with accelerated atherosclerosis in RA. In assessing data immediately prior to and after intravenous infusion of the anti-TNF-alpha monoclonal antibody-infliximab in RA patients on period treatment with this drug attributable to disease refractory to conventional disease-modifying antirheumatic drugs, a dramatic improvement of insulin resistance and insulin sensitivity was observed. A long-term positive effect of TNF-alpha antagonists infliximab and etanercept on insulin resistance in RA patients with severe disease was also reported. These results highlight the importance of therapies that act blocking TNF-alpha function to reduce the mechanisms implicated in the development of the metabolic syndrome observed in RA.
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