Tofacitinib and Baricitinib in Type 2 Diabetic Patients with Rheumatoid Arthritis
Martinez-Molina, Cristina (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Díaz Torne, César (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Park, Hye S (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Feliu, Anna (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Vidal, Silvia (Institut de Recerca Sant Pau)
Corominas, Hèctor (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Universitat Autònoma de Barcelona

Data:	2024
Resum:	Recently, a randomized controlled trial suggested a potential benefit of baricitinib in patients with diabetes mellitus, preserving β-cell function. However, the clinical evidence currently available is limited. We aimed to assess the potential impact of tofacitinib and baricitinib on type 2 diabetes mellitus (T2DM) patients with rheumatoid arthritis. Materials and Methods : The candidates for this observational, retrospective, single-center study were selected from a cohort of 120 rheumatoid arthritis patients treated with tofacitinib or baricitinib between September 2017 and September 2023. The eligibility criteria included patients with T2DM who were receiving oral antidiabetic drugs (OADs). The primary outcome was the glycosylated hemoglobin (HbA1c) value after 6 months of a JAK inhibitor treatment. Secondary outcomes included body mass index (BMI) and rheumatoid arthritis disease activity. Differences were evaluated using Fisher's exact test, as well as the Mann-Whitney test or the Wilcoxon test. Thirteen patients were included; 46. 2% (6/13) underwent treatment with tofacitinib, while 53. 8% (7/13) were treated with baricitinib. At 6 months, baricitinib treatment resulted in a reduction in HbA1c (p = 0. 035), with 57. 1% (4/7) of patients achieving values <7%, and 28. 6% (2/7) of patients requiring a reduction in OAD dosage. Concerning BMI, an increase (p = 0. 022) was observed at 6 months following baricitinib administration. All the patients treated with either tofacitinib or baricitinib achieved remission or low disease activity, without requiring statistically significant changes in concomitant rheumatoid arthritis treatment. In T2DM patients with rheumatoid arthritis, baricitinib can improve insulin sensitivity and glucose uptake, enabling the optimization of T2DM management.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Baricitinib ; Janus kinase inhibitor ; Rheumatoid arthritis ; Tofacitinib ; Type 2 diabetes mellitus
Publicat a:	Medicina, Vol. 60 (february 2024) , ISSN 1648-9144

DOI: 10.3390/medicina60030360
PMID: 38541086

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