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Tofacitinib and Baricitinib in Type 2 Diabetic Patients with Rheumatoid Arthritis.
Cristina Martinez-Molina1,2, Cesar Diaz-Torne2,3, Hye S Park2,3
1Department of Pharmacy, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain.
Medicina (Kaunas, Lithuania)
|March 28, 2024
Summary
Baricitinib treatment in rheumatoid arthritis patients with type 2 diabetes mellitus (T2DM) improved glycemic control, reducing HbA1c levels. Tofacitinib and baricitinib also effectively managed rheumatoid arthritis disease activity.
Area of Science:
- Rheumatology
- Endocrinology
- Pharmacology
Background:
- Limited clinical evidence exists regarding the impact of JAK inhibitors on type 2 diabetes mellitus (T2DM) in rheumatoid arthritis (RA) patients.
- A prior study suggested baricitinib may preserve beta-cell function in diabetic patients.
Purpose of the Study:
- To assess the effects of tofacitinib and baricitinib on glycemic control (HbA1c) and disease activity in RA patients with T2DM.
- To evaluate changes in body mass index (BMI) during JAK inhibitor therapy.
Main Methods:
- Observational, retrospective, single-center study of 13 RA patients with T2DM on oral antidiabetic drugs (OADs).
- Patients received either tofacitinib or baricitinib for 6 months.
- Primary outcome: HbA1c change; Secondary outcomes: BMI and RA disease activity.
Main Results:
- Baricitinib significantly reduced HbA1c (p=0.035) at 6 months, with 57.1% achieving <7% HbA1c.
- Baricitinib treatment led to a BMI increase (p=0.022) and OAD dosage reduction in 28.6% of patients.
- Both JAK inhibitors achieved RA remission or low disease activity without altering RA treatments.
Conclusions:
- Baricitinib may enhance insulin sensitivity and glucose uptake in T2DM patients with RA, aiding diabetes management.
- JAK inhibitors are effective for RA disease activity control in this patient population.
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