REVIEW PAPER
Carbohydrate metabolism disorders in patients with rheumatoid arthritis
and ankylosing spondylitis – impact of treatment
Submission date: 2013-07-28
Final revision date: 2014-02-13
Acceptance date: 2014-03-13
Online publication date: 2014-06-04
Publication date: 2014-04-30
Reumatologia 2014;52(2):129-135
KEYWORDS
TOPICS
Cytokines, Inflammatory mediators and adaptive immunity in rheumatic diseasesRheumatoid arthritis- aetiology, pathogenesis, clinical features and treatmentSpondyloarthropaties - aetiology, pathogenesis clinical features and treatmentDiagnostics and imaging in rheumatic diseasesEpidemiology
ABSTRACT
Chronic inflammation – the crucial pathogenic mechanism of rheumatoid arthritis and ankylosing spondylitis – is the main cause of accelerated atherosclerosis, insulin resistance and well-known consequences related to it. The conservative treatment of rheumatoid arthritis and ankylosing spondylitis may provide a significant influence on glucose metabolism. The paper is a literature overview concerning insulin resistance and impaired glucose metabolism during treatment with disease-modifying drugs including biologic DMARDs (disease-modifying antirheumatic drugs), corticosteroids and commonly used non-steroidal anti-inflammatory drugs (NSAID). It has been found that the risk of carbohydrate disorders among those patients is much lower after therapy with hydroxychloroquine, methotrexate and TNF blockers – particularly with infliximab. The NSAID may play an important protective role in reducing risk of diabetes. The recent data show, contrary to general opinion, the advantageous outcome for glucose metabolism after treatment with corticosteroids, especially in the early active stage of rheumatoid arthritis.
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Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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