Miwa Yusuke, Mitamura Yuko
Division of Rheumatology, Department of Medicine, Showa University, Tokyo, Japan.
Department of Nursing, Showa University, Tokyo, Japan.
Eur J Rheumatol. 2020 Apr;7(2):60-63. doi: 10.5152/eurjrheum.2019.19144. Epub 2020 Jan 2.
To investigate the effects of biological disease-modifying antirheumatic drugs (bDMARDs) on diabetes control among patients with rheumatoid arthritis (RA).
A total of 296 patients with RA were included in the study. The following background factors were investigated: age, gender, bDMARD type, methotrexate and prednisolone (PSL) dosages, glycated hemoglobin (HbA1c), C-reactive protein, and matrix metalloproteinase-3. We used the simplified disease activity index (SDAI) to evaluate the RA disease activity. Poor diabetes mellitus (DM) control was defined as a HbA1c of 6.0; accordingly, the patients were divided into good and poor DM control groups. SDAI and PSL dosage were the primary endpoints, respectively, 1 year later.
HbA1c ranged from 6.6±0.68 to 6.5±0.82 and 5.1±0.29 to 5.4±0.34 in the poor and good DM control groups, respectively. Although the intergroup difference was significant (p=0.000), there was no significant intergroup difference during the treatment period (p=0.084). The SDAI ranged from 27.7±15.6 to 7.1±8.0 in the group with a poor DM control (n=83) and from 22.9±14.0 to 6.3±7.6 in the group with a good DM control (n=213).
The bDMARD therapy reduced the RA disease activity regardless of a good or poor DM control.
探讨生物性改善病情抗风湿药(bDMARDs)对类风湿关节炎(RA)患者糖尿病控制的影响。
本研究共纳入296例RA患者。调查了以下背景因素:年龄、性别、bDMARD类型、甲氨蝶呤和泼尼松龙(PSL)剂量、糖化血红蛋白(HbA1c)、C反应蛋白和基质金属蛋白酶-3。我们使用简化疾病活动指数(SDAI)评估RA疾病活动度。糖尿病(DM)控制不佳定义为HbA1c≥6.0%;据此,将患者分为DM控制良好组和控制不佳组。分别将1年后的SDAI和PSL剂量作为主要终点指标。
DM控制不佳组和控制良好组HbA1c分别为6.6±0.68%至6.5±0.82%和5.1±0.29%至5.4±0.34%不等。虽然组间差异有统计学意义(p=0.000),但治疗期间组间差异无统计学意义(p=0.084)。DM控制不佳组(n=83)的SDAI为27.7±15.6至7.1±8.0,DM控制良好组(n=213)为22.9±14.0至6.3±7.6。
无论DM控制良好与否,bDMARD治疗均可降低RA疾病活动度。