The Protective Effect of IL-6 Blockade on Glucose and Cardiovascular Risk in Patients with Active Rheumatoid Arthritis

Abstract

Considering the multivalent role of interleukin-6 (IL-6) both in rheumatoid arthritis (RA) and in the metabolic processes, we aimed to evaluate the positive effect of subcutaneous tocilizumab (TCZ) on the probability of developing diabetes mellitus (DM). We recruited 56 consecutive patients with definite and active RA and assessed demographics, RA-related parameters and metabolic biomarkers, including the Homeostasis Model Assessment for insulin resistance (HOMA-IR) and the Quantitative Insulin Sensitivity Check Index (QUICKI). After 52 weeks of treatment, most of the patients showed a statistically significant reduction of HOMA-IR (3.61 � 1.21 at baseline vs. 2.45 � 1.46 at the end of the study, p[0.001), while QUICKI registered only a slight increase (0.32 � 0.01 at baseline vs. 0.33 � 0.01 at final evaluation, p[0.001). Our results strongly suggest that long-term IL-6 blockade has a beneficial effect in slowing the atherosclerotic process and reducing CV risk in active RA.