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Diabetes medications could help in RA

A team led by Dr Ronan Mullan, Consultant Rheumatologist at Tallaght Hospital, and supported by a grant from the Health Research Board, is examining the anti-inflammatory effects on a number of antidiabetic drugs on patients with RA. According to the study’s abstract, there is increasing evidence that altered glucose handling contributes to proinflammatory sequelae. This, coupled with evidence that hypoglycaemic therapies exert anti-inflammatory effects, “suggest bi-directionality between the control mechanisms of glucose homeostasis and inflammation”.

“We see insulin resistance in people with diabetes and we also see insulin resistance in people with chronic inflammatory disease, like arthritis. That prompted us to think that some drugs currently used in diabetes could help to reverse insulin resistance in people with RA,” Dr Mullan told the Medical Independent (MI).

“We’re looking at compounds that are commonly used in diabetes. One of these drugs is metformin, which is a very commonly and cheaply available drug for people with type 2 diabetes. What it is showing in cell cultures is that it reduces inflammation, so as well as having an antidiabetic effect, these drugs might also have an effect on the innate immune system.”

The next stage of the researchers’ plan is to cultivate cells from joints with rheumatoid arthritis and to treat that model with metformin and other antidiabetic medications, Dr Mullan explained.

“Once we do that, we’re going to move to an animal arthritis model at a later stage and see if we can have the same effects in the body as a whole, because in that model you get to look at the whole body in concert,” he continued. “If that was to show positive results, then clinicians could consider using drugs like this, which are already known to be safe, on patients with inflammatory diseases to see if it improves their treatment and quality of life.”

For her work on the study Dr Lorna Gallagher, Tallaght Hospital, will be awarded the ISR’s prestigious Young Investigator Award.

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