Immediate-release tofacitinib reduces insulin resistance in non-diabetic active rheumatoid arthritis patients: A single-center retrospective study

Table 1 Baseline data of 30 active rheumatoid arthritis patients naïve to biologics

Group	All (n = 30)	High-IR (n = 18)	Low-IR (n = 12)	P value1
Sex (female %)	83.3	77.8	91.7	0.622
Age (yr)	50.3 ± 11.4 (30-74)	49.2 ± 10.5 (30-65)	51.8 ± 12.9 (31-74)	0.445
BMI (kg/m2)	22.32 ± 1.93 (19.3-26.3)	22.56 ± 2.15 (19.7-26.3)	21.97 ± 1.57 (19.3-24.8)	0.624
Seropositivity (%)	86.7	83.3	91.7	0.632
DAS28	6.291 ± 0.530 (5.16-7.37)	6.499 ± 0.472 (5.56-7.37)	5.980 ± 0.470 (5.16-6.69)	0.008
ESR (mm/h)	51.7 ± 17.2 (26-88)	54.4 ± 18.5 (28-88)	47.6 ± 14.8 (28-70)	0.279
CRP (mg/L)	21.20 ± 6.90 (10.4-36.5)	22.27 ± 7.31 (10.4-36.5)	19.71 ± 6.21 (10.7-29.5)	0.341
Glucose (mg/dL)	88.7 ± 8.5 (66-104)	90.8 ± 9.3 (66-104)	85.6 ± 6.1 (77-98)	0.035
Insulin (μU/mL)	11.870 ± 5.029 (4.64-24.84)	14.710 ± 4.527 (9.07-24.84)	7.605 ± 1.410 (4.64-9.14)	< 0.001
HOMA-IR	2.639 ± 1.185 (1.07-5.89)	3.331 ± 1.036 (2.04-5.89)	1.602 ± 0.294 (1.07-2.00)	< 0.001
QUICKI	0.3353 ± 0.0222 (0.296-0.380)	0.3207 ± 0.0135 (0.296-0.343)	0.3573 ± 0.0117 (0.344-0.380)	< 0.001
Methotrexate (%)	100	100	100	1.0
Dosage (mg/wk)	15	15	15	1.0
Prednisolone (%)	26.7	22.2	33.3	0.678
Daily dosage2 (mg/d)	5.6 ± 1.8	6.3 ± 2.5	5.0 ± 0.0	1.0
Total dosage3 (mg)	865.6 ± 258.4	887.5 ± 386.5	843.8 ± 71.8	0.914
Hydroxychloroquine (%)	100	100	100	1.0
Sulfasalazine (%)	20.0	16.7	25.0	0.660
Leflunomide (%)	10.0	11.1	8.3	1.0

¹High-IR vs Low-IR.

²Average daily prednisolone dosage in 1-mo period before enrolment into this study.

³Total exposure of prednisone dosages in 6-mo period before enrolment into this study.

HOMA-IR: Homeostatic model assessment-insulin resistance; QUICKI: Quantitative Insulin Sensitivity Check Index; BMI: Body mass index; ESR: Erythrocyte sedimentation rate; CRP: C-reactive protein; DAS28: Disease Activity Score 28.

Table 2 Insulin resistance change in 30 active rheumatoid arthritis patients naïve to biologics by tofacitinib therapy

Group	Before	After	P value1
All (n = 30)
DAS28	6.291 ± 0.530 (5.16-7.37)	3.101 ± 0.522 (2.08-4.21)	< 0.001
Decrease in DAS28		3.194 ± 0.609 (1.94-4.36)
HOMA-IR	2.639 ± 1.185 (1.07-5.89)	1.947 ± 0.714 (0.98-4.19)	< 0.001
QUICKI	0.3353 ± 0.0222 (0.296-0.380)	0.3492 ± 0.0183 (0.310-0.385)	< 0.001
High IR (n = 18)
DAS28	6.499 ± 0.472 (5.56-7.37)	3.006 ± 0.444 (2.52-4.21)	< 0.001
Decrease in DAS28		3.499 ± 0.536 (2.36-4.36)
HOMA-IR	3.331 ± 1.036 (2.04-5.89)	2.292 ± 0.707 (1.21-4.19)	< 0.001
QUICKI	0.3207 ± 0.0135 (0.296-0.343)	0.3397 ± 0.0154 (0.310-0.372)	< 0.001
Low IR (n = 12)
DAS28	5.980 ± 0.470 (5.16-6.69)	3.244 ± 0.614 (2.08-3.99)	< 0.001
Decrease in DAS28		2.736 ± 0.389 (1.94-3.23)
HOMA-IR	1.602 ± 0.294 (1.07-2.00)	1.430 ± 0.293 (0.98-2.02)	0.139
QUICKI	0.3573 ± 0.0117 (0.344-0.380)	0.3634 ± 0.0122 (0.343-0.385)	0.156

¹Before vs after TOF therapy.

HOMA-IR: Homeostatic model assessment-insulin resistance; QUICKI: Quantitative Insulin Sensitivity Check Index; DAS28: Disease Activity Score 28.

Table 3 Insulin resistance change in 26 active rheumatoid arthritis patients exposed to biologics by tofacitinib therapy

Group	Before	After	P value1
All (n = 26)
DAS28	5.265 ± 0.547 (4.54-6.74)	3.051 ± 0.516 (2.11-3.99)	< 0.001
Decrease in DAS28		2.214 ± 0.688 (1.08-3.49)
HOMA-IR	2.548 ± 0.925 (1.33-4.75)	2.251 ± 1.067 (0.85-4.55)	0.016
QUICKI	0.3358 ± 0.0177 (0.305-0.366)	0.3446 ± 0.0242 (0.305-0.394)	0.016
High IR (n = 19)
DAS28	5.316 ± 0.807 (4.63-6.74)	3.070 ± 0.466 (2.42-3.90)	< 0.001
Decrease in DAS28		2.246 ± 0.672 (1.08-3.49)
HOMA-IR	2.924 ± 0.790 (2.10-4.75)	2.545 ± 1.080 (1.05-4.55)	0.018
QUICKI	0.3273 ± 0.0117 (0.305-0.341)	0.3372 ± 0.0214 (0.305-0.380)	0.008
Low IR (n = 7)
DAS28	5.124 ± 0.332 (4.54-5.48)	3.000 ± 0.672 (2.11-3.99)	0.016
Decrease in DAS28		2.124 ± 0.778 (1.25-3.33)
HOMA-IR	1.527 ± 0.159 (1.33-1.77)	1.453± 0.478 (0.85-2.18)	0.781
QUICKI	0.3589 ± 0.0059 (0.350-0.366)	0.3648 ± 0.0204 (0.340-0.394)	0.813

¹Before vs after TOF therapy.

HOMA-IR: Homeostatic model assessment-insulin resistance; QUICKI: Quantitative Insulin Sensitivity Check Index; TOF: Tofacitinib; DAS28: Disease Activity Score 28.