Use of TNF-inhibitor biologic agents such as Enbrel, Humira, and Remicade, and hydroxychloroquine (Plaquenil, Quineprox) was associated with a lower diabetes risk among patients with the inflammatory conditions than use of other disease-modifying antirheumatic drugs (DMARDs) in the study from Harvard Medical School and Brigham and Women's Hospital.
The study appears in the June 22/29 issue of the Journal of the American Medical Association.
"We are not at the point where we can make clinical leaps and say that these are the drugs to choose for high-risk patients," Solomon says. "But if future studies support the conclusion that these drugs do decrease insulin resistance and diabetes risk, one could imagine a day when we make treatment decisions based on these comorbidities."
The patients were followed from the time they started one of four categories of commonly prescribed DMARDs: biologic TNF inhibitors, methotrexate, hydroxychloroquine, and other non-biologic agents.
During the follow-up period, 267 new cases of diabetes were diagnosed among the patients.
After taking into account known diabetes risk factors, patients treated with hydroxychloroquine were 46% less likely to develop diabetes and those treated with a TNF inhibitor had a 38% lower risk than patients taking other non-biologic agents.
Methotrexate use was associated with a non-significant reduction in diabetes risk.