Review Article

Targeting Inflammatory Cytokines to Improve Type 2 Diabetes Control

Table 2

Summary of the most representative clinical trials of anticytokine therapies in patients with insulin resistance (IR), type 2 diabetes (T2D), and/or other metabolic dysfunctions.

Author, referenceType of study and study durationDrugPatients/subjectsMain findings

Ofei et al., 1996 [86]Double-blind clinical trial (8 weeks)Engineered human anti-TNF-α antibody (CDP571)Obese patients with T2DNo effect on insulin sensitivity
Paquot et al., 2000 [88]Single-center, single-blind, sequential treatment (placebo, followed by active drug) study (6 days)TNF-α antagonist: Ro 45-2081 (a recombinant fusion protein that consists of the soluble TNF-receptor p55 linked to the fc portion of human IgG1); single intravenous administrationObese insulin-resistant patientsNo effect on insulin sensitivity
Kiortsis et al., 2005 [87]Clinical prospective study (6 months)Anti-TNF-α (infliximab)Insulin-resistant patients with rheumatoid arthritis and ankylosing spondylitisIn the entire study group, no significant changes of the HOMA index or QUICKI were observed. In the tertile of patients with the highest degree of insulin resistance, a significant decrease of the HOMA index and increase of the QUICKI was found
Dominguez et al., 2005 [89]Parallel-group open-label randomized trial (4 weeks)Anti-TNF-α (etanercept)Obese patients with T2DNo effect on insulin sensitivity, increased insulin secretion
Bernstein et al., 2006 [90]Double-blind, randomized controlled trial (4 weeks)Anti-TNF-α (etanercept)Patients with metabolic syndromeNo effect on insulin sensitivity, increased adiponectin levels
Lo et al., 2007 [60]Randomized controlled trial (4 weeks)Anti-TNF-α (etanercept)Patients with metabolic syndromeDecrease in glucose levels and HbA1c values, increased adiponectin levels
Larsen et al., 2007 [33]Double-blind, parallel-group, randomized controlled trial (13 weeks)Anti-IL-1 receptor antagonist (anakinra)Patients with T2DReduced HbA1c values, increased insulin secretion, improved glycemia and beta-cell secretory function
Larsen et al., 2009 [80]Double-blind, 39-week follow-up studyAnti-IL-1 receptor antagonist (anakinra)Patients with T2DIncreased insulin secretion, decreased insulin requirements
van Asseldonk et al., 2011 [81]Randomized, placebo-controlled trial (4 weeks)Anti-IL-1 receptor antagonist (anakinra)Nondiabetic, obese subjects with metabolic syndromeIncreased disposition index, improved insulin secretion, no effect on insulin sensitivity
Stanley et al., 2011 [59]Randomized controlled trial (6 months)Anti-TNF-α (etanercept)Obese subjects with features of the metabolic syndromeDecreased fasting glucose levels and HbA1c values, increased ratio of high molecular weight adiponectin to total adiponectin
Cavelti-Weder et al., 2012 [73]Randomized, placebo-controlled trial (3 months)Anti-IL-1β (gevokizumab)Patients with T2DReduced HbA1c values, increased insulin secretion
Rissanen et al., 2012 [77]Randomized, placebo-controlled trial (4 weeks)Anti-IL-1β (canakinumab)Patients with T2D and impaired glucose toleranceTrend towards increased insulin secretion rate
Ridker et al., 2012 [82]Randomized, placebo-controlled multinational phase IIb trial (5 months)Anti-IL-1β (canakinumab)Well-controlled T2D patients with high cardiovascular riskNo changes in HbA1c values, glucose, and insulin levels
Stagakis et al., 2012 [20]Clinical prospective study (12 weeks)Anti-TNF-α agents (infliximab, adalimumab, etanercept)Patients with rheumatoid arthritisAnti-TNF therapy improved insulin sensitivity and reversed defects in the insulin signaling cascade in patients with active disease and high insulin resistance
Hensen et al., 2013 [78]Randomized, placebo-controlled trial (4 months)Anti-IL-1β (canakinumab)Patients with T2DReduced HbA1c values, nonsignificant increase in insulin secretion
Sloan-Lancaster et al., 2013 [74]Phase II, randomized, double-blind, parallel, placebo-controlled study (12 weeks)Neutralizing IL-1β antibody (LY2189102)Patients with T2DLY2189102 modestly reduced HbA1c values and fasting glucose levels
van Popper et al., 2014 [79]Randomized, double-blind, placebo-controlled, crossover study (8 weeks)Anti-IL-1 receptor antagonist (anakinra)Subjects with impaired glucose toleranceImproved insulin secretion (first-phase insulin secretion), improved insulinogenic index
Burska et al., 2015 [84]Systematic review and meta-analysisTNF-α inhibitorsPatients with rheumatoid arthritisTNF inhibition therapy improved insulin sensitivity and reduced insulin resistance
Everett et al., 2018 [19]Randomized, double-blind, placebo-controlled trial (3 months)Anti-IL-1β (canakinumab)Subjects with T2D, prediabetes and normal glucose toleranceCanakinumab reduced HbA1c values during the first 6 to 9 months of treatment, but no consistent long-term benefits on HbA1c or fasting plasma glucose were observed
Kataria et al., 2019 [21]Meta-analysis of 2921 individuals from eight phase I-IV studiesAnti-IL-1 therapiesPatients with T2DReduced HbA1c values