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Salicylate inflammation reduction could help patients with type 2 diabetes
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With a decades-old hypothesis that inflammation is among the main reasons individuals become less healthy, researchers are finding increasing evidence that the anti-inflammatory properties in a simple over-the-counter salicylate benefit patients with diabetes and obesity.
Steven E. Shoelson, MD, PhD, head of pathophysiology and molecular pharmacology at Joslin Diabetes Center and a professor of medicine at Harvard Medical School, revealed the benefits of aspirin in a presentation at the American Association of Clinical Endocrinologists 23rd Annual Scientific and Clinical Congress in Las Vegas.
“An old drug salicylate, an old anti-inflammatory drug, has these marked effects on glucose, lipid-lowering and raising of adiponectin,” Shoelson told Endocrine Today.
Significant improvements in HbA1c have been documented in the Annals of Internal Medicine, which Shoelson highlighted, with more patients treated with salsalate (a non-acetylated pro-drug of salicylate) experiencing decreases of 0.5% or more from baseline (P=.009). The average HbA1c changes were –0.36% (P=.02) at 3 g/day, –0.34% (P=.02) at 3.5 g/day and –0.49% (P=.001) at 4 g/day compared with placebo.
Other markers that Shoelson underscored as showing significant improvements with treatment came from the Targeting Inflammation Using Salsalate for Type 2 Diabetes (TINSAL-T2D) trial and included fasting blood glucose (P<.001), glycated albumin (P<.001), triglycerides (P<.02) and adiponectin (P<.003).
“Nobody knew it was going to have near this kind of effect,” Shoelson said.
Still, the success of the trials will not translate to a shift in the clinical sphere of diabetes treatment until the FDA approves salicylate, or another drug that works in a similar way, for this particular use.
“This is a drug that is approved for use, but we’re using it off label,” Shoelson said. “It is not approved for use in treating diabetes or any cardiometabolic condition, so we don’t recommend that. This is not changing day-to-day medical practice at this point.”
The “savvy endocrinologist” has likely integrated the notion into his or her own mind that inflammation can play roles in the progression of conditions, Shoelson said, but it is not likely entering their clinical practice — yet.
“We know for sure this is going to be important, we just don’t have the approved tools yet to treat our patients, but we foresee them happening in the not too distant future.” – by Allegra Tiver
For more information:
Goldfine AB. Ann Intern Med. 2010;152:346-357.
Shoelson SE. Abstract F31. Presented at: AACE 23rd Annual Scientific & Clinical Congress; May 13-18, 2014; Las Vegas.
Disclosure: Shoelson reports that he has received speaker honoraria from Merck & Co.