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Hydroxychloroquine improved insulin sensitization in obese patients without diabetes
Hydroxychloroquine, commonly prescribed to treat patients with rheumatoid arthritis, improves insulin sensitization in obese patients without diabetes, according to recent research.
Researchers recruited 13 obese, nondiabetic participants without systemic inflammatory conditions for the open-label longitudinal study. The study was designed to examine the effects of hydroxychloroquine (HCQ) on insulin resistance, insulin sensitivity and pancreatic beta-cell secretion of insulin in participants of this population. Participants were assigned HCQ 6.5 mg/kg daily for 6 weeks. The mean age of the participants was 49 years, 10 were women, and their median BMI was 36.1 kg/m2.
The participants underwent oral glucose tolerance tests three times: at pretreatment, 6 weeks (the end of the HCQ treatment) and 12 weeks (6 weeks post-HCQ treatment). The Matsuda Insulin Sensitivity Index (ISI), HOMA-IR and HOMA-B were compared across these times. At 6 weeks of HCQ therapy, the participants’ ISI had increased from a median of 4.5 (range 2.3-7.8) at baseline to 8.9 (3.7-11.4) (P=.04), and HOMA-IR had decreased from a median of 2.1 (1.6-5.4 range) at baseline to 1.8 (1.02-2.1) (P=.09). Both ISI and HOMA-IR variables returned toward baseline at week 12 (P=.45 and P=.64, comparing baseline and week 12, respectively).
While the researchers did not study participants with rheumatoid arthritis (RA), the participants were obese, had increased baseline insulin resistance and elevated baseline C-reactive protein levels similar to patients with rheumatoid arthritis.
“With HCQ’s benefit as a disease-modifying antirheumatic drug, if it also improves insulin sensitivity in patients with rheumatic diseases, it may be beneficial to maintain HCQ treatment in the rheumatic disease population,” the researchers concluded.
Researchers warned that the study’s small sample size may have generated a false negative, and that “further study of the insulin-sensitizing effects of HCQ in patients with RA is warranted.”
Disclosure: See the study for a full list of relevant disclosures.