title: Efficacy of inhibition of IL-1 in patients with rheumatoid arthritis and type 2 diabetes mellitus: two case reports and review of the literature.
abstract: BACKGROUND
  Rheumatoid arthritis is an autoimmune arthritis in which two inflammatory cytokines, tumor necrosis factor-α and interleukin-1β, play a critical role in the induction and progression of the disease. Several reports and data from registries have discussed the association between chronic inflammatory diseases and disorders in intermediary metabolism, pointing out that prevalence of peripheral insulin resistance and type 2 diabetes mellitus is increased among patients with rheumatoid arthritis. In addition, several studies have shown that type 2 diabetes mellitus may be considered an interleukin-1β inflammatory-mediated process, and both preclinical and clinical observations have reported the usefulness of interleukin-1 antagonism therapy in this disease.
  
  
  METHODS
  We describe the case of a 58-year-old Caucasian woman and a 74-year-old Caucasian man with rheumatoid arthritis associated with type 2 diabetes mellitus. In these patients, the inhibition of interleukin-1β not only induced remission for rheumatoid arthritis, but successfully controlled their metabolic status.
  
  
  CONCLUSIONS
  We report the positive effects of the inhibition of interleukin-1 in two patients with rheumatoid arthritis associated with type 2 diabetes mellitus, with both reaching the therapeutic targets of their diseases by using a single biological agent and tapering or discontinuing their antidiabetic therapies. These findings suggest that targeting interleukin-1 might be considered a good therapeutic option for the treatment of rheumatoid arthritis associated with type 2 diabetes mellitus.
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Rheumatology Unit, delta 6 building, PO Box 67100, L'Aquila, Italy. pieroruscitti@live.com.
authors.forename: Piero
authors.initials: P
authors.lastname: Ruscitti
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Rheumatology Unit, delta 6 building, PO Box 67100, L'Aquila, Italy. paola.cipriani@cc.univaq.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Cipriani
authors.affiliation: Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena,Policlinico Santa Maria alle Scotte, Viale Mario Bracci, PO Box 53100, Siena, Italy. cantariniluca@hotmail.com.
authors.forename: Luca
authors.initials: L
authors.lastname: Cantarini
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Rheumatology Unit, delta 6 building, PO Box 67100, L'Aquila, Italy. vasiliki_liakouli@yahoo.it.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Liakouli
authors.affiliation: Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena,Policlinico Santa Maria alle Scotte, Viale Mario Bracci, PO Box 53100, Siena, Italy. espositogenn@gmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vitale
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Rheumatology Unit, delta 6 building, PO Box 67100, L'Aquila, Italy. francescocarubbi@libero.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Carubbi
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Rheumatology Unit, delta 6 building, PO Box 67100, L'Aquila, Italy. berardicurtio@libero.it.
authors.forename: Onorina
authors.initials: O
authors.lastname: Berardicurti
authors.affiliation: Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena,Policlinico Santa Maria alle Scotte, Viale Mario Bracci, PO Box 53100, Siena, Italy. galeazzi@unisi.it.
authors.forename: Mauro
authors.initials: M
authors.lastname: Galeazzi
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Medical Statistic Unit, delta 6 building, PO Box 67100, L'Aquila, Italy. marco.valenti@cc.univaq.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Valenti
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Rheumatology Unit, delta 6 building, PO Box 67100, L'Aquila, Italy. Roberto.giacomelli@cc.univaq.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Giacomelli
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000627:therapeutic use*; D053583:Interleukin-1beta / Q000037:antagonists & inhibitors*; D008297:Male; D008875:Middle Aged
chemical_list: D018501:Antirheumatic Agents; D053590:Interleukin 1 Receptor Antagonist Protein; D053583:Interleukin-1beta