June 20, 2012

Arthritis Drug Shows Promise for Glucose Control
in Diabetes Patients

Philadelphia, PAThe latest therapy showing promise for lowering glucose in diabetes patients isn’t a novel pharmaceutical introduced with a marketing blitz but is a drug with ancient roots that pharmacists already regularly dispense for arthritis treatment.

In a presentation at the American Diabetes Association (ADA) 72nd Scientific Sessions here, researchers said that salsalate, currently used to relieve the pain of rheumatoid arthritis, could be a potential treatment for patients with type 2 diabetes.

“The exciting thing here is that this drug is relatively inexpensive and has a long safety record for other uses, such as treating joint pain,” Steven Shoelson, MD, PhD, associate director of research at the Joslin Diabetes Center and principal investigator for the study, said in a statement released by the ADA. “We now have to determine whether the degree to which this drug lowers blood glucose levels is large enough to warrant using it as an addition to the diabetes drug armamentarium.”

For the study, sponsored by the National Institutes of Health, researchers compared use of 3.5-mg salsalate daily to placebo in 286 patients with type 2 diabetes and found that it reduced A1C levels by 0.24% and fasting blood glucose levels by 11 mg/dL over 48 weeks. The modest results were achieved even though the group taking salsalate was also using lower doses of other diabetes medications compared to the control group.

Other benefits included:

• A reduction in white blood cell, neutrophil, and lymphocyte counts in the study group, from high levels to lower levels within the normal range;
• An increase in adiponectin of 21%, suggesting some cardiovascular protective qualities;
• A decrease in uric acid of 11%, indicating a potential reduction in risk for gout, which is often associated with diabetes.

The results were not all positive, however. Patients taking the drug gained 2.2 lbs. over the study’s year-long duration, and their cholesterol rose 8 mg/dL. At the same time, triglyceride levels dropped compared to the control group.

Another concern is the small change in urinary albumin (1.8 micrograms per mg of creatinine) experienced in the group taking salsalate. That reversed upon discontinuation of the drug, signaling some possible impact on kidney function.

Glomerular filtration rate, considered the major indicator of kidney function, didn’t change, however.

At a press conference announcing the results, Shoelson said that because the study was small and preliminary, more research is required to fully understand the full risks and benefits of the drug for diabetes patients.

Salsalate is a precursor of salicylate, a plant-derived drug that has been used as a pain medication or anti-inflammatory drug for thousands of years.

U.S. Pharmacist Social Connect