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Original Research

Sustained Effects of Interleukin-1 Receptor Antagonist Treatment in Type 2 Diabetes

  1. Claus M. Larsen, MD1,
  2. Mirjam Faulenbach, MD2,
  3. Allan Vaag, MD, PHD1,3,
  4. Jan A. Ehses, PHD2,
  5. Marc Y. Donath, MD2 and
  6. Thomas Mandrup-Poulsen, MD, PHD1,4,5
  1. 1Hagedorn Research Institute and Steno Diabetes Center, Gentofte, Denmark;
  2. 2Clinic for Endocrinology and Diabetes, University Hospital Zurich, Zurich, Switzerland;
  3. 3University of Lund, Lund, Sweden;
  4. 4Core Unit for Medical Research Methodology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark;
  5. 5Karolinska Institutet, Stockholm, Sweden.
  1. Corresponding author: Thomas Mandrup-Poulsen, tmpo{at}hagedorn.dk.
  1. C.M.L., M.F., M.Y.D., and T.M.-P. contributed equally to this study.

Diabetes Care 2009 Sep; 32(9): 1663-1668. https://doi.org/10.2337/dc09-0533
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    Figure 1

    Enrollment and outcome. Of the 70 patients who underwent randomization, 67 completed 13 weeks of anakinra or placebo treatment and were included in the present 39-week follow-up study. Of the former anakinra- and placebo-treated patients, 33 and 31, respectively, completed the study.

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    Figure 2

    Change in glycemic and inflammatory markers at study end. Data for PI/I ratio (A), A1C (B), C-reactive protein (C), and IL-6 (D) at baseline and end of study (week 52) in patients treated with anakinra (■) or placebo (□) from baseline until week 13. Data are means ± SEM.

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    Figure 3

    IL-1Ra serum levels and genotypes; A1C and insulin requirements. A: Serum IL-1Ra levels at baseline and end of study (week 52) in patients with (□, responders) or without (■, nonresponders) any reduction in A1C after 13 weeks of anakinra treatment. B: Allele frequencies of allele 2 and C of the VNTR tandem repeat polymorphism in intron 2 and the SNP tagged by rs4251961, respectively, of the IL1-Ra gene in responders (□) and nonresponders (■) to anakinra treatment. C: A1C at baseline (week 0), and 13, 26, 39, and 52 weeks in responders (□) and nonresponders (▲) to anakinra treatment. D: Daily insulin dose at baseline and end of study (week 52) in responders (□) and nonresponders (■) to anakinra treatment. Data are means ± SEM or frequencies where indicated.

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    Figure 4

    β-Cell function after anakinra withdrawal. β-Cell function assessed by PI/I (A); and AUC for C-peptide during an oral glucose-tolerance test (B); an intravenous stimulation with glucose, glucagon, and arginine (C); and the oral and intravenous test combined (D) at baseline, anakinra withdrawal (week 13), and end of study (week 52) in patients with (□, responders) or without (■, nonresponders) any reduction in A1C after 13 weeks of anakinra treatment. A: *P = 0.041 vs. nonresponders at week 13, †P = 0.435 vs. responders week 52, ‡P = 0.016 vs. nonresponders week 52, and §P = 0.005 vs. nonresponders week 52. B: *P = 0.006 vs. nonresponders at week 13, †P = 0.750 vs. responders week 52, ‡P = 0.021 vs. nonresponders week 52, and §P = 0.008 vs. nonresponders week 52. C: *P = 0.048 vs. nonresponders at week 13, †P = 0.039 vs. responders week 52, ‡P = 0.793 vs. nonresponders week 52, and §P = 0.092 vs. nonresponders week 52. D: *P = 0.025 vs. nonresponders at week 13, †P = 0.947 vs. responders week 52, ‡P = 0.021 vs. nonresponders week 52, and §P = 0.001 vs. nonresponders week 52. Data are means ± SEM.

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Diabetes Care: 32 (9)

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September 2009, 32(9)
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Sustained Effects of Interleukin-1 Receptor Antagonist Treatment in Type 2 Diabetes
Claus M. Larsen, Mirjam Faulenbach, Allan Vaag, Jan A. Ehses, Marc Y. Donath, Thomas Mandrup-Poulsen
Diabetes Care Sep 2009, 32 (9) 1663-1668; DOI: 10.2337/dc09-0533

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Sustained Effects of Interleukin-1 Receptor Antagonist Treatment in Type 2 Diabetes
Claus M. Larsen, Mirjam Faulenbach, Allan Vaag, Jan A. Ehses, Marc Y. Donath, Thomas Mandrup-Poulsen
Diabetes Care Sep 2009, 32 (9) 1663-1668; DOI: 10.2337/dc09-0533
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