A Potential Improvement of Rheumatoid Arthritis in a Patient Treated with Liraglutide for Glucocorticoid-induced Diabetes

Abstract

A 74-year-old male, who had been prescribed prednisolone (PSL) for rheumatoid arthritis (RA) since age 63 and who had developed glucocorticoid-induced diabetes at age 69, was hospitalized due to poor glycemic control. On admission, he was taking 7.5 mg/day of PSL and his HbA1c was 8.1 % despite infusion of 27 U/day of insulin. As preserved β-cell function was confirmed by a glucagon challenge test, liraglutide therapy was introduced. A stepwise increase in liraglutide successfully improved his glucose tolerance and led to discontinuation of insulin treatment. A good glycemic control was finally achieved by the combination of 0.9 mg/day of liraglutide and 3 mg/day of glimepiride. Interestingly, the level of matrix metalloproteinase-3, which indicates the RA activity, was dramatically reduced from 356 ng/ml to 187 ng/ml in parallel with this treatment. The present case may imply that there is a correlation between the administration of glucagon-like peptide-1 and an improvement in the symptoms associated with rheumatoid arthritis.