Ruscitti P, Masedu F, Alvaro S, et al. - Researchers examined if glycaemic and inflammatory parameters in participants with RA and T2D could be improved via interleukin-1 (IL-1) inhibition with anakinra, a recombinant human IL-1 receptor antagonist, compared with tumor necrosis factor (TNF) inhibitors (TNFis). In this multicentre, open-label, randomized controlled trial, 39 participants with RA and T2D (age 62.72 ± 9.97 years, 74.4% female sex) were randomized to anakinra or to a TNFi (ie, adalimumab, certolizumab pegol, etanercept, infliximab, or golimumab), in 12 Italian rheumatologic units between 2013 and 2016. They observed a significant improvement of metabolic alteration (reduction of percentage of glycated haemoglobin [HbA1c%]) after both 3 months and 6 months of therapy (crude difference of 0.93 HbA1c% between groups) in correlation with anakinra administration, but not with TNFi. They observed no severe adverse events, hypoglycaemic episodes, or deaths. Results thereby suggest that consideration could be given to the concept of IL-1 inhibition as a targeted treatment for RA and T2D. An agent inhibiting IL-1 may assist in managing the inflammatory disease and the metabolic comorbidity and thus could have a beneficial impact on participants’ compliance, their overall cardiovascular risk, and the burden of healthcare costs.