Validation of Hemoglobin A1c in Patients With Inflammatory Arthritis Treated With Sulfasalazine

The purpose of this study is to examine whether the blood test Hemoglobin A1c (HbA1c) gives an accurate picture of blood glucose levels in patients with inflammatory arthritis who are treated with sulfasalazine. HbA1c is widely used to diagnose and monitor diabetes, but sulfasalazine can shorten red blood cell lifespan and thereby lower HbA1c values independently of actual glucose levels. This may lead to underdiagnosis of diabetes in patients who develop diabetes during sulfasalazine treatment, and to undertreatment in patients with known diabetes due to falsely reassuring HbA1c values. The study aims to answer two main questions: 1. How many patients treated with sulfasalazine have undiagnosed diabetes despite having HbA1c values below the diagnostic threshold? 2. Does HbA1c underestimate actual glucose levels when compared with continuous glucose monitoring (CGM) in patients with sulfasalazine-treated inflammatory arthritis, both in those with known diabetes and those that are not diagnosed with diabetes but have borderline HbA1c values (≥ 38 mmol/mol)?

NCT Number	NCT07416656
Lead Sponsor	Klavs Würgler Hansen
Conditions	Inflammatory Arthritis, Diabetes (DM), Rheumatoid Arthritis (RA), Type 1 Diabetes Mellitus, Type 2 Diabetes (T2DM)
Enrollment	75 participants
Start Date	2026-03-10
Primary Completion	2026-09 (estimated)
Study Completion	2026-10 (estimated)
Updated on ClinicalTrials.gov	2026-06-25