Here is an excellent paper on MTOR inhibition on lipids and glucose over the long term in patients being treated with everolimus (and some sirolimus). MTORi dosages usually started at 5 or 10 mg daily (for everolimus). What is the conversion factor for Everolimus to Rapamycin?
mTOR inhibitors are known to induce dyslipidemia in 25–76% and hyperglycemia in 13–50% of patients [8–10].
In the EXIST trials (follow-up up to 5 years), the phase III trials that led to approval of mTOR inhibition in TSC patients, dyslipidemia was reported in 5–30%, but no new cases of diabetes were reported [3, 4, 6]. In a small prospective study among mainly children with TSC using mTOR inhibition, dyslipidemia and hyperglycemia were reported in 72% and 22% of children, respectively, but the highest fasting glucose did not reach diabetic levels (108 mg/dl (6 mmol/l)) [11].
We included 141 patients, the median age was 36 years, median use of mTOR inhibitors 5.1 years (aimed serum levels 3.0–5.0 µg/l). Total cholesterol, LDL- and HDL-cholesterol levels at baseline were similar to healthy reference data. After start of mTOR inhibition therapy, total cholesterol, LDL-cholesterol and triglycerides increased significantly and were higher compared to healthy reference population. Mean total cholesterol levels increased by 1.0 mmol/L after 3–6 months of mTOR inhibition therapy but did not increase further during follow-up. In this study, 2.5% (3/118) of patients developed diabetes (defined as an HbA1c ≥ 48 mmol/mol) during a median follow-up of 5 years.
I didn’t know that Rapamycin was an effective treatment for the following diseases:
MTOR inhibitors (mTORi) are very effective in treating rAML (> 30% size reduction after 4–5 years in more than 80% of patients), SEGA (response rate 100%) and epilepsy (response rate 40%) [2–6].