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Suzuki Y, Hirose T, Sugiyama N, Nomura K, Campos-Alberto E. Post-marketing surveillance of high-dose methotrexate (>8 mg/week) in Japanese patients with rheumatoid arthritis: A post hoc sub-analysis of patients according to duration of prior methotrexate use. Mod Rheumatol 2021; 31:575-586. [PMID: 32933346 DOI: 10.1080/14397595.2020.1823604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To explore whether the duration of prior low-dose methotrexate treatment (MTX; ≤8 mg/week) influences the safety and effectiveness of high-dose MTX (>8 mg/week) in Japanese patients with rheumatoid arthritis (RA). METHODS This post hoc sub-analysis of a Japanese post-marketing surveillance study evaluated patients initiating high-dose MTX with ≥1 year or <1 year prior low-dose MTX use. Over 24 or 52 weeks, adverse drug reactions (ADRs) were monitored, and effectiveness was assessed using the Disease Activity Score in 28 joints, erythrocyte sedimentation rate [DAS28-4 (ESR)]. RESULTS One thousand two hundred and ninety-two MTX ≥1 year and 1001 MTX <1 year patients were included. The incidence of ADRs during the 24- and 52-week follow-up period was significantly more frequent in MTX <1 year than ≥1 year patients and serious ADRs were significantly higher in MTX <1 year than ≥1 year patients during the 52-week follow-up period (all p < .05). Over both follow-up periods, the mean DAS28-4 (ESR) significantly decreased from baseline for all groups. Remission and low disease activity rates (DAS28-4 (ESR) <2.6 and <3.2, respectively) increased from baseline for all groups. CONCLUSION High-dose MTX reduced disease activity regardless of prior treatment duration, but ADRs occurred more frequently among MTX <1 year patients compared to MTX ≥1 year patients.
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Affiliation(s)
- Yasuo Suzuki
- Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, Tokyo, Japan
| | - Tomohiro Hirose
- Atopy (Allergy) Research Center, Juntendo University School of Medicine, Tokyo, Japan.,Immunology and Inflammation Medical Affairs, Pfizer Innovative Health, Pfizer Japan Inc, Tokyo, Japan
| | - Noriko Sugiyama
- Clinical Statistics, Biometrics and Data Management, Pfizer R&D Japan, Tokyo, Japan
| | - Kazuto Nomura
- Post-Marketing Study Strategy and Management, Development Japan, Pfizer R&D Japan, Tokyo, Japan
| | - Eduardo Campos-Alberto
- Immunology and Inflammation Medical Affairs, Pfizer Innovative Health, Pfizer Japan Inc, Tokyo, Japan
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Suzuki Y, Sugiyama N, Fukuma Y, Sugiyama N, Kokubo T. RETRACTED ARTICLE: Safety and effectiveness of high-dose methotrexate (over 8 mg/week) in 2838 Japanese patients with rheumatoid arthritis: A postmarketing surveillance report. Mod Rheumatol 2020; 30:vii-xviii. [DOI: 10.1080/14397595.2017.1304857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Yasuo Suzuki
- Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | | | - Yuri Fukuma
- Medical Affairs, Pfizer Japan Inc., Tokyo, Japan
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Rheumatology practice in Japan: challenges and opportunities. Rheumatol Int 2019; 39:1499-1505. [PMID: 30888472 DOI: 10.1007/s00296-019-04281-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 03/12/2019] [Indexed: 10/27/2022]
Abstract
This article aims to and describes the characteristics of rheumatology practice in Japan, focusing on the medical environment for the treatment of rheumatoid arthritis (RA). In Japan, the introduction of biological disease-modifying anti-rheumatic drugs (bDMARDs) has led to a significant paradigm shift in medical care; satisfactory safety outcomes have been demonstrated by periodic analysis, post-market surveillance and the development of guidelines via an industry-academia-government collaboration. Drug discontinuation is also considered an option, as well as medical economic analysis of any increase in the financial burden engendered by use of bDMARDs. Tocilizumab, a bDMARD established in Japan, was developed in an environment that facilitates translational research. The rheumatology community in Japan is expected to continue to develop novel therapies, while ensuring consistent quality of medical care despite limited healthcare resources.
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Suzuki Y, Sugiyama N, Fukuma Y, Sugiyama N, Kokubo T. Safety and effectiveness of high-dose methotrexate (over 8 mg/week) in 2838 Japanese patients with rheumatoid arthritis: a postmarketing surveillance report. Mod Rheumatol 2019; 30:24-35. [DOI: 10.1080/14397595.2018.1532483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Yasuo Suzuki
- Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | | | - Yuri Fukuma
- Medical Affairs, Pfizer Japan Inc., Tokyo, Japan
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Tanaka Y, Mimori T, Yamanaka H, Nakajima R, Morita K, Kimura J, Takeuchi T. Effectiveness and safety of initiating adalimumab plus ≥12 mg/week methotrexate with adjustable dosing in biologic-naïve patients with early rheumatoid arthritis: HAWK study postmarketing surveillance in Japan. Mod Rheumatol 2018; 29:572-580. [DOI: 10.1080/14397595.2018.1500979] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hisashi Yamanaka
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | | | | | | | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
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Yano K, Ikari K, Inoue E, Sakuma Y, Mochizuki T, Koenuma N, Tobimatsu H, Tanaka E, Taniguchi A, Okazaki K, Yamanaka H. Features of patients with rheumatoid arthritis whose debut joint is a foot or ankle joint: A 5,479-case study from the IORRA cohort. PLoS One 2018; 13:e0202427. [PMID: 30188930 PMCID: PMC6126825 DOI: 10.1371/journal.pone.0202427] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/02/2018] [Indexed: 11/18/2022] Open
Abstract
Background Foot and ankle joint disorders are serious issues for patients with rheumatoid arthritis (RA). We compared the differences between patients with RA whose first symptom involved a foot or ankle joint (FOOT group) versus other joints (non-FOOT group) within the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) cohort in our institute. Patients and methods In the IORRA survey conducted in April 2016, patients were invited to complete six questionnaires about their first symptom at RA onset, current foot or ankle symptoms, daily living activities, and mental health. Disease activity, clinical laboratory variables, functional disability, quality of life, use and ratio of anti-inflammatory and antirheumatic drugs, daily living activities and mental health were compared between the two groups. Results Among 5,637 Japanese patients with RA who participated in the IORRA survey on April 2016, 5,479 (97.2%) responded to the questionnaire regarding their debut joint. Of these patients, 2,402 (43.8%) reported that their first symptom of RA involved a foot or ankle joint. The FOOT group (n = 2,164) had higher disease activity, higher disabilities, lower quality of life, lower activities of daily living, and poorer mental health and used anti-inflammatory drugs at a higher rate and at higher doses compared with the non-FOOT group (n = 2,164). On the other hand, the use of medications to suppress the disease activity of RA was similar between the groups. Conclusion Clinicians should pay more attention to foot and ankle joints in daily practice so as not to underestimate the disease activity of RA.
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Affiliation(s)
- Koichiro Yano
- Institute of Rheumatology, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
- Department of Orthopedic surgery, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
| | - Katsunori Ikari
- Institute of Rheumatology, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
- Department of Orthopedic surgery, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
- * E-mail:
| | - Eisuke Inoue
- Institute of Rheumatology, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
- Medical Informatics, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yu Sakuma
- Institute of Rheumatology, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
- Department of Orthopedic surgery, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
| | - Takeshi Mochizuki
- Institute of Rheumatology, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
- Department of Orthopedic surgery, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
- Department of Orthopedic surgery, Kamagaya General Hospital, Kamagaya, Chiba, Japan
| | - Naoko Koenuma
- Institute of Rheumatology, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
- Department of Orthopedic surgery, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
| | - Haruki Tobimatsu
- Institute of Rheumatology, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
- Department of Orthopedic surgery, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
| | - Eiichi Tanaka
- Institute of Rheumatology, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
| | - Atsuo Taniguchi
- Institute of Rheumatology, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
| | - Ken Okazaki
- Institute of Rheumatology, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
- Department of Orthopedic surgery, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
| | - Hisashi Yamanaka
- Institute of Rheumatology, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
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Erdogan F, Sarikaya IA, Can A, Gorgun B. Management of knee rheumatoid arthritis and tibia nonunion with one-stage total knee arthroplasty and intramedullary nailing: A report of two cases. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2018; 52:65-69. [PMID: 28583752 PMCID: PMC6136314 DOI: 10.1016/j.aott.2017.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 06/09/2016] [Accepted: 06/28/2016] [Indexed: 11/24/2022]
Abstract
Total knee arthroplasty (TKA) is a surgical procedure which is widely used in the treatment of gonarthrosis secondary to rheumatoid arthritis (RA). The incidence of stress fractures in tibia in the patients with RA is higher compared to normal patients. In this study, we report two cases of TKA and intramedullary nailing in RA patients with severe knee arthritis and tibial nonunion. Both patients had a satisfactory clinical outcome with radiological healing of the tibial fracture.
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Koike T, Harigai M, Ishiguro N, Inokuma S, Takei S, Takeuchi T, Yamanaka H, Takasaki Y, Mimori T, Hiramatsu K, Komatsu S, Tanaka Y. Effect of Methotrexate Plus Adalimumab on the Achievement of Rheumatoid Arthritis Therapeutic Goals: Post Hoc Analysis of Japanese Patients (MELODY Study). Rheumatol Ther 2016; 3:129-141. [PMID: 27747511 DOI: 10.1007/s40744-015-0023-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION There is insufficient evidence regarding the appropriate dose of methotrexate (MTX) required to achieve specific treatment goals in patients with rheumatoid arthritis (RA) receiving biologic drugs in Japan. The present study aimed to assess the dose-response effect of MTX in combination with adalimumab (ADA) to achieve low disease activity (LDA) and/or remission at 24 weeks in RA patients. METHODS This analysis used data of the ADA all-case survey in Japan (n = 7740), and 5494 patients who received ADA and MTX were classified into five groups by weighted average MTX dose (>0-<4, 4-<6, 6-<8, 8-< 10, and ≥10 mg/week). Of the 5494 patients, 3097 with baseline 28-joint disease activity score based on erythrocyte sedimentation rate >3.2 were analyzed for effectiveness by MTX dose. RESULTS In biologic-naïve patients (n = 1996/3097), LDA/remission rates increased with MTX up to 6-<8 mg/week and then plateaued at higher doses (LDA, p = 0.0440; remission, p = 0.0422). In biologic-exposed patients (n = 1101/3097), LDA/remission rates increased with MTX dose (LDA, p = 0.0009; remission p = 0.0143). The incidences of serious adverse drug reactions (ADRs) and serious infections did not differ by MTX dose, but total ADRs and infections were significantly higher (p < 0.05) with increased MTX doses. CONCLUSION The appropriate MTX doses in combination with ADA to achieve LDA and/or remission at week 24 were different between biologic-naïve and biologic-exposed patients with RA, suggesting that 8 mg/week of MTX would be enough for biologic-naïve patients. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT01076959. FUNDING AbbVie and Eisai Co., Ltd.
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Affiliation(s)
| | - Masayoshi Harigai
- Department of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Naoki Ishiguro
- Department of Orthopedic Surgery, Nagoya University School of Medicine, Nagoya, Japan
| | - Shigeko Inokuma
- Department of Allergy and Rheumatic Diseases, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Syuji Takei
- Department of Maternal and Child Health Nursing, School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Tsutomu Takeuchi
- Department of Internal Medicine, Division of Rheumatology, School of Medicine, Keio University, Tokyo, Japan
| | - Hisashi Yamanaka
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yoshinari Takasaki
- Department of Internal Medicine and Rheumatology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | | | - Yoshiya Tanaka
- Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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Kinoshita H, Miyakoshi N, Kashiwagura T, Kasukawa Y, Sugimura Y, Shimada Y. Comparison of the efficacy of denosumab and bisphosphonates for treating secondary osteoporosis in patients with rheumatoid arthritis. Mod Rheumatol 2016; 27:582-586. [PMID: 27659808 DOI: 10.1080/14397595.2016.1232776] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES This study aimed to investigate the efficacy of denosumab (compared with that of bisphosphonates) for preventing secondary osteoporosis and inflammation caused by excessive bone resorption in Japanese rheumatoid arthritis (RA) patients never previously treated for osteoporosis. METHODS Ninety-eight patients with coexisting RA and osteoporosis were enrolled. The patients were subdivided by whether they were treated with denosumab (n = 49) or traditional bisphosphonates (n = 49). RA disease activity, bone turnover markers, and bone mineral density (BMD) were compared between the two groups before treatment, and after 6 and 12 months of treatment. RESULTS There was no significant difference between the groups in any of the disease activity indices and BMD at any of the measured time points. With regard to bone metabolism, denosumab significantly reduced bone-specific alkaline phosphatase at 6 and 12 months compared with pretreatment, but had no effect on tartrate-resistant acid phosphatase 5b levels, suggesting an effect on the bone formation rate, but not on the bone resorption rate. CONCLUSIONS Neither denosumab nor bisphosphonates could suppress inflammation or RA disease activity, but denosumab significantly suppressed a marker of bone metabolism in Japanese RA patients never previously treated for osteoporosis.
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Affiliation(s)
| | - Naohisa Miyakoshi
- b Department of Orthopedic Surgery , Akita University Graduate School of Medicine , Akita , Japan
| | | | - Yuji Kasukawa
- b Department of Orthopedic Surgery , Akita University Graduate School of Medicine , Akita , Japan
| | | | - Yoichi Shimada
- b Department of Orthopedic Surgery , Akita University Graduate School of Medicine , Akita , Japan
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Hoshi D, Tanaka E, Igarashi A, Inoue E, Kobayashi A, Sugimoto N, Shidara K, Sato E, Seto Y, Nakajima A, Momohara S, Taniguchi A, Tsutani K, Yamanaka H. Profiles of EQ-5D utility scores in the daily practice of Japanese patients with rheumatoid arthritis; Analysis of the IORRA database. Mod Rheumatol 2015; 26:40-5. [PMID: 26052801 DOI: 10.3109/14397595.2015.1059983] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Along with the advances of newly developed medical therapies in rheumatoid arthritis (RA), the number of pharmacoeconomical issues has been paid attention rapidly. For cost-utility analysis and determination of quality-adjusted life years, measurement of the EuroQol 5-dimensional descriptive system (EQ-5D) is essential, and has been used in several clinical studies. However, EQ-5D utility measure in Japanese patients with RA, especially in daily practice has not been fully documented. We analyzed the distribution of EQ5D utility scores and investigated the relationship between other clinical measures based on our Institute of Rheumatology, Rheumatoid Arthritis (IORRA) database. METHOD Among 5,284 outpatients who participated in the IORRA cohort study on October 2007, data from 5,043 patients who completed the EQ-5D questionnaire were cross-sectionally analyzed. EQ-5D scores in each subgroup for baseline feature such as gender, age, disease activity score 28 (DAS28), and Japanese version of health assessment questionnaire (J-HAQ) were evaluated. For the evaluation of variables that influenced EQ-5D score, the contribution of each variable was evaluated by ANOVA. RESULTS Average EQ-5D score was 0.76 in 5,284 patients (84% females, average age: 59.0 years, average disease duration: 12.4 years) whose average DAS28 was 3.3 and average J-HAQ was 0.74. EQ-5D scores were highly correlated with J-HAQ and DAS28, and were significantly lower in females and rheumatoid factor-positive patients. Older age, longer disease duration, higher DAS28, and higher J-HAQ were also significantly associated with lower EQ-5D scores. In multivariate analysis, the factor that most strongly influenced EQ-5D was J-HAQ (57.6%), followed by pain visual analog score (VAS; 12.5%). CONCLUSION This study clearly demonstrated the distribution of EQ-5D score in the daily practice of RA patients, and provides important information for the pharmacoeconomical studies in rheumatology.
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Affiliation(s)
- Daisuke Hoshi
- a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan
| | - Eiichi Tanaka
- a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan
| | - Ataru Igarashi
- b Department of Drug Policy and Management , Graduate School of Pharmaceutical Sciences, The University of Tokyo , Bunkyo-ku, Tokyo , Japan
| | - Eisuke Inoue
- a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan
| | - Akiko Kobayashi
- a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan
| | - Naoki Sugimoto
- a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan
| | - Kumi Shidara
- a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan
| | - Eri Sato
- a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan
| | - Yohei Seto
- a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan
| | - Ayako Nakajima
- a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan
| | - Shigeki Momohara
- a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan
| | - Atsuo Taniguchi
- a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan
| | - Kiichiro Tsutani
- b Department of Drug Policy and Management , Graduate School of Pharmaceutical Sciences, The University of Tokyo , Bunkyo-ku, Tokyo , Japan
| | - Hisashi Yamanaka
- a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan
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Sato E, Tanaka E, Ochiai M, Shimizu Y, Kobayashi A, Shidara K, Hoshi D, Sugimoto N, Inoue E, Seto Y, Nakajima A, Taniguchi A, Momohara S, Yamanaka H. Chronological changes in baseline disease activity of patients with rheumatoid arthritis who received biologic DMARDs between 2003 and 2012. Mod Rheumatol 2015; 25:350-7. [DOI: 10.3109/14397595.2014.958274] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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12
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Ochi K, Iwamoto T, Saito A, Ikari K, Toyama Y, Taniguchi A, Yamanaka H, Momohara S. Construct validity, reliability, response rate, and association with disease activity of the quick disabilities of the arm, shoulder and hand questionnaire in the assessment of rheumatoid arthritis. Mod Rheumatol 2014; 25:241-5. [DOI: 10.3109/14397595.2014.939420] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Miyamae T, Tanaka E, Kishi T, Matsuyama T, Igarashi T, Fujikawa S, Taniguchi A, Momohara S, Yamanaka H. Long-term outcome of 114 adult JIA patients in a non-pediatric rheumatology institute in Japan. Mod Rheumatol 2014; 25:62-6. [DOI: 10.3109/14397595.2014.929558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Takako Miyamae
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
- Department of Pediatrics, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Eiichi Tanaka
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Takayuki Kishi
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
- Department of Pediatrics, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Tsuyoshi Matsuyama
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Tohru Igarashi
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | | | - Atsuo Taniguchi
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Shigeki Momohara
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Hisashi Yamanaka
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
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Nishikawa M, Owaki H, Takahi K, Fuji T. Disease activity, knee function, and walking ability in patients with rheumatoid arthritis 10 years after primary total knee arthroplasty. J Orthop Surg (Hong Kong) 2014; 22:84-7. [PMID: 24781621 DOI: 10.1177/230949901402200121] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To evaluate disease activity, knee function, and walking ability of patients with rheumatoid arthritis (RA) over 10 years after total knee arthroplasty (TKA). METHODS Four men and 26 women (mean age, 59.9 years) underwent 42 TKAs for RA with a mean duration of 151.3 months and were followed up for a mean of 142.3 months. Preoperatively, disease activity was assessed by C-reactive protein (CRP) level only, and the range of knee motion was recorded. At the final follow-up, tender joint count, swollen joint count, visual analogue scale of RA symptoms, and the Modified Health Assessment Questionnaire (MHAQ) score were assessed. Disease activity was evaluated using CRP, matrix metalloproteinase-3, and Disease Activity Score. Range of motion and Knee Society knee and function scores were also assessed. RESULTS The use of methotrexate increased from 4 patients preoperatively to 20 patients at the final follow-up (p<0.001), and the mean dose increased from 3.9 to 6.3 mg/week (p<0.001). Among the 30 patients, the mean CRP level decreased from 2.63 mg/dl preoperatively to 0.61 mg/dl at the final follow-up (p<0.001). Disease activity was controlled. At the final follow-up, disease activity was in remission in 10 patients, low in 11, and moderate in 9. The mean Knee Society knee score was excellent (91.0), but the mean function score was poor (57.0) and diverse. Severe walking disability (function score, <40) was noted in 8 patients (11 TKAs). Knee and function scores did not correlate. CONCLUSION Walking ability in patients with RA after TKA was generally poor. Poor function was associated with a history of spinal or lower extremity fracture surgery and the MHAQ score.
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Affiliation(s)
| | - Hajime Owaki
- Department of Orthopaedic Surgery, Osaka Koseinenkin Hospital, Japan; Department of Rheumatology, Osaka Koseinenkin Hospital, Osaka, Japan
| | - Koichiro Takahi
- Department of Orthopaedic Surgery, National Hospital Organization Toneyama National Hospital, Osaka, Japan
| | - Takeshi Fuji
- Department of Orthopaedic Surgery, Osaka Koseinenkin Hospital, Japan
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Tanaka E, Hoshi D, Igarashi A, Inoue E, Shidara K, Sugimoto N, Sato E, Seto Y, Nakajima A, Momohara S, Taniguchi A, Tsutani K, Yamanaka H. Analysis of direct medical and nonmedical costs for care of rheumatoid arthritis patients using the large cohort database, IORRA. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0729-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Yamanaka H, Seto Y, Tanaka E, Furuya T, Nakajima A, Ikari K, Taniguchi A, Momohara S. Management of rheumatoid arthritis: the 2012 perspective. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0702-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Hisashi Yamanaka
- Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan
| | - Yohei Seto
- Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan
| | - Eiichi Tanaka
- Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan
| | - Takefumi Furuya
- Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan
| | - Ayako Nakajima
- Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan
| | - Katsunori Ikari
- Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan
| | - Atsuo Taniguchi
- Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan
| | - Shigeki Momohara
- Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan
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Koike T, Harigai M, Ishiguro N, Inokuma S, Takei S, Takeuchi T, Yamanaka H, Haruna S, Ushida N, Kawana K, Tanaka Y. Safety and effectiveness of adalimumab in Japanese rheumatoid arthritis patients: postmarketing surveillance report of 7740 patients. Mod Rheumatol 2013; 24:390-8. [PMID: 24252049 DOI: 10.3109/14397595.2013.843760] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To confirm the safety and effectiveness of adalimumab and to evaluate the influence of the concomitant use of methotrexate (MTX). METHODS Postmarketing surveillance of 7740 Japanese rheumatoid arthritis (RA) patients was performed. All patients who received adalimumab in the registration period were followed for 28 weeks after starting treatment for safety and 24 weeks for effectiveness. Effectiveness was measured by duration of morning stiffness, swollen and tender joint counts (28 joints), patient global assessment of disease activity, erythrocyte sedimentation rate and serum C-reactive protein. RESULTS Comparable rates of adverse drug reactions (ADRs) were reported in this study and in the interim analysis. Age, pulmonary disease history or comorbidity, co-existing diabetes mellitus, concomitant MTX at doses of > 8 mg/week and concomitant glucocorticoids at doses of > 5 mg/day were risk factors for infections. All mean values of effectiveness measurements improved. Relatively lower disease activity at baseline, biologic-naïve, concomitant MTX use and early RA stage/low functional class were background factors contributing to the effectiveness. The combination of adalimumab with MTX improved the response to adalimumab treatment. CONCLUSION Adalimumab, especially with concomitant use of MTX, provided significant improvement in disease activity, without any unexpected ADRs in Japanese RA patients.
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Affiliation(s)
- Takao Koike
- NTT Sapporo Medical Center , Sapporo Hokkaido , Japan
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Yamanaka H. [108th Scientific Meeting of the Japanese Society of Internal medicine: invited lecture: 5. IORRA, a large cohort study for rheumatoid arthritis in Japan]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2011; 100:2447-2463. [PMID: 22117333 DOI: 10.2169/naika.100.2447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Hisashi Yamanaka
- Institute of Rheumatology, Tokyo Women's Medical University, Japan
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