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Kojima M, Sugihara T, Kawahito Y, Kojima T, Kaneko Y, Ishikawa H, Abe A, Matsui K, Hirata S, Kishimoto M, Tanaka E, Morinobu A, Hashimoto M, Matsushita I, Hidaka T, Matsui T, Nishida K, Asai S, Ito H, Harada R, Harigai M. Consensus statement on the management of late-onset rheumatoid arthritis. Mod Rheumatol 2024:roae011. [PMID: 38511322 DOI: 10.1093/mr/roae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/08/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVES Late-onset rheumatoid arthritis (LORA), which has been increasing in recent years, lacks evidence for initial treatment. Japanese rheumatology experts recognized this gap and addressed it by developing consensus statements on the first clinical application of LORA. METHODS These statements were created following an introductory discussion about treatment fundamentals, which included a review of existing literature and cohort data. The steering committee created a draft, which was refined using a modified Delphi method that involved panel members reaching a consensus. The panel made decisions based on input from geriatric experts, clinical epidemiologists, guideline developers, patient groups, and the LORA Research Subcommittee of the Japan College of Rheumatology. RESULTS The consensus identified four established facts, three basic approaches, and six expert opinions for managing LORA. Methotrexate was recommended as the primary treatment, with molecular-targeted agents being considered if treatment goals cannot be achieved. An emphasis was placed on assessing the lives of older patients due to challenges in risk management and methotrexate accessibility caused by comorbidities or cognitive decline. CONCLUSIONS The experts substantiated and refined 13 statements for the initial treatment of LORA. To validate these claims, the next is to conduct a registry study focusing on new LORA cases.
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Affiliation(s)
- Masayo Kojima
- Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
- Department of Frailty Research, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Takahiko Sugihara
- Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo, Japan
| | - Yutaka Kawahito
- Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toshihisa Kojima
- Department of Orthopedic Surgery, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yuko Kaneko
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hajime Ishikawa
- Department of Rheumatology, Niigata Rheumatic Center, Shibata, Niigata, Japan
| | - Asami Abe
- Department of Rheumatology, Niigata Rheumatic Center, Shibata, Niigata, Japan
| | - Kazuo Matsui
- Department of Rheumatology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Shintaro Hirata
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
| | - Mitsumasa Kishimoto
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Eiichi Tanaka
- Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Motomu Hashimoto
- Department of Clinical Immunology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Isao Matsushita
- Department of Rehabilitation Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Toshihiko Hidaka
- Institute of Rheumatology, Miyazaki-Zenjinkai Hospital, Miyazaki, Japan
| | - Toshihiro Matsui
- Department of Rheumatology Research, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
| | | | - Shuji Asai
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiromu Ito
- Department of Orthopedic Surgery, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
| | - Ryozo Harada
- Department of Orthopaedic Surgery, Kurashiki Sweet Hospital, Kurashiki, Okayama, Japan
| | - Masayoshi Harigai
- Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
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Noda T, Nochioka K, Kaikita K, Akao M, Ako J, Matoba T, Nakamura M, Miyauchi K, Hagiwara N, Kimura K, Hirayama A, Matsui K, Ogawa H, Yasuda S. Antithrombotic monotherapy for stable coronary artery disease and atrial fibrillation patients with and without prior coronary artery revascularization: Insights from the AFIRE trial. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): The Japan Cardiovascular Research Foundation under a contract with Bayer Yakuhin
Background
The AFIRE (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease) trial demonstrated that rivaroxaban monotherapy was noninferior to combination therapy with rivaroxaban plus a single antiplatelet therapy regarding efficacy and superior for safety endpoints in patients with atrial fibrillation and stable coronary artery disease including patients not requiring revascularization [prior percutaneous coronary intervention (PCI) or bypass grafting (CABG)].
Purpose
The aim of this post-hoc subgroup analysis was to investigate the efficacy and safety of rivaroxaban monotherapy compared to combination therapy in patients with and without prior revascularization.
Methods
Among 2,215 patients included in the modified intention-to-treat analysis in the AFIRE trial, 1445 patients (65.2%) had undergone previous PCI alone, and 252 (11.4%) had undergone previous CABG. The remaining 518 patients (23.4%) was categorized as a group without prior revascularization and then compared with a group with prior revascularization (PCI or CABG). The primary efficacy end point was a composite of stroke, systemic embolism, myocardial infarction, unstable angina requiring revascularization, or death from any cause. The primary safety end point was major bleeding, according to the criteria of the International Society on Thrombosis and Hemostasis.
Results
In 1697 patients with prior revascularization, efficacy and safety endpoints of rivaroxaban monotherapy were superior to combination therapy (efficacy: HR 0.62, 95%CI 0.45-0.85, p=0.003; safety: HR 0.62, 95%CI 0.39-0.98, p=0.040), whereas there were no significant differences in efficacy and safety endpoints among 518 patients without prior revascularization (efficacy: HR 1.19, 95%CI 0.67-2.11, p=0.553; safety: HR 0.47, 95%CI 0.18-1.26, p=0.125). There was a borderline interaction of efficacy endpoint (P for interaction=0.055) by randomized treatment assignment (Figure 1 and Figure 2). Compared with combination therapy, the safety benefit of rivaroxaban monotherapy on any bleeding was significant in patients without prior revascularization (HR 0.59, 95%CI 0.38-0.93, p=0.022).
Conclusions
In patients with prior PCI or CABG, rivaroxaban monotherapy resulted in more favorable safety and efficacy outcomes than combination therapy. There was a borderline interaction for primary efficacy outcome between prior revascularization and anti-thrombotic therapy.
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Affiliation(s)
- T Noda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine , Sendai , Japan
| | - K Nochioka
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine , Sendai , Japan
| | - K Kaikita
- University of Miyazaki, Faculty of Medicine, Division of Cardiovascular Medicine and Nephrology, Department of Internal Medi , Miyazaki , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Department of Cardiology , Kyoto , Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
| | - T Matoba
- Kyushu University Faculty of Medical Sciences, Department of Cardiovascular Medicine , Fukuoka , Japan
| | - M Nakamura
- Toho University Ohashi Medical Center, Division of Cardiovascular Medicine , Tokyo , Japan
| | - K Miyauchi
- Juntendo Tokyo Koto Geriatric Medical Center, Department of Cardiovascular Medicine , Tokyo , Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Department of Cardiology , Tokyo , Japan
| | - K Kimura
- Yokohama City University Medical Center, Cardiovascular Center , Yokohama , Japan
| | - A Hirayama
- Osaka Police Hospital, Department of Cardiology , Osaka , Japan
| | - K Matsui
- Kumamoto University, Department of General Medicine and Primary Care , Kumamoto , Japan
| | - H Ogawa
- Kumamoto University , Kumamoto , Japan
| | - S Yasuda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine , Sendai , Japan
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3
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Kojima M, Kawahito Y, Sugihara T, Kojima T, Harada R, Hirata S, Hashimoto M, Hidaka T, Ishikawa H, Ito H, Kishimoto M, Kaneko Y, Matsui K, Matsui T, Matsushita I, Morinobu A, Nishida K, Tanaka E, Abe A, Ishitoku M, Asai S, Kida T, Onishi A, Takanashi S, Harigai M. Late-onset rheumatoid arthritis registry study, LORIS study: study protocol and design. BMC Rheumatol 2022; 6:90. [PMID: 36567352 PMCID: PMC9791765 DOI: 10.1186/s41927-022-00322-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/16/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Although drug treatment strategies for rheumatoid arthritis (RA) are relatively well established, there is a paucity of evidence on the treatment in older patients. The purpose of this study is to build a registry for late-onset RA (LORA), which is expected to increase rapidly worldwide. In addition, we aim to propose optimal treatment strategies according to the patient background including frailty, thereby contributing to improving the quality of treatment and daily living in patients with RA. METHODS/DESIGN The LORIS (Late-onset Rheumatoid Arthritis Registry) Study is a prospective nation-wide multicenter observational study of patients with LORA. The inclusion criteria were patients aged ≥ 65 years at onset, meeting 2010 ACR/EULAR classification criteria for RA, and starting either any disease-modifying antirheumatic drugs (DMARDs) in a DMARD-naïve patient or the first biologic/targeted synthetic DMARDs during the study period. Enrollment was started on 11 January, 2022 and will be closed on 31 December, 2023. Patients will undergo a comprehensive baseline assessment including clinical data, medication, cognitive and physical function, psychosocial factors, and frailty. Data will be collected at baseline, Month 3, 6, 12, 18, 24, 36, and summarized descriptively. The factors associated with adverse events and achieving remission will be determined. DISCUSSION A multi-disciplinary panel including patients, rheumatologists, and geriatric specialists will discuss the results and build a consensus regarding the treatment goals of LORA. We expect to provide a broad range of information for evidence-based shared decision making in the treatment of LORA. STUDY REGISTRATION Registered at the UMIN registry (UMIN000046086) on 1 January 2022.
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Affiliation(s)
- Masayo Kojima
- grid.260433.00000 0001 0728 1069Nagoya City University, Kawasumi1, Mizuho, Nagoya, Aichi 466-8601 Japan ,grid.419257.c0000 0004 1791 9005National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu City, Aichi 474-8511 Japan
| | - Yutaka Kawahito
- grid.272458.e0000 0001 0667 4960Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Kyoto Japan
| | - Takahiko Sugihara
- grid.412764.20000 0004 0372 3116Division of Rheumatology and Allergology, St. Marianna University School of Medicine, Kawasaki, Kanagawa Japan
| | - Toshihisa Kojima
- grid.410840.90000 0004 0378 7902Department of Orthopaedic Surgery, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi Japan
| | - Ryozo Harada
- Department of Orthopaedic Surgery, Kurashiki Sweet Hospital, Kurashiki, Okayama Japan
| | - Shintaro Hirata
- grid.470097.d0000 0004 0618 7953Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Hiroshima Japan
| | - Motomu Hashimoto
- grid.258799.80000 0004 0372 2033Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Osaka Japan
| | | | - Hajime Ishikawa
- Department of Rheumatology, Niigata Rheumatic Center, Shibata, Niigata Japan
| | - Hiromu Ito
- grid.415565.60000 0001 0688 6269Kurashiki Central Hospital, Kurashiki, Okayama Japan
| | - Mitsumasa Kishimoto
- grid.411205.30000 0000 9340 2869Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Mitaka, Tokyo Japan
| | - Yuko Kaneko
- grid.26091.3c0000 0004 1936 9959Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Matsui
- grid.416933.a0000 0004 0569 2202Department of Rheumatology, Teine Keijinkai Hospital, Sapporo, Hokkaido Japan
| | - Toshihiro Matsui
- grid.415689.70000 0004 0642 7451Department of Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Kanagawa Japan
| | - Isao Matsushita
- grid.411998.c0000 0001 0265 5359Department of Rehabilitation Medicine, Kanazawa Medical University, Kanazawa, Ishikawa Japan
| | - Akio Morinobu
- grid.258799.80000 0004 0372 2033Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Keiichiro Nishida
- grid.261356.50000 0001 1302 4472Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama Japan
| | - Eiichi Tanaka
- grid.410818.40000 0001 0720 6587Division of Rheumatology, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan
| | - Asami Abe
- Department of Rheumatology, Niigata Rheumatic Center, Shibata, Niigata Japan
| | - Michinori Ishitoku
- grid.27476.300000 0001 0943 978XDepartment of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi Japan
| | - Shuji Asai
- grid.470097.d0000 0004 0618 7953Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Hiroshima Japan
| | - Takashi Kida
- grid.272458.e0000 0001 0667 4960Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Kyoto Japan
| | - Akira Onishi
- grid.258799.80000 0004 0372 2033Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Kyoto Japan
| | - Satoshi Takanashi
- grid.26091.3c0000 0004 1936 9959Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masayoshi Harigai
- grid.410818.40000 0001 0720 6587Division of Rheumatology, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan
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Grayson PC, Ponte C, Suppiah R, Robson JC, Gribbons KB, Judge A, Craven A, Khalid S, Hutchings A, Danda D, Luqmani RA, Watts RA, Merkel PA, Hill C, Ranganathan D, Kronbichler A, Blockmans D, Barra L, Carette S, Pagnoux C, Dhindsa N, Fifi‐Mah A, Khalidi N, Liang P, Milman N, Pineau C, Tian X, Wang G, Wang T, Zhao M, Tesar V, Baslund B, Hammam N, Shahin A, Pirila L, Putaala J, Hellmich B, Henes J, Holle J, Lamprecht P, Moosig F, Neumann T, Schmidt W, Sunderkoettey C, Szekanecz Z, Danda D, Das S, Gupta R, Rajasekhar L, Sharma A, Wagh S, Clarkson M, Molloy E, Salvarani C, Schiavon F, Tombetti E, Vaglio A, Amano K, Arimura Y, Dobashi H, Fujimoto S, Harigai M, Hirano F, Hirahashi J, Honma S, Kawakami T, Kobayashi S, Kono H, Makino H, Matsui K, Muso E, Suzuki K, Ikeda K, Takeuchi T, Tsukamoto T, Uchida S, Wada T, Yamada H, Yamagata K, Yumura W, Lai KS, Flores‐Suarez LF, Hinojosa‐Azaola A, Rutgers B, Tak P, Grainger R, Quincey V, Stamp L, Suppiah R, Besada E, Diamantopoulos A, Sznajd J, Azevedo E, Geraldes R, Rodrigues M, Santos E, Song Y, Moiseev S, Hočevar A, Cid MC, Moreno XS, Atukorala I, Berglin E, Mohammed A, Segelmark M, Daikeler T, Direskeneli H, Hatemi G, Kamali S, Karadağ Ö, Pehlevan S, Adler M, Basu N, Bruce I, Chakravarty K, Dasgupta B, Flossmann O, Gendi N, Hassan A, Hoyles R, Jayne D, Jones C, Klocke R, Lanyon P, Laversuch C, Luqmani R, Robson J, Magliano M, Mason J, Maw WW, McInnes I, Mclaren J, Morgan M, Morgan A, Mukhtyar C, O'Riordan E, Patel S, Peall A, Robson J, Venkatachalam S, Vermaak E, Menon A, Watts R, Yee C, Albert D, Calabrese L, Chung S, Forbess L, Gaffo A, Gewurz‐Singer O, Grayson P, Liang K, Matteson E, Merkel PA, Rhee R, Springer J, Sreih A. 2022 American College of Rheumatology/EULAR Classification Criteria for Takayasu Arteritis. Arthritis Rheumatol 2022; 74:1872-1880. [PMID: 36349501 DOI: 10.1002/art.42324] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/05/2022] [Accepted: 07/30/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To develop and validate new classification criteria for Takayasu arteritis (TAK). METHODS Patients with vasculitis or comparator diseases were recruited into an international cohort. The study proceeded in 6 phases: 1) identification of candidate criteria items, 2) collection of candidate items present at diagnosis, 3) expert panel review of cases, 4) data-driven reduction of candidate items, 5) derivation of a points-based classification score in a development data set, and 6) validation in an independent data set. RESULTS The development data set consisted of 316 cases of TAK and 323 comparators. The validation data set consisted of an additional 146 cases of TAK and 127 comparators. Age ≤60 years at diagnosis and imaging evidence of large-vessel vasculitis were absolute requirements to classify a patient as having TAK. The final criteria items and weights were as follows: female sex (+1), angina (+2), limb claudication (+2), arterial bruit (+2), reduced upper extremity pulse (+2), reduced pulse or tenderness of a carotid artery (+2), blood pressure difference between arms of ≥20 mm Hg (+1), number of affected arterial territories (+1 to +3), paired artery involvement (+1), and abdominal aorta plus renal or mesenteric involvement (+3). A patient could be classified as having TAK with a cumulative score of ≥5 points. When these criteria were tested in the validation data set, the model area under the curve was 0.97 (95% confidence interval [95% CI] 0.94-0.99) with a sensitivity of 93.8% (95% CI 88.6-97.1%) and specificity of 99.2% (95% CI 96.7-100.0%). CONCLUSION The 2022 American College of Rheumatology/EULAR classification criteria for TAK are now validated for use in research.
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Affiliation(s)
- Peter C Grayson
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Cristina Ponte
- Department of Rheumatology, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal, and Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Acadámico de Medicina de Lisboa, Lisbon, Portugal
| | - Ravi Suppiah
- Te Whatu Ora - Health New Zealand, Auckland, New Zealand
| | - Joanna C Robson
- Centre for Health and Clinical Research, University of the West of England, and Rheumatology Department, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Katherine Bates Gribbons
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Andrew Judge
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK, Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK, and National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Anthea Craven
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Sara Khalid
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Andrew Hutchings
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Debashish Danda
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Raashid A Luqmani
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Richard A Watts
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK, and Norwich Medical School, University of East Anglia, Norwich, UK
| | - Peter A Merkel
- Division of Rheumatology, Department of Medicine, and Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia
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Phong VH, Nishimura S, Lorusso G, Davinson T, Estrade A, Hall O, Kawano T, Liu J, Montes F, Nishimura N, Grzywacz R, Rykaczewski KP, Agramunt J, Ahn DS, Algora A, Allmond JM, Baba H, Bae S, Brewer NT, Bruno CG, Caballero-Folch R, Calviño F, Coleman-Smith PJ, Cortes G, Dillmann I, Domingo-Pardo C, Fijalkowska A, Fukuda N, Go S, Griffin CJ, Ha J, Harkness-Brennan LJ, Isobe T, Kahl D, Khiem LH, Kiss GG, Korgul A, Kubono S, Labiche M, Lazarus I, Liang J, Liu Z, Matsui K, Miernik K, Moon B, Morales AI, Morrall P, Nepal N, Page RD, Piersa-Siłkowska M, Pucknell VFE, Rasco BC, Rubio B, Sakurai H, Shimizu Y, Stracener DW, Sumikama T, Suzuki H, Tain JL, Takeda H, Tarifeño-Saldivia A, Tolosa-Delgado A, Wolińska-Cichocka M, Woods PJ, Yokoyama R. β-Delayed One and Two Neutron Emission Probabilities Southeast of ^{132}Sn and the Odd-Even Systematics in r-Process Nuclide Abundances. Phys Rev Lett 2022; 129:172701. [PMID: 36332266 DOI: 10.1103/physrevlett.129.172701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/30/2022] [Accepted: 08/25/2022] [Indexed: 06/16/2023]
Abstract
The β-delayed one- and two-neutron emission probabilities (P_{1n} and P_{2n}) of 20 neutron-rich nuclei with N≥82 have been measured at the RIBF facility of the RIKEN Nishina Center. P_{1n} of ^{130,131}Ag, ^{133,134}Cd, ^{135,136}In, and ^{138,139}Sn were determined for the first time, and stringent upper limits were placed on P_{2n} for nearly all cases. β-delayed two-neutron emission (β2n) was unambiguously identified in ^{133}Cd and ^{135,136}In, and their P_{2n} were measured. Weak β2n was also detected from ^{137,138}Sn. Our results highlight the effect of the N=82 and Z=50 shell closures on β-delayed neutron emission probability and provide stringent benchmarks for newly developed macroscopic-microscopic and self-consistent global models with the inclusion of a statistical treatment of neutron and γ emission. The impact of our measurements on r-process nucleosynthesis was studied in a neutron star merger scenario. Our P_{1n} and P_{2n} have a direct impact on the odd-even staggering of the final abundance, improving the agreement between calculated and observed Solar System abundances. The odd isotope fraction of Ba in r-process-enhanced (r-II) stars is also better reproduced using our new data.
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Affiliation(s)
- V H Phong
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- University of Science, Vietnam National University, Hanoi 120062, Vietnam
| | - S Nishimura
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - G Lorusso
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - T Davinson
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - A Estrade
- Department of Physics, Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - O Hall
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - T Kawano
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Liu
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Hong Kong, Pokfulman Road, Hong Kong
| | - F Montes
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - N Nishimura
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Astrophysical Big-Bang Laboratory, Cluster for Pioneering Research, RIKEN, Wako, Saitama 351-0198, Japan
| | - R Grzywacz
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - K P Rykaczewski
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Agramunt
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - D S Ahn
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Center for Exotic Nuclear Studies, Institute for Basic Science, Daejeon 34126, Republic of Korea
| | - A Algora
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - J M Allmond
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - H Baba
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - S Bae
- Center for Exotic Nuclear Studies, Institute for Basic Science, Daejeon 34126, Republic of Korea
| | - N T Brewer
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - C G Bruno
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | | | - F Calviño
- Universitat Politecnica de Catalunya, E-08028 Barcelona, Spain
| | - P J Coleman-Smith
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - G Cortes
- Universitat Politecnica de Catalunya, E-08028 Barcelona, Spain
| | - I Dillmann
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - C Domingo-Pardo
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - A Fijalkowska
- Faculty of Physics, University of Warsaw, PL02-093 Warsaw, Poland
| | - N Fukuda
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - S Go
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - C J Griffin
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - J Ha
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Seoul National University, Department of Physics and Astronomy, Seoul 08826, Republic of Korea
| | - L J Harkness-Brennan
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - T Isobe
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - D Kahl
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
- Extreme Light Infrastructure-Nuclear Physics, Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 077125 Bucharest-Măgurele, Romania
| | - L H Khiem
- Institute of Physics, Vietnam Academy of Science and Technology, Ba Dinh, 118011 Hanoi, Vietnam
- Graduate University of Science and Technology, Vietnam Academy of Science and Technology, Cau Giay, 122102 Hanoi, Vietnam
| | - G G Kiss
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Institute for Nuclear Research (Atomki), Debrecen H4032, Hungary
| | - A Korgul
- Faculty of Physics, University of Warsaw, PL02-093 Warsaw, Poland
| | - S Kubono
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - M Labiche
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - I Lazarus
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - J Liang
- McMaster University, Department of Physics and Astronomy, Hamilton, Ontario L8S 4M1, Canada
| | - Z Liu
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - K Matsui
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- University of Tokyo, Department of Physics, Tokyo 113-0033, Japan
| | - K Miernik
- Faculty of Physics, University of Warsaw, PL02-093 Warsaw, Poland
| | - B Moon
- Center for Exotic Nuclear Studies, Institute for Basic Science, Daejeon 34126, Republic of Korea
| | - A I Morales
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - P Morrall
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - N Nepal
- Department of Physics, Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - R D Page
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | | | - V F E Pucknell
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - B C Rasco
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B Rubio
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - H Sakurai
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- University of Tokyo, Department of Physics, Tokyo 113-0033, Japan
| | - Y Shimizu
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - D W Stracener
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - T Sumikama
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - H Suzuki
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - J L Tain
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - H Takeda
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - A Tarifeño-Saldivia
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
- Universitat Politecnica de Catalunya, E-08028 Barcelona, Spain
| | - A Tolosa-Delgado
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - M Wolińska-Cichocka
- Heavy Ion Laboratory, University of Warsaw, Pasteura 5A, PL-02-093 Warsaw, Poland
| | - P J Woods
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - R Yokoyama
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Center for Nuclear Study, University of Tokyo, RIKEN Campus, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
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Wada H, Miyauchi KM, Yasuda SY, Kaikita KK, Akao MA, Ako JA, Matoba TM, Nakamura MN, Hagiwara NH, Kimura KK, Hirayama AH, Matsui K, Ogawa HO. Antithrombotic and proton pump inhibitor co-therapy in patients with atrial fibrillation and stable coronary disease: a post hoc analysis of the AFIRE trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Among patients with atrial fibrillation (AF) and stable coronary artery disease, bleeding events increased the cardiovascular events and mortality. We aimed to evaluate the effect of proton pump inhibitor (PPI) on the risk of bleeding events in these patients.
Methods
In the AFIRE (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease), patients with non-valvular AF and coronary artery disease were recruited and randomized to receive the rivaroxaban monotherapy or combination therapy with rivaroxaban plus antiplatelet drug. The present sub-analysis evaluated the risks of any bleeding events.
Results
Among 2,225 patients, 1,357 (61.3%) were receiving a PPI at baseline. During follow-up, 384 bleeding events were occurred, and incidence of bleeding events were significantly lower in patients with PPI compared with those without PPI (p=0.03). Among combination therapy with rivaroxaban plus antiplatelet, effect of PPI for cumulative incidence of bleeding events were significantly different between groups (p=0.01), however, these differences were not shown among rivaroxaban monotherapy patients (p=0.50, Figure 1). Multivariate Cox hazard analysis showed that PPI use had significantly lower risk of bleeding events (hazard risk 0.79, 95% confidence interval 0.64–0.97, p=0.03). In addition to PPI, male, heart failure and combination therapy with rivaroxaban plus antiplatelet drug were independent predictors of bleeding events.
Conclusions
PPI use was significantly associated with lower risk of bleeding events among patients with AF and stable coronary artery disease. Especially, for patients at high bleeding risk, such as receiving both anticoagulant and antiplatelet drugs, PPI is useful to reduce bleeding events.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): The Japan Cardiovascular Foundation through a contract with Bayer Yakuhin.
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Affiliation(s)
- H Wada
- Juntendo University Shizuoka Hospital , Izunokuni , Japan
| | - K M Miyauchi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine , Tokyo , Japan
| | | | | | - M A Akao
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - J A Ako
- Kitasato University School of Medicine , Sagamihara , Japan
| | | | - M N Nakamura
- Toho University Ohashi Medical Center , Tokyo , Japan
| | - N H Hagiwara
- Tokyo Women's Medical University , Tokyo , Japan
| | - K K Kimura
- Yokohama City University Medical Center , Yokohama , Japan
| | | | - K Matsui
- Kumamoto University , Kumamoto , Japan
| | - H O Ogawa
- National Cerebral & Cardiovascular Center , Suita , Japan
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Ishii M, Kaikita K, Yasuda S, Akao M, Ako J, Matoba T, Nakamura M, Miyauchi K, Hagiwara N, Kimura K, Hirayama A, Matsui K, Ogawa H, Tsujita K. Effect of rivaroxaban monotherapy vs. combination with anti-platelet therapy in patients with atrial fibrillation and stable coronary artery disease across different body mass index categories. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The AFIRE (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease) trial showed both noninferiority for efficacy and superiority for safety endpoints of rivaroxaban monotherapy compared to rivaroxaban plus antiplatelet therapy (combination therapy) in patients with atrial fibrillation (AF) and stable coronary artery disease (CAD). However, no accumulating evidence regarding efficacy and safety of these fixed-dose direct oral anticoagulant therapy was available in underweight and obese patients.
Purpose
The aim of this post-hoc analysis of the AFIRE trial was to evaluate outcomes of rivaroxaban monotherapy (vs. combination therapy) in patients with AF and stable CAD across body mass index (BMI) categories.
Methods
Patients were categorized into groups 1 (underweight: BMI of <18.5 kg/m2), 2 (normal: BMI of 18.5 to <25 kg/m2), 3 (overweight: BMI of 25 to <30 kg/m2), and 4 (obesity: BMI of ≥30 kg/m2). Efficacy (a composite of all-cause death, myocardial infarction, unstable angina requiring revascularization, stroke, or systemic embolism) and safety (major bleeding defined according to International Society on Thrombosis and Haemostasis criteria) were compared between rivaroxaban monotherapy and combination therapy across BMI categories.
Results
We analyzed 2,054 patients with a median age of 75.0 (interquartile range [IQR], 69 to 80)) years old and CHA2DS2-VASc of 4 (IQR, 3 to 5). Group 1 through 4 included 72 (3.5%), 1,158 (56.4%), 680 (33.1%), 144 (7.0%) patients and 62.3%, 52.3%, 36.2%, and 30.3% were received reduced dose of rivaroxaban, respectively. Although the sample sizes for group 1 and 4 were limited, monotherapy was superior to combination therapy for efficacy in group 2 (hazard ratio [HR], 0.64; 95% CI, 0.44 to 0.95) and safety in group 3 (HR, 0.25; 95% CI, 0.10 to 0.62), whereas a significant difference in the endpoints was not observed in the other BMI categories. Impact of monotherapy on endpoints did not have a significant interaction in BMI.
Conclusions
Rivaroxaban monotherapy had similar effect on prognosis across all BMI categories in patients with AF and stable CAD.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The Japan Cardiovascular Research Foundation based on a contract with Bayer Yakuhin, Ltd
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Affiliation(s)
- M Ishii
- Kumamoto University Hospital , Kumamoto , Japan
| | - K Kaikita
- University of Miyazaki , Miyazaki , Japan
| | - S Yasuda
- Tohoku University , Sendai , Japan
| | - M Akao
- Kyoto Medical Centre , Kyoto , Japan
| | - J Ako
- Kitasato University School of Medicine , Sagamihara , Japan
| | - T Matoba
- Kyushu University , Fukuoka , Japan
| | - M Nakamura
- Toho University Ohashi Medical Center , Tokyo , Japan
| | - K Miyauchi
- Juntendo University School of Medicine , Tokyo , Japan
| | - N Hagiwara
- Tokyo Women's Medical University , Tokyo , Japan
| | - K Kimura
- Yokohama City University Medical Center , Yokohama , Japan
| | | | - K Matsui
- Kumamoto University Hospital , Kumamoto , Japan
| | - H Ogawa
- Kumamoto University , Kumamoto , Japan
| | - K Tsujita
- Kumamoto University Hospital , Kumamoto , Japan
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Yoshikawa T, Furukawa T, Hashimoto T, Morimoto M, Azuma N, Matsui K. AB0401 THE BASELINE SERUM SOLUBLE TNF RECEPTOR LEVELS ARE ASSOCIATED WITH THE RESPONSE OF RHEUMATOID ARTHRITIS PATIENTS TO JAKinibs. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundRheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the multiple joints.The elucidation of the pathogenesis of RA has progressed dramatically in recent decades, and among the many cytokines involved in the pathogenesis of RA, interleukin (IL)-6 and TNF-α are known to be the major pro-inflammatory cytokines that are abundant in the bloodstream and synovial tissue. JAK inhibitors (JAKinibs) such as tofacitinib and baricitinib are used in the treatment of RA by inhibiting JAK, which in turn inhibits the signaling of various cytokines including IL-6. However, predictors of the response to JAKinibs are still required.ObjectivesWe aimed to combine soluble TNF receptor (sTNFR) I, sTNFR II, IL-6, soluble IL-6R (sIL-6R) and soluble gp130 (sgp130) levels to identify groups of JAKinibs responses in RA patients.MethodsThis research is a retrospective study. We reviewed medical records of RA patients initiating JAKinibs between July 2013 and July 2021 in our hospital. The Simplified Disease Activity Index (SDAI) was evaluated at baseline and 3, 6 months after JAKinibs administration. Clinical remission was defined when SDAI decreased ≤ 3.3. Of the 125 patients treated with JAKinibs, 89 patients with 6 months follow-up, valid SDAI and serum available were enrolled. Serum samples were tested for IL-6 (Human IL-6 Quantikine ELISA Kit, R&D systems), sIL-6R (Human soluble IL-6R alpha Quantikine ELISA Kit, R&D systems) and sgp130 (Human soluble gp130 Quantikine ELISA Kit, R&D systems), sTNFR I (Human TNF RI/TNFRSF1A Quantikine ELISA Kit DRT100) and sTNFR II (Human sTNF RII/TNFRSF1B Quantikine ELISA Kit DRT200) using specific ELISAs according to the manufacturer’s instructions. The statistical analyses were performed with EZR 1.55, and p values less than 0.05 were considered significant.ResultsThe median age of patients was 62 (IQR: 51 - 72) years and the median of disease duration was 6.0 (2.0 - 16.0) years. Twenty-seven (30.3%) patients were biologics and Jakinibs naive. The baseline SDAI was median 18.9 (12.7 - 27.9). When comparing SDAI-remission group (clinical remission: CR) and non-remission group, there were no significant differences in any of the baseline clinical parameters. There was no significant difference in the serum levels of IL-6, sIL-6R and sgp130 between the CR and non-CR groups, but the serum levels of sTNFR I and sTNFR II in the CR group were significantly lower than non-CR group. Univariate logistic regression analysis suggested Biologics and JAKinibs naive (odds ratio (OR) 3.58, p = 0.015), baseline Log sTNFR II levels (OR 0.013, P=0.034) as predictors of SDAI remission treated with JAKinibs at 6 months. Although not significant, Stage IV (OR 0.211, P=0.082) and baseline Log sTNFR I serum levels (OR 0.013, P=0.065) were associated with clinical remission.ConclusionRA patients could be easily stratified prior to JAKinibs intervention with serum sTNFR II and sTNFR I levels, not but IL-6 axis cytokines (IL-6, sIL-6R and sgp130).Univariate logistic regression analysis for clinical remission in patients treated with JAKinibs. Odds Ratio[95% C.I.]P ValueAge, year0.973[0.942 - 1.010]0.104Female (%)0.820[0.231 - 2.910]0.759BMI0.968[0.847 - 1.110]0.627Duration, year0.952[0.897 - 1.010]0.110StageIreferrenceII0.857[0.218 - 3.370]0.825III0.444[0.072 - 2.740]0.382IV0.211[0.036 - 1.220]0.082Biologic/JAKi naïve3.580[1.280 - 9.950]0.015JAKi Drug-Baricitinibreferrence-Tofacitinib1.780[0.659 - 4.800]0.256MTX use1.640[0.532 - 5.30]0.390PSL use0.476[0.176 - 1.290]0.143SASP use0.783[0.268 - 2.290]0.654IGU use0.328[0.039 - 2.750]0.304BUC use0.436[0.051 - 3.760]0.450TAC use0.233[0.029 - 1.910]0.1750W IL-6, pg/mL0.991[0.977 - 1.000]0.1980W sIL-6R, ng/mL0.983[0.947 - 1.02]0.3690W sgp130, ng/mL0.998[0.994 - 1.000]0.4440W sTNFR II/I ratio0.808[0.222 - 2.940]0.7460W Log sTNFR II, pg/mL0.002[0.0000653 - 0.634]0.0340W Log sTNFR I, pg/mL0.013[0.000126 - 1.300]0.065Disclosure of InterestsNone declared
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Yoshikawa T, Azuma K, Furukawa T, Hashimoto T, Morimoto M, Azuma N, Matsui K. AB0362 NEUTROPHIL COUNT REDUCTION 1 MONTH AFTER INITIATING SARILUMAB AND BASELINE SERUM SOLUBLE gp130 LEVELS CAN INDEPENDENTLY PREDICT CLINICAL REMISSION WITHIN 3 MONTH IN RHEUMATOID ARTHRITIS PATIENTS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundIL-6 contributes significantly to the chronic inflammatory process of rheumatoid arthritis (RA) and is elevated in serum and synovial fluid of RA patients.Sarilumab (SRL), a human anti-human IL-6 receptor alpha monoclonal antibody that blocks the signaling originated by the IL-6/IL-6R complex like tocilizumab (TCZ),is an effective treatment. Recently, an association between the therapeutic effect of TCZ and neutropenia after TCZ initiation was reported[1]. Neutropenia is a common adverse event of SRL in patients with RA, but the relationship between reduced neutrophil count and clinical response to SRL is still inconclusive. In EULAR 2020, we reported the association between serum soluble gp130 levels before SRL treatment and the efficacy of SRL[2]. It is also unclear whether there is a relationship between IL-6 axis cytokines and SRL-induced neutropenia.ObjectivesThe purpose of this study was to determine whether neutropenia at 1 month by SRL predicts clinical remission within 3 months and whether there is an association between IL-6 axis cytokines levels and SRL-induced neutropenia.MethodsThis research is a retrospective study. We reviewed medical records of RA patients initiating SRL between February 2018 and August 2021 in our hospital. The Clinical Disease Activity Index (CDAI) was evaluated at baseline (before initiating SRL) and 3 months after administration. Clinical remission was defined when CDAI decreased ≤ 2.8. Of the 66 patients treated with SRL, 42 patients with 3 months follow-up, valid CDAI and serum available were enrolled. The ratio of neutrophil counts 1 month after initiating SRL to those at baseline (neutrophil ratio) was also calculated. Serum samples were tested for IL-6 (Human IL-6 Quantikine ELISA Kit, R&D systems), sIL-6R (Human soluble IL-6R alpha Quantikine ELISA Kit, R&D systems) and sgp130 (Human soluble gp130 Quantikine ELISA Kit, R&D systems) using specific ELISAs according to the manufacturer’s instructions. The statistical analyses were performed with EZR 1.55, and p values less than 0.05 were considered significant.ResultsThe median age of patients was 69.0 (IQR: 59.3 - 73.8) years and the median of disease duration was 9.0 (3.0 - 16.0) years. Eighteen (42.9%) patients were biologics and Jakinibs naive. The baseline CDAI was median 16.7 (11.5 - 25.8). When comparing CDAI-remission group (clinical remission: CR) and non-CR group, Patients in the CR group had significantly shorter disease duration, were more Biologic and JAKinib naive, and had greater neutropenia 1 month after starting SRL (0.71 vs 0.94, P=0.0252). There was no significant difference in the baseline serum levels of IL-6, sIL-6R between the CR and non-CR groups, but baseline serum sgp130 levels in the CR group tended to be higher than in the non-CR group (264.9 vs 234.2 ng/mL, P=0.0592). Univariate logistic regression analysis suggested Biologics and JAKinibs naive (odds ratio (OR) 6.68, p = 0.0317), baseline serum sgp130 levels (OR 8.608, P=0.0312) as predictors of CDAI remission treated with SRL at 3 months. Although not significant, neutrophil ratio ≤ 0.8 was associated with achieving remission (OR 6.67, P=0.0537). Univariate logistic regression for neutrophil ratio ≤ 0.8 did not show any relevant factors, including higher baseline serum sgp130 levels (OR 1.25, P=0.782).ConclusionA 20% or greater decrease in neutrophil count after 1 month of SRL treatment and a high baseline serum sgp130 level independently predict clinical remission within 3 months.References[1]Nakajima T, Watanabe R, Hashimoto M, Murata K, Murakami K, Tanaka M, et al. Neutrophil count reduction 1 month after initiating tocilizumab can predict clinical remission within 1 year in rheumatoid arthritis patients. Rheumatol Int. 2021;1rin[2]Yoshikawa T, Furukawa T, Tamura M, Hashimoto T, Morimoto M, Azuma N, et al. FRI0113 THE BASELINE SOLUBLE GP130 IS ASSOCIATED WITH THE RESPONSE OF RHEUMATOID ARTHRITIS PATIENTS TO SARILUMAB. Ann Rheum Dis. 2020;79(Suppl 1):637.1-637.Disclosure of InterestsNone declared
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Shimojima Y, Kishida D, Ichikawa T, Kida T, Yajima N, Omura S, Nakagomi D, Abe Y, Masatoshi K, Takizawa N, Nomura A, Kukida Y, Kondo N, Yasuhiko Y, Yanagida T, Endo K, Hirata S, Kawahata K, Matsui K, Takeuchi T, Ichinose K, Kato M, Yanai R, Matsuo Y, Yamasaki A, Nishioka R, Takata T, Moriyama M, Takatani A, Ito T, Miyawaki Y, Ito-Ihara T, Kawaguchi T, Kawahito Y, Sekijima Y. POS0822 HYPERTROPHIC PACHYMENINGITIS IN ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS: A MULTICENTER SURVEY IN JAPAN. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundHypertrophic pachymeningitis (HP), characterized by an inflammatory disorder indicating intracranial or spinal thickening of dura mater, is found to develop as a neurological involvement in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Meanwhile, the previous studies focusing on HP in AAV have been reported as a single-institution study, and the analyses were performed in a small number of patients because HP is a rare neurological disorder. Therefore, neither etiological nor clinical characteristics of HP in AAV have been adequately elucidated.ObjectivesThis study clarified the characteristics of HP in AAV by analyzing the information of multicenter study in Japan (Japan collaborative registry of ANCA-associated vasculitis: J-CANVAS).MethodsWe analyzed the clinical information from 541 Asian patients with AAV enrolled in J-CANVAS. Of them, newly diagnosed and relapsed AAV were included in 448 and 93, respectively. The epidemiological and clinical findings were compared between patients with and without HP. Clinical manifestations related to AAV were evaluated based on the Birmingham Vasculitis Activity Score version 3. To elucidate independent factors in HP development, logistic regression analyses were additionally performed.ResultsOf the total 541 patients (mean age: 71±14 years, M:F = 1:1.2), HP was demonstrated in 28 (5.17%), including 17 (3.79%) in newly diagnosed AAV and 11 (11.8%) in relapsed AAV. The classification of granulomatosis with polyangiitis (GPA) was significantly higher in patients with HP than those without HP (50% vs. 21%, p = 0.0007). In newly diagnosed AAV, patients with HP significantly had higher GPA classification and higher positivity for PR3-ANCA than those without HP (53% vs. 17%, p = 0.001; 29% vs. 9%, p = 0.015, respectively). Conversely, positivity for MPO-ANCA was significantly higher in patients with HP than those without HP in relapsed AAV (91% vs. 55%, p = 0.025), despite not significantly different in the classification of AAV. Headache and cranial neuropathies were significant neurological symptoms in patients with HP compared to those without HP (82% vs. 6.6%, p < 0.0001; 32% vs. 2.9%, p < 0.0001, respectively). Besides, ear, nose and throat (ENT) and mucous membranes/eyes were significantly higher involvements in patients with HP than in those without HP (54% vs. 26%, p = 0.003; 29% vs. 9%, p = 0.003, respectively). Moreover, higher complications of “conjunctive hearing loss” and “sudden visual loss”, which are included in the categories of ENT and mucous membranes/eyes involvement, respectively, were significantly indicated in patients with HP than those without HP (39% vs. 7.2%, p < 0.0001; 21% vs. 1.2%, p < 0.0001, respectively). Multivariable logistic regression analysis identified that ENT (odds ratio [OR] 1.28, 95% confident interval [CI] 1.09 to 1.49, p = 0.002) and mucous membranes/eyes involvement (OR 1.37, CI 1.14 to 1.65, p = 0.0006), as well as conjunctive hearing loss (OR 4.52, CI 1.56 to 13.05, p = 0.005) and sudden visual loss (OR 1.84, CI 1.12 to 3.00, p = 0.015), were independent related factors in patients with HP.ConclusionGPA could be significantly classified in patients with HP. Notably, patients with HP significantly showed higher positivity for PR3-ANCA than those without HP in newly diagnosed AAV. Furthermore, sudden visual loss and conjunctive hearing loss might be implicated in HP development.Disclosure of InterestsNone declared
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Kawamori K, Oguro N, Kida T, Omura S, Nakagomi D, Masatoshi K, Takizawa N, Nomura A, Yuji K, Kondo N, Yasuhiko Y, Yanagida T, Endo K, Hirata S, Kawahata K, Matsui K, Takeuchi T, Ichinose K, Kato M, Yanai R, Matsuo Y, Shimojima Y, Nishioka R, Yamasaki A, Takata T, Ito T, Moriyama M, Takatani A, Miyawaki Y, Kawahito Y, Ito-Ihara T, Kawaguchi T, Yajima N. AB0625 Association between Cytomegalovirus Reactivation and Renal Prognosis during Remission Induction Therapy for ANCA-Associated Vasculitis. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundCytomegalovirus (CMV) has been associated with atherosclerosis in patients with chronic renal failure, and may cause secondary nephrotic syndrome. Therefore, we hypothesized that the reactivation of CMV by immunosuppressive therapy in patients with vasculitis may affect renal function.ObjectivesThe purpose of this study was to investigate relationships between CMV infection and renal function during ANCA-associated vasculitis remission induction therapy.MethodsThis retrospective cohort study enrolled microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis patients at 25 sites in Japan who had a first or severe relapse between January 2017 and June 2020. Of these, patients with MPA or GPA who had a positive renal lesion score on BVAS (version 3) at baseline, or vasculitis findings on renal biopsy, CMV assayed by 48 weeks of treatment, were included. Patients were divided into two groups based on the presence or absence of a positive CMV antigen test during the remission induction phase (0–48 weeks of treatment). Outcomes were the rate of change in estimated glomerular filtration rate (eGFR) at 48 weeks after initiation of treatment in both groups, as determined by (eGFR at 48 weeks - eGFR at the initiation of treatment)/eGFR at the initiation of treatment; where lower values were associated with worse renal function. General linear models adjusted for age, gender, presence of diabetes or chronic kidney disease, and the use of rituximab or cyclophosphamide were generated.ResultsA total of 387 patients had CMV antigen measured during ANCA-associated vasculitis treatment, of which 164 had renal involvement and eGFR measured at 48 weeks. Seventy-seven (47.0%) were male and the median age was 75 years (range 69–80 years). CMV reactivation was observed in 44 patients (26.8%). The beta coefficient of multiple regression analysis with CMV positive as 1 and negative as 0 was 0.08 (95% confidence interval -0.13 to 0.29) (p = 0.47). The rate of change in eGFR was higher in the CMV positive group, but not statistically significantly.ConclusionContrary to our hypothesis, renal prognoses tended to be better when CMV reactivation was observed. The patients in the CMV reactivation group may have been treated more aggressively, and some patients with a poor prognosis who were not followed up for 48 weeks dropped out. Further research investigating the adjustment of treatment methods is required.Disclosure of InterestsNone declared
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Nishioka R, Mizushima I, Kida T, Omura S, Nakagomi D, Masatoshi K, Takizawa N, Nomura A, Yuji K, Kondo N, Yasuhiko Y, Yanagida T, Endo K, Hirata S, Kawahata K, Matsui K, Takeuchi T, Ichinose K, Kato M, Yanai R, Matsuo Y, Shimojima Y, Yamasaki A, Takata T, Ito T, Moriyama M, Takatani A, Miyawaki Y, Ito-Ihara T, Kawaguchi T, Yajima N, Kawahito Y, Kawano M. POS0247 GLUCOCORTICOID TAPERING STRATEGY FOR ANCA-ASSOCIATED VASCULITIS: ADDRESSING THE GAP BETWEEN RECOMMENDATIONS AND REAL-WORLD PRACTICE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundAntineutrophil cytoplasmic antibody -associated vasculitis (AAV) is usually treated with combination of high-dose glucocorticoid (GC) and immunosuppressive agents, followed by tapering GC dose. Although the European League Against Rheumatism (EULAR) has specific recommendations for tapering the GC dose, clinicians often taper it slower than recommended due to concerns of potential disease relapse. However, such slower taper may prolong GC exposure for the patients, increasing the risk of adverse events, particularly infection.ObjectivesThe aims of our study were (1) to clarify GC dose tapering in the treatment of AAV in a real-world setting, in contrast to the EULAR recommendation of 2015 and (2) to compare the incidence of AAV relapse and severe infection between patients underdoing EULAR-recommended tapering and those undergoing slower tapering than the recommendation.MethodsIn this multicenter (25 sites in Japan), observational, retrospective study of AAV, 541 patients who had initial or severe relapse were enrolled between January 2017 and June 2020. Of these, 349 patients with microscopic polyangiitis (MPA) or granulomatosis with polyangiitis (GPA) who entered in GC tapering phase after successful induction treatment were included. These patients were then grouped on the pace of GC tapering, defined as the GC dose at 12 weeks after treatment initiation: (1) EULAR group: 7.5-10 mg/day of GC, according to the EULAR recommendation of 2015, and (2) SLOWER group: >10 mg/day of GC. Their baseline characteristics and clinical outcomes were compared. Primary outcome was defined as relapse-free days from treatment initiation, whereas secondary outcome included the incidence of infectious events requiring hospitalization within 48 weeks from treatment initiation. Multivariable analysis was performed to assess the relationship between tapering pace and clinical outcomes.ResultsThere were 44 patients (12.6%) in the EULAR group and 290 (83.2%) in the SLOWER group. Regarding baseline characteristics, compared with the EULAR group, the SLOWER group had significantly higher serum C-reactive protein level (EULAR, 5.89 ± 6.89 mg/dL vs SLOWER, 7.56 ± 6.01 mg/dL; p = 0.03), as well as a trend toward higher Birmingham Vasculitis Activity Score (version 3) (EULAR, 11.80 ± 7.01 SLOWER, 13.93 ± 7.06; p = 0.08) We did not observe any significant differences in the frequency of relapses between the two groups (EULAR, 8/44, 18.2% vs SLOWER, 55/290, 19.0%; p = 0.63). Multivariable Cox proportional hazard analysis revealed no relationship GC dose at 12 weeks from treatment initiation and incidence of relapse. However, upon logistic regression analysis, the SLOWER group was found to have significant higher risk of a severe infectious event within 48 weeks from treatment initiation (p = 0.046; hazard ratio, 1.27; 95% confidence interval, 1.004 – 1.601).ConclusionOur finding indicates that clinicians tended to taper GC slower for patients with higher disease activity. However, slower GC taper was not found to reduce the frequency of relapse. In addition, slower GC taper was found to increase the risk of a severe infection. Hence, clinicians should pay attention not only relapsing but also late GC taper resulting in the risk of serious infection, especially in patients with higher disease activity of AAV.References[1]Eur J Clin Invest 2015;45 (3): 346–368.[2]Rheumatology (Oxford). 2021 Dec 24;61(1):205-212.[3]Arthritis Res Ther. 2021 Mar 20;23(1):90.[4]Scand J Rheumatol. 2022 Jan 20;1-13.[5]J Rheumatol. 2018 Apr;45(4):521-528.[6]Rheumatol Adv Pract. 2021 Mar 9;5(3):rkab018.[7]Ann Rheum Dis. 2016 Sep;75(9):1583-94.Figure 1.AcknowledgementsWe would like to thank Editage (www.editage.com) for English language editing.Disclosure of InterestsNone declared
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Azuma N, Matsui K. AB0422 SODIUM BICARBONATE MOUTH RINSE IS A USEFUL SELF-CARE METHOD FOR DRY MOUTH IN PATIENTS WITH SJÖGREN’S SYNDROME. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPatients with Sjögren’s syndrome (SS) present various symptoms related to dry mouth. While hyposalivation is believed to be the main cause, saliva has various beneficial physiological effects on the intraoral environment, and qualitative changes in its composition should also be considered as a cause of the refractory intraoral manifestations in SS. One of the physiological effects of saliva is buffering, and salivary bicarbonate (HCO3-) is the main determinant of salivary buffering capacity. Since salivary concentration of bicarbonate heavily depends on the rate of salivary secretion, salivary buffering capacity and oral pH decrease in patients with dry mouth; this is associated with the development of dental caries and oral candidiasis. It is considered that sodium bicarbonate mouth rinse is effective for suppressing these intraoral disorders. It is also a practical self-care method because it is inexpensive and can be made at home.ObjectivesTo investigate the usability and changes in symptoms associated with dry mouth after use of sodium bicarbonate mouth rinse in SS patients.MethodsThe subjects were 27 SS patients (female: male =24:3, mean age 62.9 years, primary SS: secondary SS =24:3, mean disease duration 12.3 years) who had used sodium bicarbonate mouth rinse (dissolve about 5 g of commercially available baking soda in 500 cc of water in a plastic bottle. Put this sodium bicarbonate water in the mouth and rinse the mouth for 30 seconds to 1 minute so as to reach throughout the oral cavity). We investigated usage status, usability, and changes in subjective symptoms using a questionnaire. During their using the mouth rinse, medication and countermeasures against dry mouth in the daily life continued as usual.ResultsMore than half of the patients had no knowledge of sodium bicarbonate mouth rinse (n=15; 55.6%). Highest frequency of use was twice a day (n=9; 33.3%), and common use situations were before bedtime (n=18; 66.7%), after meals (n=17; 63.0%), and at waking up (n=11; 40.7%). Twenty patients (74.1%) had “very good” or “good” sense of use. Eighteen patients (66.7%) had relief of symptoms related to dry mouth. Pros were “feeling refreshed in the mouth” (n=14; 51.9%), followed by “becomes less sticky” (n=8; 29.6%), “easy to make” (n=7; 25.9%), and “inexpensive” (n=6; 22.2%). Some respondents said they had less glossitis, stomatitis, and angular cheilitis (n=4; 14.8%). For cons “troublesome” was the highest (n=10; 37.0%), followed by responses regarding “taste” (n=6; 22.2%). There were also many responses to “none in particular” (n=7; 25.9%). No obvious accidents occurred, and 20 (74.1%) of them replied that they would like to continue to use the sodium bicarbonate mouth rinse.ConclusionIn addition to the inhibition of dental caries and oral candidiasis, removal of tongue plaque and refreshing feeling in the mouth after rinsing due to its mucolytic effect, reduction of halitosis-causing volatile sulfur compounds, and improvement of gingivitis have been reported as effects of sodium bicarbonate. However, reports on the effects of sodium bicarbonate on dry mouth in SS patients are scarce. These results suggest that sodium bicarbonate mouth rinse is considered to be a useful self-care method that can compensate for the salivary buffering capacity that is impaired in SS patients and may reduce dry mouth symptoms. Since it is easy to continue and safe, it is worth actively incorporating it into the standard treatment for SS. Evaluation in more patients with objective indices is desired in the future.References[1]Gambino A, et al. Gerodontology. 34: 208-214, 2017.Disclosure of InterestsNone declared
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Sugawara E, Matsui K, Amasaki Y. Dr. Sugawara et al reply. J Rheumatol 2022; 49:438. [PMID: 35033997 DOI: 10.3899/jrheum.211178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We sincerely thank Dr. Wang et al for their comments in response to our article, "Cytomegalovirus Enteritis in a Patient with Rheumatoid Arthritis Receiving Baricitinib."1 Our case report had demonstrated increased risk of cytomegalovirus (CMV) infection under the combination therapy of baricitinib and tacrolimus.
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Affiliation(s)
- Eri Sugawara
- Department of Rheumatology, Tonan Hospital, Sapporo, Japan. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. E. Sugawara, 060-0004 N4W7, Chuo-Ku, Sapporo, Japan.
| | - Kazuo Matsui
- Department of Rheumatology, Tonan Hospital, Sapporo, Japan. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. E. Sugawara, 060-0004 N4W7, Chuo-Ku, Sapporo, Japan.
| | - Yoshiharu Amasaki
- Department of Rheumatology, Tonan Hospital, Sapporo, Japan. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. E. Sugawara, 060-0004 N4W7, Chuo-Ku, Sapporo, Japan.
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Ihara Y, Hayashi K, Kanda T, Matsui K, Kindo K, Kohama Y. Nuclear magnetic resonance measurements in dynamically controlled field pulse. Rev Sci Instrum 2021; 92:114709. [PMID: 34852526 DOI: 10.1063/5.0067821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
We present the architecture of the versatile nuclear magnetic resonance (NMR) spectrometer with software-defined radio technology and its application to the dynamically controlled pulsed magnetic fields. The pulse-field technology is the only solution to access magnetic fields greater than 50 T, but the NMR experiment in the pulsed magnetic field was difficult because of the continuously changing field strength. The dynamically controlled field pulse allows us to perform NMR experiment in a quasi-steady field condition by creating a constant magnetic field for a short time around the peak of the field pulse. We confirmed the reproducibility of the field pulses using the NMR spectroscopy as a high precision magnetometer. With the highly reproducible field strength, we succeeded in measuring the nuclear spin-lattice relaxation rate 1/T1, which had never been measured by the pulse-field NMR experiment without dynamic field control. We also implement the NMR spectrum measurement with both the frequency-sweep and field-sweep modes and discuss the appropriate choices of these modes depending on the magnetic properties of the sample to be measured. This development, with further improvement at a long-duration field pulse, will innovate the microscopic measurement in extremely high magnetic fields.
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Affiliation(s)
- Y Ihara
- Department of Physics, Faculty of Science, Hokkaido University, Sapporo 060-0810, Japan
| | - K Hayashi
- Department of Physics, Faculty of Science, Hokkaido University, Sapporo 060-0810, Japan
| | - T Kanda
- Institute for Solid State Physics, The University of Tokyo, Kashiwa, Chiba 277-8581, Japan
| | - K Matsui
- Institute for Solid State Physics, The University of Tokyo, Kashiwa, Chiba 277-8581, Japan
| | - K Kindo
- Institute for Solid State Physics, The University of Tokyo, Kashiwa, Chiba 277-8581, Japan
| | - Y Kohama
- Institute for Solid State Physics, The University of Tokyo, Kashiwa, Chiba 277-8581, Japan
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Fukaya H, Ako J, Yasuda S, Kaikita K, Akao M, Matoba T, Nakamura M, Miyauchi K, Hagiwara N, Kimura K, Hirayama A, Matsui K, Ogawa H. Aspirin vs. P2Y12 inhibitors with anticoagulation therapy for atrial fibrillation: insights from the AFIRE trial. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients with coronary artery disease (CAD) and atrial fibrillation (AF) can be treated with multiple antithrombotic therapies including antiplatelets and oral anticoagulants; however, this has the potential to increase bleeding risk.
Purpose
This sub-analysis aimed to evaluate the efficacy and safety of P2Y12 inhibitors and aspirin in patients also receiving oral anticoagulant therapy.
Methods
We evaluated patients from the Atrial Fibrillation and Ischemic Events with Rivaroxaban in Patients with Stable Coronary Artery Disease (AFIRE) trial who received combination therapy (rivaroxaban plus a single antiplatelet agent). The choice of antiplatelets was left to the physician's discretion. The primary efficacy endpoint was a composite of stroke, systemic embolism, myocardial infarction, unstable angina requiring revascularization, and death from any cause. The primary safety endpoint was major bleeding according to the International Society on Thrombosis and Haemostasis criteria.
Results
A total of 1,075 patients were included (P2Y12 inhibitor group, n=297; aspirin group, n=778). Approximately 60% of patients were administered proton pump inhibitors (PPIs), and there was no significant difference in PPI use in the P2Y12 inhibitor and aspirin groups. Regarding the primary efficacy endpoint, there was no significant difference between the P2Y12 inhibitor and aspirin groups (hazard ratio, 1.31; 95% confidence interval, 0.88–1.94; p=0.178). Likewise, the primary safety endpoint was not different between the groups (hazard ratio, 0.79; 95% confidence interval, 0.43–1.47; p=0.456). In the detailed subgroup analysis, there were no differences in the efficacy and safety endpoints.
Conclusions
There were no significant differences between P2Y12 inhibitors and aspirin in cardiovascular events in patients with AF and stable CAD taking rivaroxaban in the chronic phase.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): The Japan Cardiovascular Research Foundation based on a contract with Bayer Yakuhin, Ltd. Summary of this study
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Affiliation(s)
- H Fukaya
- Kitasato University School of Medicine, Cardiovascular Medicine, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Cardiovascular Medicine, Sagamihara, Japan
| | - S Yasuda
- Tohoku University Graduate School of Medicine, Cardiovascular Medicine, Sendai, Japan
| | - K Kaikita
- Kumamoto University, Cardiovascular Medicine, Kumamoto, Japan
| | - M Akao
- Kyoto Medical Centre, Cardiology, Kyoto, Japan
| | - T Matoba
- Kyushu University, Cardiovascular Medicine, Fukuoka, Japan
| | - M Nakamura
- Toho University Ohashi Medical Center, Cardiovascular Medicine, Tokyo, Japan
| | - K Miyauchi
- Juntendo University School of Medicine, Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Kimura
- Yokohama City University Medical Center, Cardiovascular Center, Yokohama, Japan
| | - A Hirayama
- Osaka Police Hospital, Cardiovascular division, Osaka, Japan
| | - K Matsui
- Kumamoto University Hospital, General and Community Medicine, Kumamoto, Japan
| | - H Ogawa
- National Cerebral & Cardiovascular Center, Suita, Japan
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Ochiai T, Nagayama T, Matsui K, Amano K, Sano T, Wakabayashi T, Iwatsubo T. Tauroursodeoxycholic Acid Attenuates Diet-Induced and Age-Related Peripheral Endoplasmic Reticulum Stress and Cerebral Amyloid Pathology in a Mouse Model of Alzheimer's Disease. J Prev Alzheimers Dis 2021; 8:483-494. [PMID: 34585224 DOI: 10.14283/jpad.2021.33] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Obesity and diabetes are well-established risk factors of Alzheimer's disease (AD). In the brains of patients with AD and model mice, diabetes-related factors have been implicated in the pathological changes of AD. However, the molecular mechanistic link between the peripheral metabolic state and AD pathophysiology have remained elusive. Endoplasmic reticulum (ER) stress is known as one of the major contributors to the metabolic abnormalities in obesity and diabetes. Interventions aimed at reducing ER stress have been shown to improve the systemic metabolic abnormalities, although their effects on the AD pathology have not been extensively studied. OBJECTIVES We examined whether interventions targeting ER stress attenuate the obesity/diabetes-induced Aβ accumulation in brains. We also aimed to determine whether ER stress that took place in the peripheral tissues or central nervous system was more important in the Aβ neuropathology. Furthermore, we explored if age-related metabolic abnormalities and Aβ accumulation could be suppressed by reducing ER stress. METHODS APP transgenic mice (A7-Tg), which exhibit Aβ accumulation in the brain, were used as a model of AD to analyze parameters of peripheral metabolic state, ER stress, and Aβ pathology in the brain. Intraperitoneal or intracerebroventricular administration of taurodeoxycholic acid (TUDCA), a chemical chaperone, was performed in high-fat diet (HFD)-fed A7-Tg mice for ~1 month, followed by analyses at 9 months of age. Mice fed a normal diet were treated with TUDCA by drinking water for 4 months and intraperitoneally for 1 month in parallel, and analyzed at 15 months of age. RESULTS Intraperitoneal administration of TUDCA suppressed ER stress in the peripheral tissues and ameliorated the HFD-induced obesity and insulin resistance. Concomitantly, Aβ levels in the brain were significantly reduced. In contrast, intracerebroventricular administration of TUDCA had no effect on the Aβ levels. Peripheral administration of TUDCA was also effective against the age-related obesity and insulin resistance, and markedly reduced amyloid accumulation. CONCLUSIONS Interventions that target peripheral ER stress might be beneficial therapeutic and prevention strategies against brain Aβ pathology associated with metabolic overload and aging.
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Affiliation(s)
- T Ochiai
- Tomoko Wakabayashi, Takeshi Iwatsubo, Department of Neuropathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan, Tel: +81-3-5841-3541, Fax: +81-3-5841-3613 ,
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Kishimoto M, Ono K, Fukui S, Kawaai S, Deshpande GA, Yoshida K, Ichikawa N, Kaneko Y, Kawasaki T, Matsui K, Morita M, Tada K, Takizawa N, Tamura N, Taniguchi A, Taniguchi Y, Tsuji S, Okada M, Kobayashi S, Komagata Y, López-Medina C, Molto A, van der Heijde D, Dougados M, Tomita T, Kaname S. Clinical characteristics of non-radiographic versus radiographic axial spondyloarthritis in Asia and non-radiographic axial spondyloarthritis in other regions: results of the cross-sectional ASAS-COMOSPA study. RMD Open 2021; 7:rmdopen-2021-001752. [PMID: 34531305 PMCID: PMC8449957 DOI: 10.1136/rmdopen-2021-001752] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/28/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives To delineate characteristics of non-radiographic axial spondyloarthritis (nr-axSpA) in Asia versus non-Asian regions, and compare radiographic axSpA (r-axSpA) with nr-axSpA within Asia. Methods Data were collected from the Assessment of SpondyloArthritis international Society-COMOrbidities in SPondyloArthritis database. Categorising patients by region, we compared clinical characteristics between nr-axSpA from Asia vs elsewhere (Europe, the Americas and Africa). Within Asians, we additionally compared patient characteristics of those with nr-axSpA versus r-axSpA. Results Among 3984 SpA cases, 1094 were from Asian countries. Of 780 axSpA patients in Asia, 112 (14.4%) had nr-axSpA, less than in non-Asian countries (486/1997, 24.3%). Nr-axSpA patients in Asia were predominantly male (75.9% vs 47.1%), younger at onset (22.8 vs 27.8 years) and diagnosis (27.2 vs 34.5 years), and experienced less diagnostic delay (1.9 vs 2.9 years) compared with nr-axSpA in non-Asian countries. Nr-axSpA in Asia exhibited higher human leucocyte antigens-B27 prevalence (90.6% vs 61.9%), fewer peripheral SpA features (53.6% vs 66.3%) and similar extra-articular and comorbid disease rates compared with those with nr-axSpA in non-Asian countries. Disease activity, functional impairment and MRI sacroiliitis were less in nr-axSpA in Asia, with higher rates of non-steroidal anti-inflammatory drug response and less methotrexate and biological disease-modifying antirheumatic drugs use. Within Asia, r-axSpA showed higher disease activity and structural damage compared with nr-axSpA, with no differences in other features. Conclusion Among axSpA, lower frequency of nr-axSpA was observed in Asia. Our results offer an opportunity to better understand clinical characteristics and optimise diagnostic strategies, such as ensuring access and availability of MRI resources for accurate diagnosis of nr-axSpA in Asia.
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Affiliation(s)
- Mitsumasa Kishimoto
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Keisuke Ono
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Sho Fukui
- Immuno-Rheumatology Center, St Luke's International University, Chuo-ku, Tokyo, Japan
| | - Satoshi Kawaai
- Immuno-Rheumatology Center, St Luke's International University, Chuo-ku, Tokyo, Japan
| | - Gautam A Deshpande
- Center for Clinical Epidemiology, St Luke's International University, Chuo-ku, Tokyo, Japan
| | - Kazuki Yoshida
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Naomi Ichikawa
- Department of Rheumatology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Yuko Kaneko
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Minato-ku, Tokyo, Japan
| | - Taku Kawasaki
- Orthopedics, Shiga University of Medical Science, Otsu, Japan
| | - Kazuo Matsui
- Department of Rheumatology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Mitsuhro Morita
- Department of Orthopaedic Surgery, Fujita Health University, Toyoake, Aichi, Japan
| | - Kurisu Tada
- Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | | | - Naoto Tamura
- Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Atsuo Taniguchi
- Department of Rheumatology, Fukujuji Hospital, Kiyose, Tokyo, Japan
| | - Yoshinori Taniguchi
- Department of Endocrinology, Metabolism, Nephrology and Rheumatology, Kochi Medical School, Nankoku, Kochi, Japan
| | | | - Masato Okada
- Immuno-Rheumatology Center, St Luke's International University, Chuo-ku, Tokyo, Japan
| | - Shigeto Kobayashi
- Department of Internal Medicine and Rheumatology, Juntendo University Koshigaya Hospital, Koshigaya, Saitama, Japan
| | - Yoshinori Komagata
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | | | - Anna Molto
- Rheumatology Department, Hôpital Cochin - APHP Centre, Paris, France
| | | | - Maxime Dougados
- Rheumatology Department, Hôpital Cochin - APHP Centre, Paris, France
| | - Tetsuya Tomita
- Department of Orthopaedic Biomaterial Science, Osaka University School of Medicine Graduate School of Medicine, Suita, Osaka, Japan
| | - Shinya Kaname
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
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Yoshikawa T, Azuma K, Furukawa T, Tamura M, Hashimoto T, Morimoto M, Azuma N, Matsui K. AB0311 INCREASED LEVELS OF SERUM WISTERIA FLORIBUNDA AGGLUTININPOSITIVE MAC-2 BINDING PROTEIN IN RHEUMATIC DISEASES INCLUDING SLE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Mac-2 binding protein is a cell-adhesive glycoprotein of the extracellular matrix secreted as a ligand of galectin-3 (Mac-2). Recently, a Wisteria floribunda agglutinin positive-M2BP (M2BP) assay developed using a lectin-antibody sandwich immunoassay has shown promise as a new fibrotic marker in liver fibrosis and interstitial lung disease (ILD) to detect unique fibrosis-related glycoalteration.Objectives:The aim of this study is to evaluate the utility of serum Mac-2 binding protein glycosylation isomer (M2BPGi) levels in patients with rheumatic diseases (RD).Methods:We retrospectively measured serum M2BPGi levels in 68 patients with RD and 16 healthy controls (HC). There were no patients of cirrhosis and active hepatitis. Serum levels of M2BPGi were measured using HISCL M2BP glycosylation isomer Assay Kit. We examined the relationship between serum M2BPGi levels and clinical parameters in patients with RD.Results:In patients with RD, the median age was 62.0 years and 79.4% of them were female.Serum M2BPGi levels were significantly higher in patients with RD than in HC (median 0.98 cutoff index [COI], 0.32 COI, respectively; P < 0.00001). Patients with SLE tended to have higher serum M2BPGi levels than other rheumatic diseases.In patients with RD, a significant correlation was not found between serum M2BP levels and inflammation markers such as CRP or ferritin. However, serum M2BPGi levels were significantly correlated with B cell activation markers such as immunoglobulin free light chain and IgG (r = 0.588, 0.504) and T cell activation marker such as sIL-2R (r = 0.408).Conclusion:Most of the rheumatic diseases in this study were considered to be type I interferonopathy diseases such as rheumatoid arthritis, Sjogren’s syndrome, inflammatory myositis, scleroderma and SLE.Serum M2BPGi was reported to have a significant correlation with SLE disease activity [SS Ahn et al. Lupus. 2018; 27: 771], and also to have a significant correlation with Gakectin-9, a novel biomarker for IFN signiture [Lucas L van den Hoogen et al. Ann Rheum Dis. 2018; 77: 1810].So, it was suggested that serum M2BPGi may be a novel biomarker that indirectly indicates how much IFN is activated in rheumatic diseases.Disclosure of Interests:None declared
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Ono K, Kishimoto M, Fukui S, Kawaai S, Deshpande GA, Yoshida K, Ichikawa N, Kaneko Y, Kawasaki T, Matsui K, Morita M, Tada K, Takizawa N, Tamura N, Taniguchi A, Taniguchi Y, Tsuji S, Kobayashi S, Okada M, López-Medina C, Moltó A, Van der Heijde D, Dougados M, Komagata Y, Tomita T, Kaname S. POS0975 CLINICAL CHARACTERISTICS OF NONRADIOGRAPHIC AXIAL SPONDYLOARTHRITIS IN ASIAN COUNTRIES COMPARED TO OTHER REGIONS: RESULTS OF THE INTERNATIONAL CROSS-SECTIONAL ASAS-COMOSPA STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Clinical characteristics of nonradiographic axial spondyloarthritis (nr-ax-SpA) are highly variable across patients, and may potentially vary across patient populations, particularly due to differing distributions of human leukocyte antigens (HLA) and other genetic factors. The majority of nr-ax-SpA studies have been conducted in Europe, the United States, and small studies are reported from Asia [1].Objectives:To delineate clinical characteristics of patients with nr-ax-SpA in Asian countries in comparison to other areas of the world.Methods:Utilizing the ASAS-COMOSPA data, an international cross-sectional observational study of SpA patients, we analyzed information on demographics, disease characteristics, comorbidities, and risk factors. Patients were classified by region: Asia (China, Japan, Singapore, South Korea, and Taiwan), and non-Asian countries (Europe, Americas, and Africa); patient characteristics, including diagnosis and treatment, were compared.Results:Among 3984 SpA patients included in the study, 1094 were from centers in Asian countries, and 2890 from other regions. 112/780 (14.4%) of axial SpA patients in Asian countries were nr-ax-SpA, substantially less than in other countries (486/1997, 24.3%). Nr-ax-SpA patients in Asian countries compared to nr-ax-SpA in other countries were more likely male (75.9 vs 47.1%), have onset (22.8 vs 27.8 years) and diagnosis (27.2 vs 34.5 years) at younger age, and experience less diagnostic delay (1.88 vs 2.92 years) (Table 1). Nr-ax-SpA patients in Asian countries have higher prevalence of positive HLA-B27 (90.6% vs 61.9%) and fewer peripheral signs such as arthritis, enthesitis, or dactylitis (53.6% vs 66.3%) but have similar rate of extra-articular manifestations (psoriasis, IBD, or uveitis) and co-morbidities. Disease activity, functional impairment, and inflammation on MRI were less in nr-ax-SpA patients in Asian countries. NSAIDs response was higher and use of methotrexate and b-DMARDs were lower among nr-ax-SpA in Asian countries.Conclusion:Among axial SpA patients, substantially lower frequency of nr-ax-SpA was observed in Asian countries compared to other regions of the world. Nr-ax-SpA patients in Asian countries were predominantly male, and had younger disease onset with higher HLA-B27 positivity rate and less peripheral signs, and better response to NSAIDs. These results offer an opportunity to improve both early diagnosis and treatment of nr-ax-SpA patients in Asian countries.Table 1.Characteristics of nonradiographic axial SpA in Asia versus non-Asian regionsVariablesAsianon-Asian regionsp valueN112486Age at disease diagnosis, yrs27.2 [21.1, 39.6]34.5 [27.7, 41.7]<0.001Diagnostic delay, yrs1.88 [0.27, 5.56]2.92 [0.59, 9.58]0.011Male (%)85 (75.9)229 (47.1)<0.001Sacroiliitis on MRI among tested (%)49 (67.1)341 (82.2)0.005HLA B27 positivity among measured (%)96 (90.6)273 (61.9)<0.001Inflammatory Back Pain (%)107 (95.5)478 (98.4)0.076Arthritis, enthesitis, or dactylitis (%)60 (53.6)322 (66.3)0.016Psoriasis (%)12 (10.7)82 (16.9)0.142Uveitis (%)20 (17.9)81 (16.7)0.870Inflammatory bowel disease (%)5 (4.5)27 (5.6)0.817Elevated CRP (%)37 (33.0)213 (43.8)0.048Physician global assessment (0-10)2.0 [1.0, 5.0]2.0 [1.0, 4.0]0.741Patient global assessment (0-10)3.0 [1.0, 6.0]4.0 [2.0, 6.0]0.012ASDAS-CRP1.40 [0.95, 2.08]1.97 [1.21, 2.78]<0.001BASFI0.8 [0.05, 2.65]2.9 [0.8, 5.6]<0.001Good response to NSAIDs (%)80 (71.4)272 (56.0)0.004Methotrexate use (%)18 (16.1)134 (27.6)0.016Biological DMARDs use (%)27 (24.1)191 (39.3)0.004References:[1]López-Medina C, Ramiro S, van der Heijde D, et al. Characteristics and burden of disease in patients with radiographic and non-radiographic axial Spondyloarthritis: a comparison by systematic literature review and meta-analysis. RMD Open. 2019 Nov 21;5(2): e001108.Acknowledgements:This study was conducted under the umbrella of the International Society for Spondyloarthritis Assessment (ASAS) and COMOSPA study was supported by unrestricted grants from Pfizer, AbbVie and UCB.Disclosure of Interests:Keisuke Ono: None declared, Mitsumasa Kishimoto Speakers bureau: AbbVie, Amgen-Astellas BioPharma, Asahi-Kasei Pharma, Astellas, Ayumi Pharma, BMS, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Janssen, Kyowa Kirin, Novartis, Ono Pharma, Pfizer, Tanabe-Mitsubishi, Teijin Pharma, and UCB Pharma, Consultant of: AbbVie, Amgen-Astellas BioPharma, Asahi-Kasei Pharma, Astellas, Ayumi Pharma, BMS, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Janssen, Kyowa Kirin, Novartis, Ono Pharma, Pfizer, Tanabe-Mitsubishi, Teijin Pharma, and UCB Pharma, Sho Fukui: None declared, Satoshi Kawaai: None declared, Gautam A. Deshpande: None declared, Kazuki Yoshida Consultant of: OM1, Inc., Grant/research support from: Corrona, LLC, Naomi Ichikawa: None declared, Yuko Kaneko Speakers bureau: AbbVie, Astellas, Ayumi, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly, Hisamitsu, Jansen, Kissei, Pfizer, Sanofi, Takeda, Tanabe-Mitsubishi, and UCB, Taku Kawasaki: None declared, Kazuo Matsui: None declared, Mitsuhiro Morita: None declared, Kurisu Tada: None declared, Naoho Takizawa: None declared, Naoto Tamura: None declared, Atsuo Taniguchi: None declared, Yoshinori Taniguchi: None declared, Shigeyoshi Tsuji: None declared, Shigeto Kobayashi: None declared, Masato Okada: None declared, Clementina López-Medina: None declared, Anna Moltó Consultant of: AbbVie, Pfizer, MSD, Novartis, Gilead, Lilly and UCB, Grant/research support from: AbbVie, Pfizer, MSD, Novartis, Gilead, Lilly and UCB, Désirée van der Heijde Consultant of: AbbVie, Amgen, Astellas, AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Celgene, Cyxone, Daiichi, Eisai, Eli-Lilly, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, UCB Pharma, Employee of: Imaging Rheumatology bv. (Director), Maxime Dougados: None declared, Yoshinori Komagata: None declared, Tetsuya Tomita: None declared, Shinya Kaname: None declared.
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Affiliation(s)
- Eri Sugawara
- Department of Rheumatology, Tonan Hospital, Sapporo, Japan.
| | - Kazuo Matsui
- Department of Rheumatology, Tonan Hospital, Sapporo, Japan
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Sato A, Omura M, Minagawa Y, Takino K, Matsui K, Hongo H, Shirata R, Hashimoto H, Misumi T, Sasaki Y, Inoue T, Hata M. PO-1258: Intensity modulated radiation therapy for lymph node oligo-recurrence. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01276-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Fujieda Y, Horita T, Nishimoto N, Tanimura K, Amasaki Y, Kasahara H, Furukawa S, Takeda T, Fukaya S, Matsui K, Tsutsumi A, Furusaki A, Sagawa A, Katayama K, Takeuchi K, Katsumata K, Kurita T, Shane P, Kato M, Oku K, Yasuda S, Takahata M, Iwasaki N, Atsumi T. Efficacy and safety of sodium RISedronate for glucocorticoid-induced OsTeoporosis with rheumaTOid arthritis (RISOTTO study): A multicentre, double-blind, randomized, placebo-controlled trial. Mod Rheumatol 2020; 31:593-599. [PMID: 32820698 DOI: 10.1080/14397595.2020.1812835] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE No evidence has shown the efficacy of Sodium Risedronate (Risedronate) for glucocorticoid-induced osteoporosis (GIO) in patients with Rheumatoid arthritis (RA). The aim of this study was to explore the effectiveness and safety of Risedronate for GIO complicated with RA. METHODS This was a six-month randomized, double-blind, placebo-controlled trial of 95 patients with GIO complicated with RA from 19 centers. The primary endpoint was the change from baseline in lumbar spine bone mineral density (L-BMD). Secondary endpoints included changes in femoral neck and total hip BMD and bone turnover markers, as well as rheumatoid arthritis Disease Activity Score with 28-joint counts. Incident of non-traumatic spine fractures and adverse events were tracked as safety endpoints. RESULTS Increase in L-BMD was significantly greater in the Risedronate group compared to the Placebo group (Risedronate: 3.49% [95% CI: 1.92-5.05] vs Placebo: 0.12% [95% CI: -2.07 to 2.30], p < .0001). No significant difference was found in the femoral neck and total hip BMD. Although adverse events were observed in 28 patients, none were considered serious. Non-traumatic vertebral fractures were identified in 10 patients. CONCLUSION Risedronate was effective in increasing L-BMD and was well tolerated in patients with GIO complicated with RA.
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Affiliation(s)
- Yuichiro Fujieda
- Department of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine and Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Tetsuya Horita
- Internal Medicine, Tomakomai City Hospital, Tomakomai, Japan
| | - Naoki Nishimoto
- Department of Biostatistics, Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan
| | | | | | - Hideki Kasahara
- Department of Rheumatology, NTT Sapporo Medical Center, Sapporo, Japan
| | - Shin Furukawa
- Internal Medicine, Kushiro Red Cross Hospital, Kushiro, Japan
| | - Tsuyoshi Takeda
- Internal Medicine, Hokkaido Spinal Cord Injury Center, Bibai, Japan
| | - Shinji Fukaya
- 3rd Department of Internal Medicine, Obihiro Kosei Hospital, Obihiro, Japan
| | - Kazuo Matsui
- Internal Medicine, Takikawa City Hospital, Takikawa, Japan
| | - Akito Tsutsumi
- Internal Medicine, Takikawa City Hospital, Takikawa, Japan
| | | | - Akira Sagawa
- Sagawa Akira Rheumatology Clinic, Sapporo, Japan
| | - Kou Katayama
- Katayama Orthopaedic Rheumatology Clinic, Asahikawa, Japan
| | - Kaoru Takeuchi
- Aozora Takeuchi Internal Medicine Clinic, Sapporo, Japan
| | - Kazuaki Katsumata
- Department of Rheumatology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Takashi Kurita
- Internal Medicine, Kitami Red Cross Hospital, Kitami, Japan
| | - Peter Shane
- International Medical Department, Hokkaido University Hospital, Sapporo, Japan
| | - Masaru Kato
- Department of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine and Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Kenji Oku
- Department of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine and Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Shinsuke Yasuda
- Department of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine and Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Graduate School of Medicine and Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Graduate School of Medicine and Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Tatsuya Atsumi
- Department of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine and Faculty of Medicine, Hokkaido University, Sapporo, Japan
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Utsunomiya M, Dobashi H, Odani T, Saito K, Yokogawa N, Nagasaka K, Takenaka K, Soejima M, Sugihara T, Hagiyama H, Hirata S, Matsui K, Nonomura Y, Kondo M, Suzuki F, Nawata Y, Tomita M, Kihara M, Yokoyama-Kokuryo W, Hirano F, Yamazaki H, Sakai R, Nanki T, Koike R, Miyasaka N, Harigai M. An open-label, randomized controlled trial of sulfamethoxazole-trimethoprim for Pneumocystis prophylaxis: results of 52-week follow-up. Rheumatol Adv Pract 2020; 4:rkaa029. [PMID: 33134810 PMCID: PMC7585401 DOI: 10.1093/rap/rkaa029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/10/2020] [Indexed: 11/14/2022] Open
Abstract
Objectives The aim was to investigate the long-term prophylactic efficacy, drug retention and safety of low-dose sulfamethoxazole–trimethoprim (SMX/TMP) prophylaxis against Pneumocystis pneumonia (PCP). Methods Adult patients with rheumatic diseases receiving prednisolone ≥0.6 mg/kg/day were randomized into the single-strength group (SS; SMX/TMP 400/80 mg daily), the half-strength group (HS; 200/40 mg daily) or the escalation group (ES; starting at 40/8 mg and increasing incrementally to 200/40 mg daily) and treated for 24 weeks, then observed for 52 weeks. The primary endpoint, the PCP non-incidence rate (non-IR) at week 24, has been reported previously. The secondary endpoints were the PCP non-IR at week 52, treatment discontinuation rate and adverse events. Results Fifty-eight, 59 and 55 patients in the SS, HS and ES, respectively, received SMX/TMP. PCP did not develop in any of the patients by week 52. The estimated PCP non-IR in patients receiving SMX/TMP 200/40 mg daily (HS and ES) was 96.8–100%. Throughout the 52-week observation period, the overall discontinuation rate was significantly lower in HS than in SS (22.7 vs 47.2%, P = 0.004). The discontinuation rates attributable to adverse events were significantly lower in HS (19.1%, P = 0.007) and ES (20.3%, P = 0.007) than in SS (41.8%). The IRs of adverse events requiring SMX/TMP dose reduction before week 52 differed among the three groups, with a significantly higher IR in SS than in HS or ES (P = 0.007). Conclusion SMX/TMP 200/40 mg had a high PCP prevention rate and was superior to SMX/TMP 400/80 mg in terms of drug retention and safety. Trial registration University Hospital Medical Information Network Clinical Trials Registry, UMIN000007727.
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Affiliation(s)
- Masako Utsunomiya
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo.,Departments of Pharmacovigilance.,Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo.,Department of Rheumatology, Musashino Red Cross Hospital, Musashino, Tokyo
| | - Hiroaki Dobashi
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kida-gun, Kagawa
| | - Toshio Odani
- Third Department of Internal Medicine, Obihiro-Kosei General Hospital, Obihiro, Hokkaido
| | - Kazuyoshi Saito
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka
| | - Naoto Yokogawa
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo
| | - Kenji Nagasaka
- Departments of Pharmacovigilance.,Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo.,Department of Rheumatology, Ome Municipal General Hospital, Ome, Tokyo
| | - Kenchi Takenaka
- Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo.,Department of Rheumatology, Ome Municipal General Hospital, Ome, Tokyo
| | - Makoto Soejima
- Department of Rheumatology, Ome Municipal General Hospital, Ome, Tokyo
| | - Takahiko Sugihara
- Department of Medicine and Rheumatology, Tokyo Metropolitan Geriatric Hospital, Tokyo
| | - Hiroyuki Hagiyama
- Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Kanagawa
| | - Shinya Hirata
- Department of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, Kumamoto, Kumamoto
| | - Kazuo Matsui
- Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba
| | | | - Masahiro Kondo
- Department of Rheumatology, Faculty of Medicine, Shimane University, Izumo, Shimane
| | - Fumihito Suzuki
- Department of Rheumatology, Soka Municipal Hospital, Soka, Saitama
| | - Yasushi Nawata
- Center for Rheumatic Disease, Chibaken Saiseikai Narashino Hospital, Narashino, Chiba
| | - Makoto Tomita
- Clinical Research Center, Medical Hospital of Tokyo Medical and Dental University
| | - Mari Kihara
- Departments of Pharmacovigilance.,Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Waka Yokoyama-Kokuryo
- Departments of Pharmacovigilance.,Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Fumio Hirano
- Departments of Pharmacovigilance.,Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Hayato Yamazaki
- Departments of Pharmacovigilance.,Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Ryoko Sakai
- Departments of Pharmacovigilance.,Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo.,Division of Epidemiology and Pharmacoepidemiology, Institute of Rheumatology, Tokyo Women's Medical University.,Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Toshihiro Nanki
- Departments of Pharmacovigilance.,Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Ryuji Koike
- Departments of Pharmacovigilance.,Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Nobuyuki Miyasaka
- Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Masayoshi Harigai
- Departments of Pharmacovigilance.,Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo.,Division of Epidemiology and Pharmacoepidemiology, Institute of Rheumatology, Tokyo Women's Medical University.,Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
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25
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Frotscher A, Gómez-Ramos M, Obertelli A, Doornenbal P, Authelet G, Baba H, Calvet D, Château F, Chen S, Corsi A, Delbart A, Gheller JM, Giganon A, Gillibert A, Isobe T, Lapoux V, Matsushita M, Momiyama S, Motobayashi T, Niikura M, Otsu H, Paul N, Péron C, Peyaud A, Pollacco EC, Roussé JY, Sakurai H, Santamaria C, Sasano M, Shiga Y, Shimizu N, Steppenbeck D, Takeuchi S, Taniuchi R, Uesaka T, Wang H, Yoneda K, Ando T, Arici T, Blazhev A, Browne F, Bruce AM, Carroll R, Chung LX, Cortés ML, Dewald M, Ding B, Dombradi Z, Flavigny F, Franchoo S, Giacoppo F, Górska M, Gottardo A, Hadyńska-Klęk K, Korkulu Z, Koyama S, Kubota Y, Jungclaus A, Lee J, Lettmann M, Linh BD, Liu J, Liu Z, Lizarazo C, Louchart C, Lozeva R, Matsui K, Miyazaki T, Moschner K, Nagamine S, Nakatsuka N, Nita C, Nishimura S, Nobs CR, Olivier L, Ota S, Patel Z, Podolyák Z, Rudigier M, Sahin E, Saito TY, Shand C, Söderström PA, Stefan IG, Sumikama T, Suzuki D, Orlandi R, Vaquero V, Vajta Z, Werner V, Wimmer K, Wu J, Xu Z. Sequential Nature of (p,3p) Two-Proton Knockout from Neutron-Rich Nuclei. Phys Rev Lett 2020; 125:012501. [PMID: 32678621 DOI: 10.1103/physrevlett.125.012501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/27/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
Twenty-one two-proton knockout (p,3p) cross sections were measured from neutron-rich nuclei at ∼250 MeV/nucleon in inverse kinematics. The angular distribution of the three emitted protons was determined for the first time, demonstrating that the (p,3p) kinematics are consistent with two sequential proton-proton collisions within the projectile nucleus. Ratios of (p,3p) over (p,2p) inclusive cross sections follow the trend of other many-nucleon removal reactions, further reinforcing the sequential nature of (p,3p) in neutron-rich nuclei.
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Affiliation(s)
- A Frotscher
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - M Gómez-Ramos
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - A Obertelli
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - P Doornenbal
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - G Authelet
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - H Baba
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Calvet
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - F Château
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - S Chen
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- School of Physics and State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871, People's Republic of China
| | - A Corsi
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Delbart
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J-M Gheller
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Giganon
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Gillibert
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - T Isobe
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - V Lapoux
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Matsushita
- Center for Nuclear Study, The University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - S Momiyama
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - T Motobayashi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - M Niikura
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H Otsu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - N Paul
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - C Péron
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Peyaud
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - E C Pollacco
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J-Y Roussé
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - H Sakurai
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - C Santamaria
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - M Sasano
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y Shiga
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 172-8501, Japan
| | - N Shimizu
- Center for Nuclear Study, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - D Steppenbeck
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - S Takeuchi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - R Taniuchi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - T Uesaka
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Wang
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Yoneda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Ando
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - T Arici
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
- Justus-Liebig-Universität Giessen, D-35392 Giessen, Germany
| | - A Blazhev
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - F Browne
- School of Computing Engineering and Mathematics, University of Brighton, Brighton BN2 4GJ, United Kingdom
| | - A M Bruce
- School of Computing Engineering and Mathematics, University of Brighton, Brighton BN2 4GJ, United Kingdom
| | - R Carroll
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - L X Chung
- Institute for Nuclear Science & Technology, VINATOM, P.O. Box 5T-160, Nghia Do, Hanoi, Vietnam
| | - M L Cortés
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - M Dewald
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - B Ding
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, People's Republic of China
| | - Zs Dombradi
- MTA Atomki, P.O. Box 51, Debrecen H-4001, Hungary
| | - F Flavigny
- Present affiliation: LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, 14050 Caen Cedex 04, France
| | - S Franchoo
- Present affiliation: LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, 14050 Caen Cedex 04, France
| | - F Giacoppo
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
- Department of Physics, University of Oslo, N-0316 Oslo, Norway
| | - M Górska
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - A Gottardo
- Present affiliation: LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, 14050 Caen Cedex 04, France
| | - K Hadyńska-Klęk
- Department of Physics, University of Oslo, N-0316 Oslo, Norway
| | - Z Korkulu
- MTA Atomki, P.O. Box 51, Debrecen H-4001, Hungary
| | - S Koyama
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Y Kubota
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Center for Nuclear Study, The University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - A Jungclaus
- Instituto de Estructura de la Materia, CSIC, 28006 Madrid, Spain
| | - J Lee
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - M Lettmann
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - B D Linh
- Institute for Nuclear Science & Technology, VINATOM, P.O. Box 5T-160, Nghia Do, Hanoi, Vietnam
| | - J Liu
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - Z Liu
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, People's Republic of China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - C Lizarazo
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - C Louchart
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - R Lozeva
- IPHC, CNRS/IN2P3, Université de Strasbourg, F-67037 Strasbourg, France
- CSNSM, CNRS/IN2P3, Université Paris-Sud, F-91405 Orsay Campus, France
| | - K Matsui
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - T Miyazaki
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - K Moschner
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - S Nagamine
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - N Nakatsuka
- Department of Physics, Faculty of Science, Kyoto University, Kyoto 606-8502, Japan
| | - C Nita
- Horia Hulubei National Institute of Physics and Nuclear Engineering (IFIN-HH), RO-077125 Bucharest, Romania
| | - S Nishimura
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - C R Nobs
- School of Computing Engineering and Mathematics, University of Brighton, Brighton BN2 4GJ, United Kingdom
| | - L Olivier
- Present affiliation: LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, 14050 Caen Cedex 04, France
| | - S Ota
- Center for Nuclear Study, The University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - Z Patel
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - Zs Podolyák
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - M Rudigier
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - E Sahin
- Department of Physics, University of Oslo, N-0316 Oslo, Norway
| | - T Y Saito
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - C Shand
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - P-A Söderström
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Extreme Light Infrastructure-Nuclear Physics (ELI-NP), 077125 Bucharest-Măgurele, Romania
| | - I G Stefan
- Present affiliation: LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, 14050 Caen Cedex 04, France
| | - T Sumikama
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - D Suzuki
- Present affiliation: LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, 14050 Caen Cedex 04, France
| | - R Orlandi
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - V Vaquero
- Instituto de Estructura de la Materia, CSIC, 28006 Madrid, Spain
| | - Zs Vajta
- MTA Atomki, P.O. Box 51, Debrecen H-4001, Hungary
| | - V Werner
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - K Wimmer
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - J Wu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- School of Physics and State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871, People's Republic of China
| | - Z Xu
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
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Azuma N, Furukawa T, Shima Y, Matsui K. FRI0227 A USABILITY SURVEY OF WRIST MOUNTED DISPOSABLE HEAT PAD ON RAYNAUD’S PHENOMENON IN PATIENTS WITH CONNECTIVE TISSUE DISEASES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:For patients with connective tissue diseases (CTD), vasodilators are used to treat Raynaud’s phenomenon (RP), they are difficult to control only by medication. Although physicians recommend the use of a portable handwarmer or gloves to patients with CTD presenting with RP, sustained heat-retention effects cannot be obtained from them because the patients’ daily life-related activities prevent their continued use. Since the wrist mounted disposable heat pad maintains the degrees of freedom of the hands and fingers and can remain usable during the daily activities, we considered this heat pad as a useful and highly practical heating method for CTD patients presenting with RP.Objectives:To investigate the usability and changes in symptoms resulting from the use of the wrist mounted disposable heat pad in CTD patients presenting with RP.Methods:Subjects were 23 outpatients with CTD presenting with RP (23 females; mean age 62.6 years; mean duration following the onset of RP 10.3 years; 12 systemic sclerosis, 5 mixed connective tissue disease, 5 Sjögren’s syndrome, and 1 systemic lupus erythematosus) who had used the wrist mounted disposable heat pad (put the pad in a specifically designed holder and wrap it around wrist joint (max. temperature 42 degrees Celsius, heat-retention time 6 hours)). We investigated through interviews with them the use situations, usability, and changes in RP. During their using the heat pad, medication and daily life-related precautions against RP continued to be implemented as before.Results:Many patients had no knowledge of the heat pad (n=17, 73.9%). The most common wearing time of the heat pad was 5–6 hours (n=8, 34.8%). As for scenes of wearing the heat pad, patients who wore the pad when being out of the home accounted for the highest proportion (n=16, 69.6%), and as follows: at home (n=6, 26.1%), during kitchen work (n=3, 13.0%), and during housework (n=2, 8.7%). 17 patients (73.9%) replied that usability was “good”, and 18 (78.3%) replied that usability was “better” compared with conventional measures. Moreover, many patients (n=16, 69.6%) replied that RP and associated symptoms had become reduced or alleviated. No patients replied that RP and associated symptoms had become exacerbated or severer. In terms of advantages of using the heat pad, patients who replied that the site on which the pad was mounted was felt to be warm accounted for the highest proportion (n=8, 34.8%), and those who replied that sites other than where the pad was mounted (such as fingertips, hands, and arms) were also warmed accounted for virtually the same proportion (n=7, 30.4%). Over 60% of the patients (n=14, 60.9%) replied that symptoms associated with RP (skin color, cold sensation, and pain) had become reduced or disappeared. In terms of disadvantages of using the heat pad, patients who replied that it was bothersome to use the pad accounted for the highest proportion while other patients made replies referring to cost and bad appearance. No significant accident occurred and as many as 17 patients (73.9%) replied that they would like to continue to use the heat pad in the future.Conclusion:There have been few reports evaluating the usefulness of a heat pad for RP. The wrist mounted disposable heat pad was thought to be a heating method having the potential to achieve high levels of usability and practicality on CTD patients presenting with RP. Given that the heat pad alleviated RP or caused sites other than where the pad was mounted to be felt warm even though it did not directly heat the hands and fingers, the pad seemed to have usefulness attributed to the heating of the wrist. Although the heat pad seems to be an excellent method for addressing RP in patients’ daily lives, we hope that this heat pad will be evaluated on a larger number of patients with the addition of objective indices.References:[1]Koscheyev VS, et al. Aviat Space Environ Med. 72: 713-719, 2001.Disclosure of Interests:Naoto Azuma: None declared, Tetsuya Furukawa: None declared, Yoshihito Shima Grant/research support from: Endowed chair funded by/accepted a researcher from Kirikai Chemical and Kobayashi Pharmaceutical., Kiyoshi Matsui Grant/research support from: Asahi Kasei Pharma, Astellas Pharma (research grants), Speakers bureau: Bristol-Myers Squibb (lecture fees)
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Tokunaga K, Matsui K, Oshikawa H, Matsui T, Tohma S. SAT0124 RISK OF SERIOUS INFECTION, MALIGNANCY, OR DEATH IN JAPANESE RHEUMATOID ARTHRITIS PATIENTS TREATED WITH A COMBINATION OF ABATACEPT AND TACROLIMUS: A RETROSPECTIVE COHORT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Both Abatacept (ABT) and Tacrolimus (Tac) suppress T cell immunity, but it is unknown whether combinations of these will increase the risk of adverse events.Objectives:To evaluate whether combining ABT and Tac increases the risk of infection and malignancy compared to their individual use in Japanese rheumatoid arthritis (RA) patients.Methods:We conducted a retrospective cohort study of RA patients using the multicenter database in Japan (NinJa). The dataset was clinical information at a certain point within each year, and the point was any point selected by a registered physician. RA was clinically diagnosed in the dataset. (1)We analyzed the data from RA patients registered in NinJa during the period from April 2010 to March 2019. In this study, we compared three groups who received Tac, ABT or a combination of both. We included patients who had just begun initiating treatment with ABT or Tac, and we excluded patients who used TNF inhibitors, IL-6 inhibitors, and Jak inhibitors in the first year. The primary outcome was defined the composite events including infections that require hospitalization, newly diagnosed malignancy, and death from any cause after initiation of ABT or Tac. We assessed whether the combination contributed to increase the risk of outcome by performing a Cox regression analysis.Results:Among the 27032 RA patients in the registry, 2009 patients were included. The Tac, ABT and combination groups consisted of 1328, 563 and 118 patients, respectively. (Figure 1) (Table 1) Primary outcomes occurred in 149 (13.4%), 62 (13.5%), 14 (13.9%) patients, of the Tac, ABT and combination groups, respectively. The incidence between groups was not significantly different (p= 0.638). (Figure 2) A Cox regression analysis was adjusted for the following parameters: age, sex, disease duration, modified health assessment questionnaire, disease activity score 28-CRP, CRP, use of prednisolone, and use of methotrexate. The analysis revealed no significant differences between groups. The hazard ratio (95% confidence interval) was as follows: Tac 1.00 (Ref), ABT 1.02 (0.74-1.40), and combination 1.15 (0.65-2.05).Table 1.baseline characteristicsTacrolimusAbataceptCombinationp valueN (person-year)1328 (2505)563 (944)118 (193)age (median [IQR])69.00 [60.00, 76.00]70.00 [61.00, 76.00]67.00 [59.00, 74.00]0.169*sex female (%)1038 (78.2)468 (83.1)97 (82.2)0.039†disease duration (yr) (median [IQR])9.00 [4.00, 18.00]11.00 [5.00, 21.00]11.00 [7.00, 20.00]0.002*Steinbrocker stage (%)I285 (23.5)82 (15.6)12 (12.1)<0.001†II361 (29.8)125 (23.8)25 (25.3)III232 (19.1)150 (28.5)31 (31.3)IV334 (27.6)169 (32.1)31 (31.3)mHAQ (median [IQR])0.25 [0.00, 0.75]0.38 [0.00, 1.00]0.50 [0.00, 1.13]<0.001*DAS28CRP (median [IQR])2.58 [1.88, 3.40]2.77 [2.09, 3.62]3.01 [2.27, 3.98]<0.001*CRP (mg/dL) (median [IQR])0.30 [0.10, 1.02]0.35 [0.13, 1.10]0.30 [0.14, 0.82]0.590*RF positivity (%)708/895 (79.1)331/400 (82.8)57/71 (80.3)0.314†Tacrolimus (mg/d) (median [IQR])1.50 [1.00, 2.00]0.00 [0.00, 0.00]2.00 [1.00, 2.50]<0.001*MTX use (%)619 (46.6)264 (46.9)32 (27.1)<0.001†PSL use (%)749 (56.4)299 (53.1)71 (60.2)0.253†Abbreviations: anti-CCP, anti-cyclic citrullinated peptide; mHAQ, modified Health Assessment Questionnaire; MTX, methotrexate; PSL, prednisolone; RF, rheumatoid factor * Kruskal-Wallis test; † chi square test; ‡ analysis of variance (ANOVA)Conclusion:The combination of ABT and Tac does not increase the risk of adverse events in patients with rheumatoid arthritis in Japan when compared to the use ABT or Tac alone. Further evaluation is needed.References:[1]Matsui T, et al. Ann Rheum Dis 2007;66:1221–6.Disclosure of Interests:Kenichiro Tokunaga: None declared, Kunihiko Matsui: None declared, Hideto Oshikawa: None declared, Toshihiro Matsui Paid instructor for: Chugai Pharmaceutical Co., LTD., Janssen Pharmaceutical K,K,, Shigeto Tohma: None declared
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Yoshikawa T, Furukawa T, Tamura M, Hashimoto T, Morimoto M, Azuma N, Matsui K. FRI0113 THE BASELINE SOLUBLE GP130 IS ASSOCIATED WITH THE RESPONSE OF RHEUMATOID ARTHRITIS PATIENTS TO SARILUMAB. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:IL-6 contributes significantly to the chronic inflammatory process of rheumatoid arthritis (RA). Sarilumab (SRL), a human anti-human IL-6 receptor alpha monoclonal antibody that blocks the signaling originated by the IL-6/IL-6R complex like tocilizumab,is an effective treatment. However, predictors of the response to sarilumab are still required.Objectives:We aimed to combine IL-6, soluble IL-6R (sIL-6R) and gp130 (sgp130) levels to identify groups of sarilumab responses.Methods:This research is a retrospective study. a total of 32 RA patients with SRL therapy in our department from February 1 in 2018 to December 31 in 2019 were included. Serum and clinical data from 32 RA patients were collected before treatment and until the last visit. Follow-up period was up to one year after starting SRL treatment. Serum were tested for IL-6 (Human IL-6 Quantikine ELISA Kit, R&D systems), sIL-6R (Human soluble IL-6R alpha Quantikine ELISA Kit, R&D systems) and sgp130 (Human soluble gp130 Quantikine ELISA Kit, R&D systems), using specific ELISAs according to the manufacturer’s instructions. Hierarchical cluster analysis (JMP14.3.0) was used to establish the relationship between IL-6, sIL-6R and sgp130. We evaluated the efficacy of SRL treatment on the last visit using European League Against Rheumatism (EULAR) response criteria in the groups of patients. The other statistical analyses were performed with EZR 1.41, and p Values less than 0.05 were considered significant.Results:The median age of patients was 70.5 (IQR: 66.5-74.3) years and the median of disease duration was 7.3 (1.7-15.3) years. Nine (28.1%) patients were biologics and Jakinibs naive. the median follow-up periods were 24 (12-26) weeks. The baseline DAS28 was median 4.39 (3.77 - 5.43), and CDAI was 21.1 (11.7-29.5). When comparing responders and non-responders, there were no significant differences in any of the baseline parameters and cytokines. Four statistical significant clusters of RA patients (i.e., Group1, Group2, Group3 and tocilizumab use group before SRL) were defined by serum concentrations of IL-6, sIL-6R and spg130 at baseline. The levels of IL-6 expressed as median in Group1 patients were 25.6 (14.4–72.2) pg/ml, in Group2 5.9 (3.3–11.3) pg/ml, and in Group3 70.2 (45.4–86.1) pg/ml (p < 0.002, significant difference only between Group2 and Group3). The levels of sIL-6R expressed as median in Group1 patients were 38.7 (34.7-45.1) ng/ml, in Group2 35.1 (24.8-41.9) ng/ml, and in Group3 35.7 (34.2-39.8) ng/ml (p = 0.5477). The levels of sgp130 expressed as median in Group1 patients were 272.6 (263.0-277.2) ng/ml, in Group2 223.1 (221.0-228.0) ng/ml, and in Group3 204.6 (192.0-207.6) ng/ml (p < 0.00003, significant difference between the three groups respectively). There were no significant differences in any of the baseline clinical features and laboratory findings between the three groups. Out of the 8 patients in Group1 had a good or moderate response to SRL. Conversely, the percentage of patients with no response to SRL was higher in Group3 than in Group1 and Group2.Conclusion:RA patients could be easily stratified prior to the rapeutic intervention with sgp130 related to the IL-6 signal reguration. Group1 patients, who had the best response to SRL, had the highest level of sgp130.Table 1.Comparison of baseline serum IL-6, sIL-6R and sgp130 of each groups of patientsTCZ use before SRLGroup 1Group 2Group 3P valuen=3N=9N=8N=9IL-6,pg/mL69.8,77.6,592.6Median[IQR]25.6[14.4-72.2]5.9[3.3-11.3]70.2[45.4-86.1]<0.002csIL-6R,ng/mL390.5,413.2,481.7Median[IQR]38.7[34.7-45.1]35.1[24.8-41.9]35.7[34.2-39.8]0.547sgp130,ng/mL205.6,219.2,239.8Median[IQR]273[263-277]223[221-228]205[192-208]<0.001abc*a, b and c mean that statically significant difference between subgroups as a: group1 vs. 2, b: group 1 vs. 3, c: group 2 vs. 3.Disclosure of Interests:Takahiro Yoshikawa: None declared, Tetsuya Furukawa: None declared, Masao Tamura: None declared, Teppei Hashimoto: None declared, Mai Morimoto: None declared, Naoto Azuma: None declared, Kiyoshi Matsui Grant/research support from: Asahi Kasei Pharma, Astellas Pharma (research grants), Speakers bureau: Bristol-Myers Squibb (lecture fees)
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Hosono Y, Takahashi K, Akimoto S, Ifuku M, Iso T, Yazaki K, Yamada M, Matsui K, Akimoto K, Nakanishi K, Nii M, Kawasaki S, Kishiro M, Shimizu T. P1357 Left atrial function decreases with age in patients with repaired tetralogy of Fallot decrease. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Left ventricular function has been shown to be an important prognostic indicator in patients with repaired tetralogy of Fallot (rTOF) and tends to decrease with age. In recent years, left atrial (LA) function was reported to be a useful prognostic indicator more than or equal to left ventricular function in acquired heart diseases. However, atrial function in rTOF has not yet been sufficiently examined.
PURPOSE
The aim of this study was to investigate the relationship between LA dysfunction and age in rTOF using strain analysis.
METHODS
In order to assess the relationship between LA function and age, we recruited 59 patients with rTOF ranging in age from 5-40 years. We stratified the patients into 3 groups (T1: 5-10 years, T2: 11-20 years, T3: 21-40 years) and divided 54 controls of similar age into 3 corresponding groups (N1, N2, and N3). Two-dimensional speckle tracking images (2D-STI) obtained from four- and two-chamber views were used to assess LA functions by measuring reservoir, conduit, and pump strain. Additionally, we measured the strain rate (SR) in the systole, early diastole, and late diastole.
RESULTS
LA reservoir strain (37.4 ± 2.2% vs. 47.9 ± 1.7%, P= 0.004), LA pump strain (8.3 ± 1.4% vs. 14.1 ± 2.7%, p <.001), atrial systolic LA-SR (1.5 ± 0.4% vs. 2.4 ± 0.6%, p <.001), and systolic LA-SR (1.5 ± 0.3% vs. 2.1 ± 0.4%, p = 0.003) were significantly decreased in T3 compared with N3. Although only LA conduit strain decreased with aging (r = -0.3204, p = 0011) in controls, all of the LA reservoir (r = -0.325, p = 0.020), conduit (r = -0.314, p = 0.025), and pump strain (r = -0.481, p < 0.001) in rTOF decreased with aging.
Early diastole SR was significantly decreased in the T1 and T3 groups compared with the N1 and N3 groups (T1 vs N1, 3.00 ± 0.63% vs. 4.03 ± 0.0.80%, p <.0.001, T3 vs N3, 2.31 ± 0.57% vs.3.31 ± 0.47%, p < 0.001). Both systolic SR and late diastole SR decreased in T3 group compared with the N3 (1.54 ± 0.32% vs. 2.08 ± 0.42%, p = 0.003, 1.42 ± 0.32% vs.2.42 ± 0.61%, p < 0.001), respectively. Although only early diastole SR decreased with aging (r = -0.415, p < 0.001) in controls, all of the systole (r = -0.287, p = 0.041), early diastole (r = -0.337, p = 0.019), and late diastole SR (r = -0.407, p = 0.003) in rTOF decreased with aging.
CONCLUSIONS
In rTOF, most of the LA functions assessed by strain analysis decreased compared to normal controls in over 20 years old age. Furthermore, all measured functions decreased with age in rTOF while only two parameters decreased with age in normal controls. These results suggest that LA function may be an important indicator in long-term rTOF follow-up. These are new insights into LA function in patients with rTOF.
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Affiliation(s)
- Y Hosono
- Juntendo University School of Medicine, Tokyo, Japan
| | - K Takahashi
- Juntendo University School of Medicine, Tokyo, Japan
| | - S Akimoto
- Juntendo University School of Medicine, Tokyo, Japan
| | - M Ifuku
- Juntendo University School of Medicine, Tokyo, Japan
| | - T Iso
- Juntendo University, Pediatrics, Tokyo, Japan
| | - K Yazaki
- Juntendo University, Pediatrics, Tokyo, Japan
| | - M Yamada
- Juntendo University, Pediatrics, Tokyo, Japan
| | - K Matsui
- Juntendo University, Pediatrics, Tokyo, Japan
| | - K Akimoto
- Juntendo University, Pediatrics, Tokyo, Japan
| | - K Nakanishi
- Juntendo University, Cardiovascular surgery, Tokyo, Japan
| | - M Nii
- Shizuoka Children"s Hospital, Pediatric Cardiology, Shizuoka, Japan
| | - S Kawasaki
- Juntendo University, Cardiovascular surgery, Tokyo, Japan
| | - M Kishiro
- Juntendo University, Pediatrics, Tokyo, Japan
| | - T Shimizu
- Juntendo University, Pediatrics, Tokyo, Japan
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Suzuki M, Okamoto T, Akagi Y, Sekiguchi H, Matsui K, Satoya N, Inoue Y, Hagiwara N. Impact of oral myofunctional therapy to treat the patients with moderate to severe obstructive sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ota T, Fukui T, Nakahara Y, Takeda T, Uchino J, Mouri T, Kudo K, Nakajima S, Suzumura T, Okabe T, Hayashi H, Miyatake N, Nakano Y, Terashima M, Hasegawa Y, Tsukuda H, Matsui K, Masuda N, Fukuoka M. P1.04-40 Serum Perforin Levels During the First Cycle of Anti-PD-1 Antibody Therapies in Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Azuma N, Ohta M, Kageyama Y, Kawanaka Y, Matsui K. Delayed onset of metronidazole-induced encephalopathy in a patient with systemic sclerosis accompanied by intestinal pseudo-obstruction. Scand J Rheumatol 2019; 49:77-79. [PMID: 31307267 DOI: 10.1080/03009742.2019.1615123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- N Azuma
- Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - M Ohta
- Department of Neurology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Y Kageyama
- Department of Neurology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Y Kawanaka
- Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - K Matsui
- Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
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Paul N, Obertelli A, Bertulani CA, Corsi A, Doornenbal P, Rodriguez-Sanchez JL, Authelet G, Baba H, Calvet D, Château F, Chen S, Delbart A, Gheller JM, Giganon A, Gillibert A, Isobe T, Lapoux V, Matsushita M, Momiyama S, Motobayashi T, Niikura M, Otsu H, Péron C, Peyaud A, Pollacco EC, Roussé JY, Sakurai H, Santamaria C, Sasano M, Shiga Y, Steppenbeck D, Takeuchi S, Taniuchi R, Uesaka T, Wang H, Yoneda K, Ando T, Arici T, Blazhev A, Browne F, Bruce AM, Carroll R, Chung LX, Cortés ML, Dewald M, Ding B, Dombradi Z, Flavigny F, Franchoo S, Giacoppo F, Górska M, Gottardo A, Hadynska-Klek K, Korkulu Z, Koyama S, Kubota Y, Jungclaus A, Lee J, Lettmann M, Linh BD, Liu J, Liu Z, Lizarazo C, Louchart C, Lozeva R, Matsui K, Miyazaki T, Moschner K, Nagamine S, Nakatsuka N, Nita C, Nishimura S, Nobs CR, Olivier L, Ota S, Patel Z, Podolyák Z, Rudigier M, Sahin E, Saito TY, Shand C, Söderström PA, Stefan IG, Sumikama T, Suzuki D, Orlandi R, Vaquero V, Vajta Z, Werner V, Wimmer K, Wu J, Xu Z. Prominence of Pairing in Inclusive (p,2p) and (p,pn) Cross Sections from Neutron-Rich Nuclei. Phys Rev Lett 2019; 122:162503. [PMID: 31075035 DOI: 10.1103/physrevlett.122.162503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Indexed: 06/09/2023]
Abstract
Fifty-five inclusive single nucleon-removal cross sections from medium mass neutron-rich nuclei impinging on a hydrogen target at ∼250 MeV/nucleon are measured at the RIKEN Radioactive Isotope Beam Factory. Systematically higher cross sections are found for proton removal from nuclei with an even number of protons as compared to odd-proton number projectiles for a given neutron separation energy. Neutron removal cross sections display no even-odd splitting, contrary to nuclear cascade model predictions. Both effects are understood through simple considerations of neutron separation energies and bound state level densities originating in pairing correlations in the daughter nuclei. These conclusions are supported by comparison with semimicroscopic model predictions, highlighting the enhanced role of low-lying level densities in nucleon-removal cross sections from loosely bound nuclei.
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Affiliation(s)
- N Paul
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A Obertelli
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - C A Bertulani
- Department of Physics and Astronomy, Texas A&M University-Commerce, Commerce, Texas 75429-3011, USA
| | - A Corsi
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - P Doornenbal
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - J L Rodriguez-Sanchez
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- GSI Helmholtzzentrum für Schwerionenforschung, GmbH, D-64291 Darmstadt, Germany
| | - G Authelet
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - H Baba
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Calvet
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - F Château
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - S Chen
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- School of Physics and State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871, People's Republic of China
| | - A Delbart
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J-M Gheller
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Giganon
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Gillibert
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - T Isobe
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - V Lapoux
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Matsushita
- Center for Nuclear Study, The University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - S Momiyama
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - T Motobayashi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - M Niikura
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H Otsu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - C Péron
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Peyaud
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - E C Pollacco
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J-Y Roussé
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - H Sakurai
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - C Santamaria
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - M Sasano
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y Shiga
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 172-8501, Japan
| | - D Steppenbeck
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - S Takeuchi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - R Taniuchi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - T Uesaka
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Wang
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Yoneda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Ando
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - T Arici
- GSI Helmholtzzentrum für Schwerionenforschung, GmbH, D-64291 Darmstadt, Germany
- Justus-Liebig-Universität Giessen, D-35392 Giessen, Germany
| | - A Blazhev
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - F Browne
- School of Computing Engineering and Mathematics, University of Brighton, Brighton, England BN2 4GJ, United Kingdom
| | - A M Bruce
- School of Computing Engineering and Mathematics, University of Brighton, Brighton, England BN2 4GJ, United Kingdom
| | - R Carroll
- Department of Physics, University of Surrey, Guildford, England GU2 7XH, United Kingdom
| | - L X Chung
- Institute for Nuclear Science and Technology, VINATOM, P.O. Box 5T-160, Nghia Do, Hanoi, Vietnam
| | - M L Cortés
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, GmbH, D-64291 Darmstadt, Germany
| | - M Dewald
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - B Ding
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, People's Republic of China
| | - Zs Dombradi
- MTA Atomki, P.O. Box 51, Debrecen H-4001, Hungary
| | - F Flavigny
- Institut de Physique Nucléaire, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, F-91406 Orsay Cedex, France
| | - S Franchoo
- Institut de Physique Nucléaire, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, F-91406 Orsay Cedex, France
| | - F Giacoppo
- Department of Physics, University of Oslo, N-0316 Oslo, Norway
| | - M Górska
- GSI Helmholtzzentrum für Schwerionenforschung, GmbH, D-64291 Darmstadt, Germany
| | - A Gottardo
- Institut de Physique Nucléaire, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, F-91406 Orsay Cedex, France
| | - K Hadynska-Klek
- Department of Physics, University of Oslo, N-0316 Oslo, Norway
| | - Z Korkulu
- MTA Atomki, P.O. Box 51, Debrecen H-4001, Hungary
| | - S Koyama
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Y Kubota
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Center for Nuclear Study, The University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - A Jungclaus
- Instituto de Estructura de la Materia, CSIC, 28006 Madrid, Spain
| | - J Lee
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - M Lettmann
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - B D Linh
- Institute for Nuclear Science and Technology, VINATOM, P.O. Box 5T-160, Nghia Do, Hanoi, Vietnam
| | - J Liu
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - Z Liu
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, People's Republic of China
| | - C Lizarazo
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, GmbH, D-64291 Darmstadt, Germany
| | - C Louchart
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - R Lozeva
- IPHC, CNRS/IN2P3, Université de Strasbourg, F-67037 Strasbourg, France
- CSNSM, CNRS/IN2P3, Université Paris-Sud, F-91405 Orsay Campus, France
| | - K Matsui
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - T Miyazaki
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - K Moschner
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - S Nagamine
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - N Nakatsuka
- Department of Physics, Faculty of Science, Kyoto University, Kyoto 606-8502, Japan
| | - C Nita
- Horia Hulubei National Institute of Physics and Nuclear Engineering (IFIN-HH), RO-077125 Bucharest, Romania
| | - S Nishimura
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - C R Nobs
- School of Computing Engineering and Mathematics, University of Brighton, Brighton, England BN2 4GJ, United Kingdom
| | - L Olivier
- Institut de Physique Nucléaire, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, F-91406 Orsay Cedex, France
| | - S Ota
- Center for Nuclear Study, The University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - Z Patel
- Department of Physics, University of Surrey, Guildford, England GU2 7XH, United Kingdom
| | - Zs Podolyák
- Department of Physics, University of Surrey, Guildford, England GU2 7XH, United Kingdom
| | - M Rudigier
- Department of Physics, University of Surrey, Guildford, England GU2 7XH, United Kingdom
| | - E Sahin
- Department of Physics, University of Oslo, N-0316 Oslo, Norway
| | - T Y Saito
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - C Shand
- Department of Physics, University of Surrey, Guildford, England GU2 7XH, United Kingdom
| | - P-A Söderström
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Extreme Light Infrastructure-Nuclear Physics (ELI-NP), 077125 Bucharest-Măgurele, Romania
| | - I G Stefan
- Institut de Physique Nucléaire, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, F-91406 Orsay Cedex, France
| | - T Sumikama
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - D Suzuki
- Institut de Physique Nucléaire, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, F-91406 Orsay Cedex, France
| | - R Orlandi
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - V Vaquero
- Instituto de Estructura de la Materia, CSIC, 28006 Madrid, Spain
| | - Zs Vajta
- MTA Atomki, P.O. Box 51, Debrecen H-4001, Hungary
| | - V Werner
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - K Wimmer
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - J Wu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- School of Physics and State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871, People's Republic of China
| | - Z Xu
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
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Oki R, Hidaka S, Moriya H, Miyake K, Oda Y, Matsui K, Taguchi S, Mochida Y, Ishioka K, Ohtake T, Kobayashi S. Remarkable Improvement of Cardiac Function After Pre-emptive Kidney Transplant in a Patient With Severe Mitral Regurgitation Accompanied by Low Cardiac Function: A Case Report. Transplant Proc 2019; 51:548-550. [PMID: 30879587 DOI: 10.1016/j.transproceed.2018.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 12/09/2018] [Indexed: 10/27/2022]
Abstract
Patients with end-stage renal disease are at a high risk for cardiovascular diseases. It is controversial whether end-stage renal disease patients with low cardiac function can safely accept kidney transplant. Here, we present a 42-year-old kidney transplant recipient with severe mitral regurgitation accompanied by low cardiac function. He wanted to undergo a pre-emptive kidney transplant from his uncle. We decided to perform living kidney transplant prior to cardiac surgery. Despite adequate ultrafiltration and hemodiafiltration before operation, the patient's ejection fraction still remained 35% 1 day before transplant. He showed complete recovery of cardiac function in only 2 days after pre-emptive kidney transplant, although his body weight did not change before and after the operation. Early removal of the uremic toxin or inflammatory cytokines may play a role in rapid improvement of the cardiac function. Increase of vasoactive substances by improvement of kidney function may lead to reduction of afterload and amelioration of cardiac microcirculation. This report also suggests that optimal timing for operation might be important.
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Affiliation(s)
- R Oki
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan.
| | - S Hidaka
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - H Moriya
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - K Miyake
- Department of Kidney transplant surgery, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Y Oda
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - K Matsui
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - S Taguchi
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Y Mochida
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - K Ishioka
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - T Ohtake
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - S Kobayashi
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
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Kishimoto M, Yoshida K, Ichikawa N, Inoue H, Kaneko Y, Kawasaki T, Matsui K, Morita M, Suda M, Tada K, Takizawa N, Tamura N, Taniguchi A, Taniguchi Y, Tsuji S, Haji Y, Rokutanda R, Yanaoka H, Cheung PP, Gu J, Kim TH, Luo SF, Okada M, López Medina C, Molto A, Dougados M, Kobayashi S, van der Heijde D, Tomita T. Clinical Characteristics of Patients with Spondyloarthritis in Japan in Comparison with Other Regions of the World. J Rheumatol 2019; 46:896-903. [DOI: 10.3899/jrheum.180412] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2018] [Indexed: 12/21/2022]
Abstract
Objective.To delineate clinical characteristics of patients with spondyloarthritis (SpA) in Japan in comparison to other areas of the world.Methods.Using the ASAS-COMOSPA (Assessment of Spondyloarthritis international Society–COMOrbidities in SPondyloArthritis) data, an international cross-sectional observational study of patients with SpA, we analyzed information on demographics, disease characteristics, comorbidities, and risk factors. Patients were classified by region: Japan, other Asian countries (China, Singapore, South Korea, Taiwan), and non-Asian countries (Europe, the Americas, Africa). Patient characteristics, including diagnosis and treatment, were compared.Results.Among 3984 patients included in the study, 161 were from centers in Japan, 933 from other Asian countries, and 2890 from other regions. Of patients with SpA in Japan, 42 (26.1%) had peripheral SpA, substantially more than in other countries. This trend was explained by the predominance of psoriatic arthritis (PsA) among Japanese patients with SpA. In contrast to the relatively low number in Japan, 54% of patients from other Asian countries had pure axial SpA (axSpA) without peripheral features. HLA-B27 testing, considered an integral part of the classification of axSpA, was performed in only 63.6% of Japanese patients with axSpA. More than half of Japanese patients with axSpA were classified using imaging criteria.Conclusion.In our study, there was a more substantial number of peripheral SpA cases observed in Japan compared to other parts of Asia and other regions of the world. Aside from ethnic differences, increasing recognition of PsA in Japan, as well as a potential underdiagnosis of axSpA due to the insufficient use of HLA-B27 testing, may partly explain regional discrepancies.
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Ota T, Takeda T, Fukui T, Nakahara Y, Kudo K, Okabe T, Hayashi H, Otani S, Hiyoshi Y, Yonesaka K, Sugiura T, Suzumura T, Terashima M, Nakano Y, Hasegawa Y, Tsukuda H, Matsui K, Masuda N, Fukuoka M. Serum biomarkers during the first cycle of anti-PD-1 antibody therapies in non-small cell lung cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Nakatake R, Iida H, Ishizaki M, Matsui K, Nakamura Y, Kaibori M, Nishizawa M, Okumura T. Metformin has a protective effect through the inhibition of inducible nitric oxide synthase gene expression in hepatocytes. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.2013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Olivier L, Franchoo S, Niikura M, Vajta Z, Sohler D, Doornenbal P, Obertelli A, Tsunoda Y, Otsuka T, Authelet G, Baba H, Calvet D, Château F, Corsi A, Delbart A, Gheller JM, Gillibert A, Isobe T, Lapoux V, Matsushita M, Momiyama S, Motobayashi T, Otsu H, Péron C, Peyaud A, Pollacco EC, Roussé JY, Sakurai H, Santamaria C, Sasano M, Shiga Y, Takeuchi S, Taniuchi R, Uesaka T, Wang H, Yoneda K, Browne F, Chung LX, Dombradi Z, Flavigny F, Giacoppo F, Gottardo A, Hadyńska-Klęk K, Korkulu Z, Koyama S, Kubota Y, Lee J, Lettmann M, Louchart C, Lozeva R, Matsui K, Miyazaki T, Nishimura S, Ogata K, Ota S, Patel Z, Sahin E, Shand C, Söderström PA, Stefan I, Steppenbeck D, Sumikama T, Suzuki D, Werner V, Wu J, Xu Z. Erratum: Persistence of the Z=28 Shell Gap Around ^{78}Ni: First Spectroscopy of ^{79}Cu [Phys. Rev. Lett. 119, 192501 (2017)]. Phys Rev Lett 2018; 121:099902. [PMID: 30230867 DOI: 10.1103/physrevlett.121.099902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Indexed: 06/08/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.119.192501.
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Okita T, Hsu E, Aizawa K, Nakada H, Toya W, Matsui K. Quantitative Survey of Laypersons' Attitudes Toward Organ Transplantation in Japan. Transplant Proc 2018; 50:3-9. [PMID: 29407326 DOI: 10.1016/j.transproceed.2017.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 09/25/2017] [Accepted: 11/03/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND In comparison with foreign countries, living-organ transplantations (LOT) have been performed more frequently than dead organ transplants, including brain-dead organ transplantation (BOT) in Japan. This situation has given rise to organ transplantation tourism. Therefore, we clarify laypersons' preferences regarding organ transplantation that are producing the current situation in Japan, to suggest a possible framework for further efforts. METHODS Voluntary completion of a quantitative and anonymous survey was promoted online (a sample size of 1030). The questionnaire had two types of variables concerning demographic characteristics and organ transplantation-related issues. RESULTS LOT was favored over BOT. However, for willingness to donate to family members, the participants showed a significantly more positive attitude toward brain-dead organ donors (BODs) than living organ donors (LODs). In the evaluation of each transplantation technology, BOT and LOT were positioned in the middle, between transplantation that does not depend on others and the utilization of animal organs. CONCLUSIONS Although LOT was favored over BOT, for participants hypothesized to be in a position to donate and receive organs, BODs received a conversely better reputation than LODs. Our survey and discussion suggest that the present conditions of organ transplantation in Japan might be because there is a lack of deliberation on transplantation tourism and LOT. Therefore, more surveys concerning LOT cases and the implications of avoidance of organs from brain-dead bodies, coupled with more discussions based on these surveys, are necessary to formulate a Japanese transplantation policy for the future.
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Affiliation(s)
- T Okita
- Department of Medical Ethics, Tohoku University Graduate School of Medicine, Sendai, Japan; Office for Research Ethics & Bioethics, National Cerebral and Cardiovascular Center, Suita, Japan.
| | - E Hsu
- Office for Research Ethics & Bioethics, National Cerebral and Cardiovascular Center, Suita, Japan; Fulbright, Washington, DC
| | - K Aizawa
- Office for Research Ethics & Bioethics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - H Nakada
- Department of Intellectual Asset Management, National Cerebral and Cardiovascular Center, Suita, Japan; Bioethics Section, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - W Toya
- Office for Research Ethics & Bioethics, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Philosophy, University of Bergen, Bergen, Norway
| | - K Matsui
- Office for Research Ethics & Bioethics, National Cerebral and Cardiovascular Center, Suita, Japan
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Matsui K, Atkins H, Lebowtiz E, Greenberg D, Ansari A, Klopper J, Sacker D, Hathorn L, Som P. Microautoradiographic Studies on the Cellular Localization of Radiothallium. Nuklearmedizin 2018. [DOI: 10.1055/s-0037-1620705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
201Tl-chloride and 204Tl-nitr-ate were similarly distributed in organs of mice 10 min and 60 min after intravenous injection. Autoradiographic studies were carried out with 204Tl-nitrate in rats (injected intraperitoneally) as well as in mice and dogs (injected intravenously). Thallium localized in the cells of proximal and distal convoluted tubules and collecting tubules of the kidney. In the intestines, it was distributed mostly in the cells of the smooth musculature and surface epithelium of the villi. Some silver grains were seen in the goblet cells and in the lumen as well. It localized in the sarcoplasm of the myocardium and the skeletal muscle cells. In thyroid, most of the thallium was seen in the colloidal part of the follicle. In testes, silver grains were seen in and around the cells of Sertoli and in the lumen of the seminiferous tubules. Some localized concentration in the interstitial cells of the testes was also observed.
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Olivier L, Franchoo S, Niikura M, Vajta Z, Sohler D, Doornenbal P, Obertelli A, Tsunoda Y, Otsuka T, Authelet G, Baba H, Calvet D, Château F, Corsi A, Delbart A, Gheller JM, Gillibert A, Isobe T, Lapoux V, Matsushita M, Momiyama S, Motobayashi T, Otsu H, Péron C, Peyaud A, Pollacco EC, Roussé JY, Sakurai H, Santamaria C, Sasano M, Shiga Y, Takeuchi S, Taniuchi R, Uesaka T, Wang H, Yoneda K, Browne F, Chung LX, Dombradi Z, Flavigny F, Giacoppo F, Gottardo A, Hadyńska-Klęk K, Korkulu Z, Koyama S, Kubota Y, Lee J, Lettmann M, Louchart C, Lozeva R, Matsui K, Miyazaki T, Nishimura S, Ogata K, Ota S, Patel Z, Sahin E, Shand C, Söderström PA, Stefan I, Steppenbeck D, Sumikama T, Suzuki D, Werner V, Wu J, Xu Z. Persistence of the Z=28 Shell Gap Around ^{78}Ni: First Spectroscopy of ^{79}Cu. Phys Rev Lett 2017; 119:192501. [PMID: 29219515 DOI: 10.1103/physrevlett.119.192501] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Indexed: 06/07/2023]
Abstract
In-beam γ-ray spectroscopy of ^{79}Cu is performed at the Radioactive Isotope Beam Factory of RIKEN. The nucleus of interest is produced through proton knockout from a ^{80}Zn beam at 270 MeV/nucleon. The level scheme up to 4.6 MeV is established for the first time and the results are compared to Monte Carlo shell-model calculations. We do not observe significant knockout feeding to the excited states below 2.2 MeV, which indicates that the Z=28 gap at N=50 remains large. The results show that the ^{79}Cu nucleus can be described in terms of a valence proton outside a ^{78}Ni core, implying the magic character of the latter.
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Affiliation(s)
- L Olivier
- Institut de Physique Nucléaire, IN2P3-CNRS, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - S Franchoo
- Institut de Physique Nucléaire, IN2P3-CNRS, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - M Niikura
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Z Vajta
- MTA Atomki, P.O. Box 51, Debrecen H-4001, Hungary
| | - D Sohler
- MTA Atomki, P.O. Box 51, Debrecen H-4001, Hungary
| | - P Doornenbal
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A Obertelli
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - Y Tsunoda
- Center for Nuclear Study, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - T Otsuka
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Center for Nuclear Study, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - G Authelet
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - H Baba
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Calvet
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - F Château
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Corsi
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Delbart
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J-M Gheller
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Gillibert
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - T Isobe
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - V Lapoux
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Matsushita
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - S Momiyama
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - T Motobayashi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Otsu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - C Péron
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Peyaud
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - E C Pollacco
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J-Y Roussé
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - H Sakurai
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - C Santamaria
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Sasano
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y Shiga
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 172-8501, Japan
| | - S Takeuchi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - R Taniuchi
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Uesaka
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Wang
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Yoneda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - F Browne
- School of Computing Engineering and Mathematics, University of Brighton, Brighton BN2 4GJ, United Kingdom
| | - L X Chung
- Institute for Nuclear Science & Technology, VINATOM, P.O. Box 5T-160, Nghia Do, Hanoi, Vietnam
| | - Z Dombradi
- MTA Atomki, P.O. Box 51, Debrecen H-4001, Hungary
| | - F Flavigny
- Institut de Physique Nucléaire, IN2P3-CNRS, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - F Giacoppo
- Department of Physics, University of Oslo, N-0316 Oslo, Norway
| | - A Gottardo
- Institut de Physique Nucléaire, IN2P3-CNRS, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - K Hadyńska-Klęk
- Department of Physics, University of Oslo, N-0316 Oslo, Norway
| | - Z Korkulu
- MTA Atomki, P.O. Box 51, Debrecen H-4001, Hungary
| | - S Koyama
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Y Kubota
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - J Lee
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - M Lettmann
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - C Louchart
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - R Lozeva
- IPHC, CNRS/IN2P3, Université de Strasbourg, F-67037 Strasbourg, France
| | - K Matsui
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Miyazaki
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - S Nishimura
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Ogata
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - S Ota
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - Z Patel
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - E Sahin
- Department of Physics, University of Oslo, N-0316 Oslo, Norway
| | - C Shand
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - P-A Söderström
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - I Stefan
- Institut de Physique Nucléaire, IN2P3-CNRS, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - D Steppenbeck
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - T Sumikama
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - D Suzuki
- Institut de Physique Nucléaire, IN2P3-CNRS, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - V Werner
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - J Wu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871, People's Republic of China
| | - Z Xu
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
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Earashi M, Matsui K, Maeda K, Fukushima W, Shimada K, Shimizu T, Nozaki Z, Tanada Y, Oyama K, Nagata T, Tsuneda A, Yoshikawa A, Yoshida T, Kiyohara K, Iwata K, Ii T. Evaluation of eribulin and bevacizumab for the real world treatment of recurrent breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx654.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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43
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Matsui K, Yoshikawa A, Oyama K, Nozaki Z, Tanada Y, Earashi M, Kiyohara K, Nagata T, Fukushima W, Shimizu T, Maeda K. Efficacy of T-DM1 in patients with HER2-positive metastatic breast cancer previously treated with pertuzumab. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx654.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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44
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Koizumi N, Kajitani H, Matsui K, Hemmi T, Yamane M, Ando S, Nakamoto M, Takano K. Series production of ITER toroidal field coil double pancakes in Japan. Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2017.03.083] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Niwa H, Chikuchi R, Amakusa Y, Matsui K, Matsuo K. Pre-stroke anti-coagulant treatment for cardiogenic embolism in the pre- and post-DOAC era: A regional ten-year study from the middle part of Japan. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nakatake R, Hishikawa H, Matushima H, Nakamura Y, Ishizaki M, Matsui K, Kaibori M, Nishizawa M, Okumura T, Kwon AH. SUN-LB315: Curcumin Protects Liver Inflammation by Suppressing INOS Induction in Rat Hepatocytes. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30648-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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47
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Sahin E, Bello Garrote FL, Tsunoda Y, Otsuka T, de Angelis G, Görgen A, Niikura M, Nishimura S, Xu ZY, Baba H, Browne F, Delattre MC, Doornenbal P, Franchoo S, Gey G, Hadyńska-Klȩk K, Isobe T, John PR, Jung HS, Kojouharov I, Kubo T, Kurz N, Li Z, Lorusso G, Matea I, Matsui K, Mengoni D, Morfouace P, Napoli DR, Naqvi F, Nishibata H, Odahara A, Sakurai H, Schaffner H, Söderström PA, Sohler D, Stefan IG, Sumikama T, Suzuki D, Taniuchi R, Taprogge J, Vajta Z, Watanabe H, Werner V, Wu J, Yagi A, Yalcinkaya M, Yoshinaga K. Shell Evolution towards ^{78}Ni: Low-Lying States in ^{77}Cu. Phys Rev Lett 2017; 118:242502. [PMID: 28665637 DOI: 10.1103/physrevlett.118.242502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Indexed: 06/07/2023]
Abstract
The level structure of the neutron-rich ^{77}Cu nucleus is investigated through β-delayed γ-ray spectroscopy at the Radioactive Isotope Beam Factory of the RIKEN Nishina Center. Ions of ^{77}Ni are produced by in-flight fission, separated and identified in the BigRIPS fragment separator, and implanted in the WAS3ABi silicon detector array, surrounded by Ge cluster detectors of the EURICA array. A large number of excited states in ^{77}Cu are identified for the first time by correlating γ rays with the β decay of ^{77}Ni, and a level scheme is constructed by utilizing their coincidence relationships. The good agreement between large-scale Monte Carlo shell model calculations and experimental results allows for the evaluation of the single-particle structure near ^{78}Ni and suggests a single-particle nature for both the 5/2_{1}^{-} and 3/2_{1}^{-} states in ^{77}Cu, leading to doubly magic ^{78}Ni.
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Affiliation(s)
- E Sahin
- Department of Physics, University of Oslo, Oslo 0316, Norway
| | | | - Y Tsunoda
- Center for Nuclear Study, University of Tokyo, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - T Otsuka
- Center for Nuclear Study, University of Tokyo, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Instituut voor Kern- en Stralingsfysica, KU Leuven, B-3001 Leuven, Belgium
| | - G de Angelis
- Laboratori Nazionali di Legnaro dell'INFN, Legnaro 35020, Italy
| | - A Görgen
- Department of Physics, University of Oslo, Oslo 0316, Norway
| | - M Niikura
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - S Nishimura
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Z Y Xu
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H Baba
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - F Browne
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- School of Computing, Engineering and Mathematics, University of Brighton, Brighton BN2 4GJ, United Kingdom
| | - M-C Delattre
- Institut de Physique Nucleaire (IPN), IN2P3-CNRS, Université Paris-Sud 11, F-91406 Orsay Cedex, France
| | - P Doornenbal
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - S Franchoo
- Institut de Physique Nucleaire (IPN), IN2P3-CNRS, Université Paris-Sud 11, F-91406 Orsay Cedex, France
| | - G Gey
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- LPSC, Université Joseph Fourier Grenoble 1, CNRS/IN2P3, Institut National Polytechnique de Grenoble, F-38026 Grenoble Cedex, France
| | - K Hadyńska-Klȩk
- Department of Physics, University of Oslo, Oslo 0316, Norway
- Laboratori Nazionali di Legnaro dell'INFN, Legnaro 35020, Italy
| | - T Isobe
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - P R John
- INFN Sezione di Padova and Dipartimento di Fisica e Astronomia, Università di Padova, Padova 35131, Italy
| | - H S Jung
- Department of Physics, University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - I Kojouharov
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - T Kubo
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - N Kurz
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - Z Li
- Department of Physics, Peking University, Beijing 100871, China
| | - G Lorusso
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - I Matea
- Institut de Physique Nucleaire (IPN), IN2P3-CNRS, Université Paris-Sud 11, F-91406 Orsay Cedex, France
| | - K Matsui
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - D Mengoni
- INFN Sezione di Padova and Dipartimento di Fisica e Astronomia, Università di Padova, Padova 35131, Italy
| | - P Morfouace
- Institut de Physique Nucleaire (IPN), IN2P3-CNRS, Université Paris-Sud 11, F-91406 Orsay Cedex, France
| | - D R Napoli
- Laboratori Nazionali di Legnaro dell'INFN, Legnaro 35020, Italy
| | - F Naqvi
- Wright Nuclear Structure Laboratory, Yale University, New Haven, Connecticut 06520-8120, USA
| | - H Nishibata
- Department of Physics, Osaka University, 1-1 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - A Odahara
- Department of Physics, Osaka University, 1-1 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - H Sakurai
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Schaffner
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - P-A Söderström
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Sohler
- Institute for Nuclear Research of the Hungarian Academy of Sciences, Debrecen H-4001, Hungary
| | - I G Stefan
- Institut de Physique Nucleaire (IPN), IN2P3-CNRS, Université Paris-Sud 11, F-91406 Orsay Cedex, France
| | - T Sumikama
- Department of Physics, Tohoku University, 6-3 Aramaki-Aoba, Aoba, Sendai 980-8578, Japan
| | - D Suzuki
- Institut de Physique Nucleaire (IPN), IN2P3-CNRS, Université Paris-Sud 11, F-91406 Orsay Cedex, France
| | - R Taniuchi
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - J Taprogge
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Departamento de Física Teórica, Universidad Autonoma de Madrid, E-28049 Madrid, Spain
- Instituto de Estructura de la Materia, CSIC, E-28006 Madrid, Spain
| | - Z Vajta
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Institute for Nuclear Research of the Hungarian Academy of Sciences, Debrecen H-4001, Hungary
| | - H Watanabe
- International Research Center for Nuclei and Particles in the Cosmos, Beihang University, Beijing 100191, China
| | - V Werner
- Wright Nuclear Structure Laboratory, Yale University, New Haven, Connecticut 06520-8120, USA
- Institut für Kernphysik, TU Darmstadt, 64289 Darmstadt, Germany
| | - J Wu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Peking University, Beijing 100871, China
| | - A Yagi
- Department of Physics, Osaka University, 1-1 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - M Yalcinkaya
- Department of Physics, Faculty of Science, Istanbul University, Vezneciler/Fatih 34134, Istanbul, Turkey
| | - K Yoshinaga
- Department of Physics, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba 278-8510, Japan
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Hida A, Ohsawa Y, Kitamura S, Nakazaki K, Ayabe N, Motomura Y, Matsui K, Kobayashi M, Usui A, Inoue Y, Kusanagi H, Kamei Y, Mishima K. Evaluation of circadian phenotypes utilizing fibroblasts from patients with circadian rhythm sleep disorders. Transl Psychiatry 2017; 7:e1106. [PMID: 28440811 PMCID: PMC5416712 DOI: 10.1038/tp.2017.75] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 02/12/2017] [Accepted: 03/08/2017] [Indexed: 12/11/2022] Open
Abstract
We evaluated the circadian phenotypes of patients with delayed sleep-wake phase disorder (DSWPD) and non-24-hour sleep-wake rhythm disorder (N24SWD), two different circadian rhythm sleep disorders (CRSDs) by measuring clock gene expression rhythms in fibroblast cells derived from individual patients. Bmal1-luciferase (Bmal1-luc) expression rhythms were measured in the primary fibroblast cells derived from skin biopsy samples of patients with DSWPD and N24SWD, as well as control subjects. The period length of the Bmal1-luc rhythm (in vitro period) was distributed normally and was 22.80±0.47 (mean±s.d.) h in control-derived fibroblasts. The in vitro periods in DSWPD-derived fibroblasts and N24SWD-derived fibroblasts were 22.67±0.67 h and 23.18±0.70 h, respectively. The N24SWD group showed a significantly longer in vitro period than did the control or DSWPD group. Furthermore, in vitro period was associated with response to chronotherapy in the N24SWD group. Longer in vitro periods were observed in the non-responders (mean±s.d.: 23.59±0.89 h) compared with the responders (mean±s.d.: 22.97±0.47 h) in the N24SWD group. Our results indicate that prolonged circadian periods contribute to the onset and poor treatment outcome of N24SWD. In vitro rhythm assays could be useful for predicting circadian phenotypes and clinical prognosis in patients with CRSDs.
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Affiliation(s)
- A Hida
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Y Ohsawa
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - S Kitamura
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - K Nakazaki
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - N Ayabe
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Y Motomura
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - K Matsui
- Yoyogi Sleep Disorder Center, Tokyo, Japan
| | - M Kobayashi
- Yoyogi Sleep Disorder Center, Tokyo, Japan
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - A Usui
- Yoyogi Sleep Disorder Center, Tokyo, Japan
| | - Y Inoue
- Yoyogi Sleep Disorder Center, Tokyo, Japan
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - H Kusanagi
- Department of Neuropsychiatry, Bioregulatory Medicine, Akita University, Graduate School of Medicine, Akita, Japan
| | - Y Kamei
- Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - K Mishima
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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49
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Kawai T, Matsui K, Ezoe Y, Kajii F, Suzuki O, Takahashi T, Kamakura S. Affinity of octacalcium phosphate collagen composite for titanium dental implants. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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50
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Utsunomiya M, Dobashi H, Odani T, Saito K, Yokogawa N, Nagasaka K, Takenaka K, Soejima M, Sugihara T, Hagiyama H, Hirata S, Matsui K, Nonomura Y, Kondo M, Suzuki F, Tomita M, Kihara M, Yokoyama W, Hirano F, Yamazaki H, Sakai R, Nanki T, Koike R, Kohsaka H, Miyasaka N, Harigai M. Optimal regimens of sulfamethoxazole-trimethoprim for chemoprophylaxis of Pneumocystis pneumonia in patients with systemic rheumatic diseases: results from a non-blinded, randomized controlled trial. Arthritis Res Ther 2017; 19:7. [PMID: 28100282 PMCID: PMC5241919 DOI: 10.1186/s13075-016-1206-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 12/08/2016] [Indexed: 11/13/2022] Open
Abstract
Background Sulfamethoxazole-trimethoprim (SMX/TMP) is a standard drug for the prophylaxis of Pneumocystis pneumonia (PJP) in immunosuppressed patients with systemic rheumatic diseases, but is sometimes discontinued due to adverse events (AEs). The objective of this non-blinded, randomized, 52-week non-inferiority trial was to quest an effective chemoprophylaxis regimen for PJP with a low drug discontinuation rate. Results at week 24 were reported. Methods Adult patients with systemic rheumatic diseases who started prednisolone ≥0.6 mg/kg/day were randomized into three dosage groups: a single-strength group (SS, SMX/TMP of 400/80 mg daily), half-strength group (HS, 200/40 mg daily), and escalation group (ES, started with 40/8 mg daily, increasing incrementally to 200/40 mg daily). The primary endpoint was non-incidence rates (non-IR) of PJP at week 24. Results Of 183 patients randomly allocated at a 1:1:1 ratio into the three groups, 58 patients in SS, 59 in HS, and 55 in ES started SMX/TMP. A total of 172 patients were included in the analysis. No cases of PJP were reported up to week 24. Estimated non-IR of PJP in patients who received daily SMX/TMP of 200/40 mg, either starting at this dose or increasing incrementally, was 96.8–100% using the exact confidence interval as a post-hoc analysis. The overall discontinuation rate was significantly lower with HS compared to SS (p = 0.007). The discontinuation rates due to AEs were significantly lower with HS (p = 0.006) and ES (p = 0.004) compared to SS. The IR of AEs requiring reduction in the dose of SMX/TMP (p = 0.009) and AEs of special interest (p = 0.003) were different among the three groups with significantly higher IR in SS compared to HS and ES. Conclusions Although there were no PJP cases, the combined group of HS and ES had an excellent estimated non-IR of PJP and both were superior in safety to SS. From the perspective of feasibility and drug discontinuation rates, the daily half-strength regimen was suggested to be optimal for prophylaxis of PJP in patients with systemic rheumatic diseases. Trial registration The University Hospital Medical Information Network Clinical Trials Registry number is UMIN000007727, registered 10 April 2012. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-1206-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Masako Utsunomiya
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Rheumatology, Musashino Red Cross Hospital, 1-26-1 Kyonancho, Musashino, Tokyo, 180-0023, Japan
| | - Hiroaki Dobashi
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kida-gun, Kagawa, 761-0793, Japan
| | - Toshio Odani
- Third Department of Internal Medicine, Obihiro-Kosei General Hospital, West-6, South-8, Obihiro, Hokkaido, 080-0016, Japan.,Department of Internal Medicine, Hokusei Hospital, 5-1-1 Seiryu, Chitose, Hokkaido, 066-0081, Japan
| | - Kazuyoshi Saito
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Naoto Yokogawa
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8524, Japan
| | - Kenji Nagasaka
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Rheumatology, Ome Municipal General Hospital, 4-16-5 Higashi-Ome, Ome, Tokyo, 198-0042, Japan
| | - Kenchi Takenaka
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Rheumatology, Ome Municipal General Hospital, 4-16-5 Higashi-Ome, Ome, Tokyo, 198-0042, Japan
| | - Makoto Soejima
- Department of Rheumatology, Ome Municipal General Hospital, 4-16-5 Higashi-Ome, Ome, Tokyo, 198-0042, Japan.,Department of Rheumatology, Soka Municipal Hospital, 2-21-1 Soka, Soka, Saitama, 340-8560, Japan
| | - Takahiko Sugihara
- Department of Medicine and Rheumatology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Hiroyuki Hagiyama
- Department of Rheumatology, Yokohama City Minato Red Cross Hospital, 3-12-1, Shinyamashita, Naka-ku, Yokohama, Kanagawa, 231-8682, Japan
| | - Shinya Hirata
- Department of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo, Kumamoto, Kumamoto, 860-8556, Japan
| | - Kazuo Matsui
- Department of Rheumatology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan.,Department of Internal Medicine, Takikawa Municipal Hospital, 2-2-34 Oh-machi, Takikawa, Hokkaido, 073-0022, Japan
| | - Yoshinori Nonomura
- Department of Rheumatology, Tokyo Kyosai Hospital, 2-3-8 Nakameguro, Meguro-ku, Tokyo, 153-8934, Japan
| | - Masahiro Kondo
- Department of Rheumatology, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Fumihito Suzuki
- Department of Rheumatology, Soka Municipal Hospital, 2-21-1 Soka, Soka, Saitama, 340-0043, Japan.,Department of Rheumatology, JA Toride Medical Center, 2-1-1 Hongo, Toride, Ibaraki, 302-0022, Japan
| | - Makoto Tomita
- Clinical Research Center, Medical Hospital of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8549, Japan
| | - Mari Kihara
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Waka Yokoyama
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Fumio Hirano
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Hayato Yamazaki
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Ryoko Sakai
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Division of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases, Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan
| | - Toshihiro Nanki
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Ryuji Koike
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Hitoshi Kohsaka
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Nobuyuki Miyasaka
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Masayoshi Harigai
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. .,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. .,Division of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases, Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan.
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