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Kharatyan T, Gopireddy SR, Ogawa T, Kodama T, Nishimoto N, Osada S, Scherließ R, Urbanetz NA. Quantitative Analysis of Glassy State Relaxation and Ostwald Ripening during Annealing Using Freeze-Drying Microscopy. Pharmaceutics 2022; 14:pharmaceutics14061176. [PMID: 35745749 PMCID: PMC9231378 DOI: 10.3390/pharmaceutics14061176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/27/2022] [Accepted: 05/27/2022] [Indexed: 02/06/2023] Open
Abstract
Supercooling during the freezing of pharmaceutical solutions often leads to suboptimal freeze-drying results, such as long primary drying times or a collapse in the cake structure. Thermal treatment of the frozen solution, known as annealing, can improve those issues by influencing properties such as the pore size and collapse temperature of the lyophilisate. In this study we aimed to show that annealing causes a rearrangement of water molecules between ice crystals, as well as between the freeze-concentrated amorphous matrix and the crystalline ice phase in a frozen binary aqueous solution. Ice crystal sizes, as well as volume fractions of the crystalline and amorphous phases of 10% (w/w) sucrose and trehalose solutions, were quantified after annealing using freeze-drying microscopy and image labelling. Depending on the annealing time and temperature, the amorphous phase was shown to decrease its volume due to the crystallisation of vitreous water (i.e., glassy state relaxation) while the crystalline phase was undergoing coarsening (i.e., Ostwald ripening). These results allow, for the first time, a quantitative comparison of the two phenomena. It was demonstrated that glassy state relaxation and Ostwald ripening, although occurring simultaneously, are distinct processes that follow different kinetics.
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Affiliation(s)
- Tigran Kharatyan
- Department of Pharmaceutics and Biopharmaceutics, Kiel University, 24118 Kiel, Germany; (T.K.); (R.S.)
- Pharmaceutical Development, Daiichi-Sankyo Europe GmbH, 85276 Pfaffenhofen an der Ilm, Germany;
| | - Srikanth R. Gopireddy
- Pharmaceutical Development, Daiichi-Sankyo Europe GmbH, 85276 Pfaffenhofen an der Ilm, Germany;
- Correspondence:
| | - Toru Ogawa
- Formulation Technology Research Laboratories, Daiichi Sankyo Co., Ltd., Hiratsuka 254-0014, Japan; (T.O.); (T.K.); (N.N.); (S.O.)
| | - Tatsuhiro Kodama
- Formulation Technology Research Laboratories, Daiichi Sankyo Co., Ltd., Hiratsuka 254-0014, Japan; (T.O.); (T.K.); (N.N.); (S.O.)
| | - Norihiro Nishimoto
- Formulation Technology Research Laboratories, Daiichi Sankyo Co., Ltd., Hiratsuka 254-0014, Japan; (T.O.); (T.K.); (N.N.); (S.O.)
| | - Sayaka Osada
- Formulation Technology Research Laboratories, Daiichi Sankyo Co., Ltd., Hiratsuka 254-0014, Japan; (T.O.); (T.K.); (N.N.); (S.O.)
| | - Regina Scherließ
- Department of Pharmaceutics and Biopharmaceutics, Kiel University, 24118 Kiel, Germany; (T.K.); (R.S.)
| | - Nora A. Urbanetz
- Pharmaceutical Development, Daiichi-Sankyo Europe GmbH, 85276 Pfaffenhofen an der Ilm, Germany;
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Tanaka Y, Yamaguchi A, Miyamoto T, Tanimura K, Iwai H, Kaneko Y, Takeuchi T, Amano K, Iwamoto N, Kawakami A, Murakami M, Nishimoto N, Atsumi T, Sumida T, Ohmura K, Mimori T, Yamanaka H, Fujio K, Fujino Y, Saito K, Nakano K, Hirata S, Nakayamada S. OUP accepted manuscript. Rheumatology (Oxford) 2022; 61:4273-4285. [PMID: 35136990 PMCID: PMC9629352 DOI: 10.1093/rheumatology/keac075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/25/2022] [Indexed: 11/16/2022] Open
Abstract
Objective To compare the outcome of various treatment de-escalation regimens in patients with RA who achieved sustained remission. Methods At period 1, 436 RA patients who were treated with MTX and bDMARDs and had maintained DAS28(ESR) at <2.6 were divided into five groups based on shared patient/physician decision-making; continuation, dose reduction and discontinuation of MTX or bDMARDs. At end of year 1, patients who achieved DAS28(ESR) <3.2 were allowed to enrol in period 2 for treatment using the de-escalation regimens for another year. The primary and secondary endpoints were the proportion of patients with DAS28(ESR) <2.6 at year 1 and 2, respectively. Results Based on shared decision-making, 81.4% elected de-escalation of treatment and 48.4% selected de-escalation of MTX. At end of period 1, similar proportions of patients maintained DAS28(ESR) <2.6 (continuation, 85.2%; MTX dose reduction, 79.0%; MTX-discontinuation, 80.0%; bDMARD dose reduction, 73.9%), although the rate was significantly different between the continuation and bDMARD-discontinuation. At end of period 2, similar proportions of patients of the MTX groups maintained DAS28(ESR) <2.6 (continuation or de-escalation), but the rates were significantly lower in the bDMARD-discontinuation group. However, half of the latter group satisfactorily discontinued bDMARDs. Adverse events were numerically lower in MTX and bDMARD-de-escalation groups during period 1 and 2, compared with the continuation group. Conclusions After achieving sustained remission by combination treatment of MTX/bDMARDs, disease control was achieved comparably by continuation, dose reduction or discontinuation of MTX and dose reduction of bDMARDs at end of year 1. Subsequent de-escalation of MTX had no impacts on disease control but decreased adverse events in year 2.
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Affiliation(s)
- Yoshiya Tanaka
- Correspondence to: Yoshiya Tanaka, The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu 807-8555, Japan. E-mail:
| | - Ayako Yamaguchi
- The First Department of Internal Medicine, School of Medicine
- Department of Laboratory and Transfusion Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu
| | - Toshiaki Miyamoto
- Department of Internal Medicine and Rheumatology, Seirei Hamamatsu General Hospital, Hamamatsu
| | - Kazuhide Tanimura
- Department of Rheumatology, Hokkaido Medical Center for Rheumatic Diseases, Sapporo
| | - Hideyuki Iwai
- Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Yuko Kaneko
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo
| | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo
| | - Koichi Amano
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama
| | - Naoki Iwamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Miho Murakami
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Osaka
| | - Norihiro Nishimoto
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Osaka
| | - Tatsuya Atsumi
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido
| | - Takayuki Sumida
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba
| | - Koichiro Ohmura
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University
- Ijinkai Takeda General Hospital, Kyoto
| | | | - Keishi Fujio
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health
| | - Kazuyoshi Saito
- The First Department of Internal Medicine, School of Medicine
- Tobata General Hospital, Kitakyushu
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, School of Medicine
| | - Shintaro Hirata
- The First Department of Internal Medicine, School of Medicine
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
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Matsubara Y, Nakamura Y, Tamura N, Kameda H, Otomo K, Kishimoto M, Kadono Y, Tsuji S, Atsumi T, Matsuno H, Takagi M, Kobayashi S, Fujio K, Nishimoto N, Okamoto N, Nakajima A, Matsui K, Yamamura M, Nakashima Y, Kawakami A, Mori M, Tomita T. A Nationwide Questionnaire Survey on the Prevalence of Ankylosing Spondylitis and Non-Radiographic Axial Spondyloarthritis in Japan. Mod Rheumatol 2021; 32:960-967. [PMID: 34755187 DOI: 10.1093/mr/roab096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 08/06/2021] [Revised: 10/17/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This nationwide study aimed to reveal the prevalence of ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-ax SpA), and the positive rate of human leukocyte antigen (HLA) among these patients in Japan. METHODS The first survey was conducted in 2221 randomly selected facilities (26.3%) in September, 2018, where the patients with AS/nr-ax SpA were taken care of from January to December, 2017. We estimated the total number of these patients using response and extraction rate. A second survey was conducted in 117 facilities (49.8%) to assess for HLA-B 27 positivity rate and clinical features. RESULTS The estimated total number of the patients with AS and nr-ax SpA were 3200 (95% confidence interval [CI]: 2400-3900) and 800 (530-1100), suggesting that the prevalence of AS and nr-ax SpA in general population were 2.6/100,000 (0.0026%) and 0.6/100,000 (0.0006%), respectively. Although 55.5 % (76/137) of patients with AS were HLA-B27 positive, those whose age of onset was estimated to be over 50 years tended to undergo less HLA-B27 testing. CONCLUSION This study revealed the lower prevalence of AS/nr-ax SpA in Japan, compared to those in other countries. Further studies are required to reveal the association of HLA-B27 with the clinical features.
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Affiliation(s)
- Yuri Matsubara
- Department of Public Health, Jichi Medical University, Tochigi, Japan
| | - Yosikazu Nakamura
- Department of Public Health, Jichi Medical University, Tochigi, Japan
| | - Naoto Tamura
- Department of Rheumatology and Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hideto Kameda
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Kotaro Otomo
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Mitsumasa Kishimoto
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Yuho Kadono
- Department of Orthopaedic Surgery, Saitama Medical University, Saitama, Japan
| | - Shigeyoshi Tsuji
- Department of Orthopaedics and Rheumatology, National Hospital Organization Osaka Minami Medical Center, Osaka, Japan
| | - Tatsuya Atsumi
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine Hokkaido University, Hokkaido, Japan
| | | | - Michiaki Takagi
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Shigeto Kobayashi
- Department of Internal Medicine and Rheumatology, Juntendo University Koshigaya Hospital, Saitama, Japan
| | - Keishi Fujio
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Norihiro Nishimoto
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan.,Osaka Rheumatology Clinic, Osaka, Japan
| | - Nami Okamoto
- Department of Pediatrics, Osaka Medical College, Osaka, Japan
| | - Ayako Nakajima
- Center for Rheumatic Diseases, Mie University Hospital, Mie, Japan
| | - Kiyoshi Matsui
- Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Masahiro Yamamura
- Center for Rheumatology, Okayama Saiseikai General Hospital, Okayama, Japan
| | | | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masaaki Mori
- Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Tomita
- Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Osaka, Japan
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Nakaoka Y, Isobe M, Tanaka Y, Ishii T, Ooka S, Niiro H, Tamura N, Banno S, Yoshifuji H, Sakata Y, Kawakami A, Atsumi T, Furuta S, Kohsaka H, Suzuki K, Hara R, Maejima Y, Tsukamoto H, Takasaki Y, Yamashita K, Okada N, Yamakido S, Takei S, Yokota S, Nishimoto N. Long-term efficacy and safety of tocilizumab in refractory Takayasu arteritis: final results of the randomized controlled phase 3 TAKT study. Rheumatology (Oxford) 2021; 59:2427-2434. [PMID: 31951279 PMCID: PMC7449811 DOI: 10.1093/rheumatology/kez630] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [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: 07/25/2019] [Revised: 10/25/2019] [Indexed: 11/27/2022] Open
Abstract
Objective To investigate the long-term efficacy and safety of the IL-6 receptor antibody tocilizumab in patients with Takayasu arteritis (TAK). Methods Patients completing the randomized, double-blind, placebo-controlled period of the TAKT (Takayasu arteritis Treated with Tocilizumab) trial were followed up during open-label extended treatment with weekly s.c. tocilizumab 162 mg for up to 96 weeks or longer, with oral glucocorticoid tapering performed at the investigators’ discretion. Endpoints of the extension analysis included steroid-sparing effects of tocilizumab, imaging data, patient-reported outcomes (36-Item Short Form Health Survey) and safety. Results All 36 patients enrolled in the double-blind period entered the open-label extension; 28 patients received tocilizumab for 96 weeks. The median glucocorticoid dose was 0.223 mg/kg/day at the time of relapse before study entry, 0.131 mg/kg/day (interquartile range 0.099, 0.207) after 48 weeks and 0.105 mg/kg/day (interquartile range 0.039, 0.153) after 96 weeks. Overall, 46.4% of patients reduced their dose to <0.1 mg/kg/day, which was less than half the dose administered at relapse before study entry (mean difference –0.120 mg/kg/day; 95% CI −0.154, −0.087). Imaging evaluations indicated that most patients’ disease was improved (17.9%) or stable (67.9%) after 96 weeks compared with baseline. Mean 36-Item Short Form Health Survey physical and mental component summary scores and 7 of 8 domain scores were clinically improved from baseline and maintained over 96 weeks of tocilizumab treatment. No unexpected safety issues were reported. Conclusion These results in patients with Takayasu arteritis provide evidence of a steroid-sparing effect and improvements in well-being during long-term treatment with once-weekly tocilizumab 162 mg, with no new safety concerns. Trial registration JAPIC Clinical Trials Information, http://www.clinicaltrials.jp/user/cteSearch_e.jsp, JapicCTI-142616.
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Affiliation(s)
- Yoshikazu Nakaoka
- Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute, Suita Japan.,Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka Japan
| | | | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu Japan
| | - Tomonori Ishii
- Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai Japan
| | - Seido Ooka
- Division of Rheumatology and Allergology, Department of Internal Medicine, St Marianna University School of Medicine, Kawasaki Japan
| | - Hiroaki Niiro
- Department of Medical Education, Faculty of Medical Sciences, Kyushu University, Fukuoka Japan
| | - Naoto Tamura
- Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine, Tokyo Japan
| | - Shogo Banno
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto Kyoto, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan
| | - Tatsuya Atsumi
- Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo Japan
| | - Shunsuke Furuta
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba Japan
| | - Hitoshi Kohsaka
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo Japan
| | - Katsuya Suzuki
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo Japan
| | - Ryoki Hara
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama Japan
| | - Yasuhiro Maejima
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo Japan
| | | | - Yoshinari Takasaki
- Juntendo University Koshigaya Hospital, Juntendo University Faculty of Medicine, Saitama Japan
| | | | | | | | - Syuji Takei
- Pediatrics and Developmental Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima Japan
| | - Shumpei Yokota
- Pediatric Rheumatology, Fuji Toranomon Orthopedics Hospital, Shizuoka, Japan
| | - Norihiro Nishimoto
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
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Murakami M, Nishimoto N. AB0709 SERUM IL-12/23 AND IL-17 LEVELS IN PATIENTS WITH SPONDYLOARTHRITIS WERE NOT INFLUENCED BY TNF-BLOCKADE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5624] [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:Spondyloarthritis (SpA) refers to a heterogeneous group of disorders with clinical features that can include axial and peripheral arthritis, inflammatory bowel disease, uveitis, and psoriasis. Several cytokines including interleukin (IL)-12/23, IL-17 and tumor necrosis factor (TNF) are involved in pathogenesis of SpA. It is assumed that TNF is the upstream cytokine in the cytokine cascade (Schett, et al., 2013).Objectives:To investigate whether TNF inhibitors decrease serum IL-12/23 and IL-17 levels in patients with SpA.Methods:Serum were obtained from 23 SpA patients (AS, 10 patients; PsA, 13 patients) enrolled in this study, at baseline, 24 and 48 weeks of TNF inhibitor treatment. Serum IL-12/23 and IL17 levels were measured using LEGEND MAX Human IL-12/IL-23 (p40) ELISA Kit (BioLegend) and Human IL-17A ELISA kit (Invitrogen), respectively. IL-6 levels, the other downstream cytokine, was measured using Lumipulse G600II (FUJIREBIO) as a control.Results:Any significant reduction in IL-12/23 levels (143.9±143.6 pg/mL at baseline, 156.3±117.1 pg/mL at 24 weeks and 139.3±118.1 pg/mL at 48 weeks), as well as that in IL-17 levels (13.6±51.9 pg/mL at baseline, 12.3±41.4 pg/mL at 24 weeks and 11.6±39.2 pg/mL at 48 weeks) were not observed in 23 SpA patients. On the other hand, serum IL-6 levels were significantly decreased after treatment (4.0±4.2 pg/mL at baseline; 1.8±1.4 pg/mL,p=0.002, at 24 weeks; 1.6±1.9 pg/mL,p=0.0002at 48 weeks. Pain-VAS was significantly reduced at 24 and 48 weeks compared with that at baseline. No significant differences in serum levels of analyzed cytokines were observed in the AS group compared with the PsA group at baseline (IL-12/23 levels: 110.8±70.0 vs.169.3±180.3 pg/mL,p=0.28; IL-17 levels: 26.8±78.6 vs. 3.4±7.6pg/mL,p=0.08).Conclusion:TNF inhibitors did not alter serum IL-12/23 and IL-17 levels but reduced IL-6 levels in patients with SpA. These results imply that IL-12/23 and IL-17 expression might be regulated by alternative pathways.References:[1]Schett, et al. Toward a cytokine-based disease taxonomy. Nat Med. 2013 Jul; 19 (7):822-4Disclosure of Interests:Miho Murakami Grant/research support from: Chugai, Eisai, Consultant of: Chugai, Norihiro Nishimoto Grant/research support from: Chugai, Eisai, Consultant of: Chugai, Speakers bureau: Chugai, Eisai, AYUMI, Mitsubishi Tanabe, AbbVie, Novartis, Nippon Kayaku, TOWA, Astellas, Kyowa Kirin
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Murakami M, Johkoh T, Hayashi S, Ohshima S, Mizuki M, Nakatsuka SI, Tomobe M, Kuroyanagi K, Nakasone A, Nishimoto N. Clinicopathologic characteristics of 342 patients with multicentric Castleman disease in Japan. Mod Rheumatol 2020; 30:843-851. [DOI: 10.1080/14397595.2019.1704983] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Miho Murakami
- Osaka Rheumatology Clinic, Osaka, Japan
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
| | - Takeshi Johkoh
- Department of Radiology, Kansai Rosai Hospital, Hyogo, Japan
| | - Seiji Hayashi
- National Hospital Organization Kinki Chuo Chest Medical Center, Osaka, Japan
| | - Shiro Ohshima
- Department of Rheumatology and Allergology, National Hospital Organization, Osaka Minami Medical Center, Osaka, Japan
| | - Masao Mizuki
- Department of Chemotherapy, Osaka University Hospital, Osaka, Japan
| | - Shin-ichi Nakatsuka
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
| | - Minako Tomobe
- Chugai Pharmaceutical Co., Ltd., Tokyo, Japan; and Safety Evaluation Committee of tocilizumab for Castleman disease
| | - Kazuyuki Kuroyanagi
- Chugai Pharmaceutical Co., Ltd., Tokyo, Japan; and Safety Evaluation Committee of tocilizumab for Castleman disease
| | - Ayako Nakasone
- Chugai Pharmaceutical Co., Ltd., Tokyo, Japan; and Safety Evaluation Committee of tocilizumab for Castleman disease
| | - Norihiro Nishimoto
- Osaka Rheumatology Clinic, Osaka, Japan
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
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Sasaki Y, Muranaka T, Kawamoto Y, Sawada K, Nakatsumi H, Harada K, Miyagishima T, Hatanaka K, Dazai M, Ueda A, Sasaki T, Shinada K, Tsuji Y, Yuki S, Sakamoto N, Nishimoto N, Sakata Y, Komatsu Y. Multi-centered phase II trial of weekly 5-FU plus l-LV regimen as salvage line chemotherapy for oral fluorouracil resistant advanced gastric cancer (HGCSG1502). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz422.041] [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: 11/13/2022] Open
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Nakamura M, Yuki S, Takahashi N, Shichinohe T, Nakatsumi H, Kawamoto Y, Kusumi T, Ishiguro A, Harada K, Iwanaga I, Hatanaka K, Oomori K, Senmaru N, Iwai K, Koike M, Sakamoto N, Taketomi A, Hirano S, Nishimoto N, Komatsu Y. NORTH/HGCSG1003: North Japan multicenter phase II study of oxaliplatin-containing regimen as adjuvant chemotherapy for stage III colon cancer: Final analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz421.016] [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: 11/14/2022] Open
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Ueda A, Muranaka T, Kawamoto Y, Sawada K, Nakatsumi H, Harada K, Kobayashi Y, Miyagishima T, Hatanaka K, Dazai M, Kawahata S, Sasaki T, Sasaki Y, Kato S, Shinada K, Tsuji Y, Yuki S, Sakamoto N, Nishimoto N, Sakata Y, Komatsu Y. Multicenter phase 2 trial of weekly 5-FU plus l-LV regimen as salvage line chemotherapy for oral fluorouracil-resistant advanced gastric cancer (HGCSG1502). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.175] [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: 11/13/2022] Open
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Ishizawa M, Inoue T, Tobiume A, Hasui Y, Yokoyama S, Ishikawa S, Matsunaga K, Mantani K, Miyake Y, Ishikawa K, Tsuji T, Murakami K, Nishimoto N, Noma T, Minamino T. P1936Multiple measurements with an automated blood pressure monitor can detect atrial fibrillation with high sensitivity and specificity in general cardiac patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1936] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Ishizawa
- Kagawa University, Cardiorenal Cerebrovascular Medicine, Kagawa, Japan
| | - T Inoue
- Kagawa University, Cardiorenal Cerebrovascular Medicine, Kagawa, Japan
| | - A Tobiume
- Kagawa University, Cardiorenal Cerebrovascular Medicine, Kagawa, Japan
| | - Y Hasui
- Kagawa University, Cardiorenal Cerebrovascular Medicine, Kagawa, Japan
| | - S Yokoyama
- Kagawa University, Emergency and Disaster Medicine, Kagawa, Japan
| | - S Ishikawa
- Kagawa University, Cardiorenal Cerebrovascular Medicine, Kagawa, Japan
| | - K Matsunaga
- Kagawa University, Cardiorenal Cerebrovascular Medicine, Kagawa, Japan
| | - K Mantani
- Kagawa University, Cardiorenal Cerebrovascular Medicine, Kagawa, Japan
| | - Y Miyake
- Kagawa University, Cardiorenal Cerebrovascular Medicine, Kagawa, Japan
| | - K Ishikawa
- Kagawa University, Cardiorenal Cerebrovascular Medicine, Kagawa, Japan
| | - T Tsuji
- Kagawa University, Cardiorenal Cerebrovascular Medicine, Kagawa, Japan
| | - K Murakami
- Kagawa University, Cardiorenal Cerebrovascular Medicine, Kagawa, Japan
| | - N Nishimoto
- Kagawa University, Clinical Research Support Center, Kagawa, Japan
| | - T Noma
- Kagawa University, Cardiorenal Cerebrovascular Medicine, Kagawa, Japan
| | - T Minamino
- Kagawa University, Cardiorenal Cerebrovascular Medicine, Kagawa, Japan
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11
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Murakami K, Sekiguchi M, Hirata S, Fujii T, Matsui K, Morita S, Ohmura K, Kawahito Y, Nishimoto N, Mimori T, Sano H. Predictive factors for structural remission using abatacept: Results from the ABROAD study. Mod Rheumatol 2018; 29:406-412. [PMID: 29807445 DOI: 10.1080/14397595.2018.1482609] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To investigate the effect of abatacept (ABA) on preventing joint destruction in biological disease-modifying anti-rheumatic drug (bDMARD)-naïve rheumatoid arthritis (RA) patients in real-world clinical practice. PATIENTS AND METHODS RA patients were collected from the ABROAD (ABatacept Research Outcomes as a First-line Biological Agent in the Real WorlD) study cohort. They had moderate or high disease activity and were treated with ABA as a first-line bDMARD. Radiographic change between baseline and 1 year after ABA treatment was assessed with the van der Heijde's modified Total Sharp Score (mTSS). Predictive factors for structural remission (St-REM), defined as ΔmTSS ≤0.5/year, were determined. RESULTS Among 118 patients, 81 (67.5%) achieved St-REM. Disease duration <3 years (odds ratio (OR) = 3.152, p = .007) and slower radiographic progression (shown as 'baseline mTSS/year <3', OR = 3.727, p = .004) were independently significant baseline predictive factors for St-REM irrespective of age and sex. St-REM prevalence increased significantly if clinical remission based on the Simplified Disease Activity Index was achieved at least once until 24 weeks after ABA treatment. CONCLUSION Shorter disease duration, smaller radiographic progression at baseline, and rapid clinical response were predictive factors for sustained St-REM after ABA therapy in bDMARD-naïve RA patients.
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Affiliation(s)
- Kosaku Murakami
- a Department of Rheumatology and Clinical Immunology, Graduate School of Medicine , Kyoto University , Kyoto , Japan
| | - Masahiro Sekiguchi
- b Department of Internal Medicine, Division of Rheumatology, Hyogo College of Medicine , Nishinomiya , Japan.,c Department of Internal Medicine, Division of Rheumatology , Hyogo Prefectural Nishinomiya Hospital , Nishinomiya , Japan
| | - Shintaro Hirata
- d Department of Clinical Immunology and Rheumatology , Hiroshima University Hospital , Hiroshima, Japan
| | - Takao Fujii
- e Department of Clinical Immunology and Rheumatology , Wakayama Medical University , Wakayama , Japan
| | - Kiyoshi Matsui
- b Department of Internal Medicine, Division of Rheumatology, Hyogo College of Medicine , Nishinomiya , Japan
| | - Satoshi Morita
- f Biomedical Statistics and Bioinformatics , Kyoto University , Kyoto , Japan
| | - Koichiro Ohmura
- a Department of Rheumatology and Clinical Immunology, Graduate School of Medicine , Kyoto University , Kyoto , Japan
| | - Yutaka Kawahito
- g Inflammation and Immunology, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kyoto , Japan
| | - Norihiro Nishimoto
- h Osaka Rheumatology Clinic , Osaka , Japan.,i Department of Molecular Regulation for Intractable Diseases , Institute of Medical Science, Tokyo Medical University , Tokyo , Japan
| | - Tsuneyo Mimori
- a Department of Rheumatology and Clinical Immunology, Graduate School of Medicine , Kyoto University , Kyoto , Japan
| | - Hajime Sano
- b Department of Internal Medicine, Division of Rheumatology, Hyogo College of Medicine , Nishinomiya , Japan
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12
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Mimura T, Kondo Y, Ohta A, Iwamoto M, Ota A, Okamoto N, Kawaguchi Y, Kono H, Takasaki Y, Takei S, Nishimoto N, Fujimoto M, Asanuma YF, Mimori A, Okiyama N, Kaneko S, Takahashi H, Yokosawa M, Sumida T. Evidence-based clinical practice guideline for adult Still’s disease. Mod Rheumatol 2018; 28:736-757. [DOI: 10.1080/14397595.2018.1465633] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Toshihide Mimura
- Department of Rheumatology and Applied Immunology, Saitama Medical University, Saitama, Japan
- Center for Intractable Diseases, Saitama Medical University, Saitama, Japan
| | - Yuya Kondo
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Akihide Ohta
- Faculty of Medicine, Saga University, Saga, Japan
| | - Masahiro Iwamoto
- Department of Internal Medicine, Division of Rheumatology/Clinical Immunology, Jichi Medical University, Tochigi, Japan
| | - Akiko Ota
- Department of Social Medicine, Faculty of Medicine, Division of Public Health, Saitama Medical University, Saitama, Japan
| | - Nami Okamoto
- Department of Pediatrics, Osaka Medical College, Osaka, Japan
| | - Yasushi Kawaguchi
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hajime Kono
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Yoshinari Takasaki
- Department of Rheumatology, Juntendo University Koshigaya Hospital, Saitama, Japan
| | - Shuji Takei
- Faculty of Medicine, School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Norihiro Nishimoto
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yu Funakubo Asanuma
- Department of Rheumatology and Applied Immunology, Saitama Medical University, Saitama, Japan
| | - Akio Mimori
- Department of Rheumatology, Iwate Prefectural Central Hospital, Iwate, Japan
| | - Naoko Okiyama
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Shunta Kaneko
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hiroyuki Takahashi
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masahiro Yokosawa
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Takayuki Sumida
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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13
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Terae S, Uesugi M, Ogasawara K, Sakurai T, Nishimoto N. Development of a Medical-text Parsing Algorithm Based on Character Adjacent Probability Distribution for Japanese Radiology Reports. Methods Inf Med 2018; 47:513-21. [DOI: 10.3414/me9127] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Summary
Objectives:
The objectives of this study were to investigate the transitional probability distribution of medical term boundaries between characters and to develop a parsing algorithm specifically for medical texts.
Methods:
Medical terms in Japanese computed tomography (CT) reports were identified using the ChaSen morphological analysis system. MeSH-based medical terms (51,385 entries), obtained from the metathesaurus in the Unified Medical Language System (UMLS, 2005AA), were added as a medical dictionary for ChaSen. A radiographer corrected the set of results containing 300 parsed CT reports. In addition, two radiologists checked the medical term parsing of 200 CT sentences.
Results:
We obtained modified inter-annotator agreement scores for the text corrected by the radiologists. We retrieved the transitional probability as the conditional probability of a uni-gram, bi-gram, and tri-gram. The highest transitional probability P(Ci | Ci - 2*Ci - 1) was 1.00. For an example of anatomical location, the term “pulmonary hilum” was parsed as a tri-gram.
Conclusions:
Retrieval of transitional probability will improve the accuracy of parsing compound medical terms.
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14
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Nakaoka Y, Isobe M, Takei S, Tanaka Y, Ishii T, Yokota S, Nomura A, Yoshida S, Nishimoto N. Efficacy and safety of tocilizumab in patients with refractory Takayasu arteritis: results from a randomised, double-blind, placebo-controlled, phase 3 trial in Japan (the TAKT study). Ann Rheum Dis 2017; 77:348-354. [PMID: 29191819 PMCID: PMC5867398 DOI: 10.1136/annrheumdis-2017-211878] [Citation(s) in RCA: 228] [Impact Index Per Article: 32.6] [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: 06/01/2017] [Revised: 10/25/2017] [Accepted: 10/31/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate the efficacy and safety of the interleukin-6 receptor antibody tocilizumab in patients with Takayasu arteritis (TAK). METHODS Patients with TAK who had relapsed within the previous 12 weeks were induced into remission with oral glucocorticoid therapy. In this double-blind, placebo-controlled trial, patients were randomly assigned 1:1 to receive weekly tocilizumab 162 mg or placebo subcutaneously, and oral glucocorticoids were tapered 10 %/week from week 4 to a minimum of 0.1 mg/kg/day until 19 patients relapsed. The primary endpoint was time to relapse of TAK, defined as ≥2 of the following: objective systemic symptoms, subjective systemic symptoms, elevated inflammation markers, vascular signs and symptoms or ischaemic symptoms. RESULTS The intent-to-treat and safety populations included 18 tocilizumab-treated and 18 placebo-treated patients. The per-protocol set (PPS) included 16 tocilizumab-treated and 17 placebo-treated patients. HRs for time to relapse of TAK were 0.41 (95.41% CI 0.15 to 1.10; p=0.0596) in the intent-to-treat population (primary endpoint) based on relapse in eight tocilizumab-treated and 11 placebo-treated patients and 0.34 (95.41% CI 0.11 to 1.00; p=0.0345) in the PPS. The secondary endpoints, time to relapse assessed by Kerr's definition and clinical symptoms only, were consistent with the primary endpoint. Serious adverse events were reported in one tocilizumab-treated and two placebo-treated patients. There were no serious infections and no deaths. CONCLUSION Although the primary endpoint was not met, the results suggest favour for tocilizumab over placebo for time to relapse of TAK without new safety concerns. Further investigation is warranted to confirm the efficacy of tocilizumab in patients with refractory TAK. TRIAL REGISTRATION NUMBER JapicCTI-142616.
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Affiliation(s)
- Yoshikazu Nakaoka
- Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Mitsuaki Isobe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Syuji Takei
- Faculty of Medicine, School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Yoshiya Tanaka
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tomonori Ishii
- Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan
| | - Shumpei Yokota
- Laboratory of Pediatric Research, Institute of Tokyo Medical School, Tokyo, Japan
| | | | | | - Norihiro Nishimoto
- Department of Molecular Regulation for Intractable Disease, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
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15
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Hirao M, Hashimoto J, Tsuboi H, Ebina K, Nampei A, Noguchi T, Tsuji S, Nishimoto N, Yoshikawa H. Total Ankle Arthroplasty for Rheumatoid Arthritis in Japanese Patients: A Retrospective Study of Intermediate to Long-Term Follow-up. JB JS Open Access 2017; 2:e0033. [PMID: 30229229 PMCID: PMC6133145 DOI: 10.2106/jbjs.oa.17.00033] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background: Outcomes after total ankle arthroplasty (TAA) combined with additive techniques (augmentation of bone strength, control of soft-tissue balance, adjustment of the loading axis) for the treatment of rheumatoid arthritis were evaluated after intermediate to long-term follow-up. The influences of biologic treatment on the outcomes after TAA were also evaluated. Methods: We performed a retrospective observational study involving 50 ankles (44 patients) that underwent TAA for the treatment of rheumatoid arthritis. The mean duration of follow-up was 7.1 years. Clinical outcomes were evaluated with use of the Japanese Society for Surgery of the Foot (JSSF) scale score and a postoperative self-administered foot-evaluation questionnaire (SAFE-Q). Radiographic findings were evaluated as well. These parameters also were compared between patients managed with and without biologic treatment. Results: This procedure significantly improved the clinical scores of the JSSF rheumatoid arthritis foot and ankle scale (p < 0.0001). Forty-eight of the 50 ankles had no revision TAA surgery. Subsidence of the talar component was seen in 8 ankles (6 in the biologic treatment group and 2 in the non-biologic treatment group); 2 of these ankles (both in the biologic treatment group) underwent revision TAA. The social functioning score of the SAFE-Q scale at the time of the latest follow-up was significantly higher in the biologic treatment group (p = 0.0079). The dosage of prednisolone (p = 0.0003), rate of usage of prednisolone (p = 0.0001), and disease-activity score (p < 0.01) at the time of the latest follow-up were all significantly lower in the biologic treatment group. Conclusions: TAA is recommended for the treatment of rheumatoid arthritis if disease control, augmentation of bone strength, control of soft-tissue balance, and adjustment of the loading axis are taken into account. The prevention of talar component subsidence remains a challenge in patients with the combination of subtalar fusion, rheumatoid arthritis, and higher social activity levels. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Makoto Hirao
- Department of Orthopaedics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Jun Hashimoto
- Department of Orthopaedics/Rheumatology, National Hospital Organization, Osaka Minami Medical Center, Osaka, Japan
| | - Hideki Tsuboi
- Department of Orthopaedics, Osaka Rosai Hospital, Osaka, Japan
| | - Kosuke Ebina
- Department of Orthopaedics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Akihide Nampei
- Department of Orthopaedics/Rheumatology, National Hospital Organization, Osaka Minami Medical Center, Osaka, Japan
| | - Takaaki Noguchi
- Department of Orthopaedics/Rheumatology, National Hospital Organization, Osaka Minami Medical Center, Osaka, Japan
| | - Shigeyoshi Tsuji
- Department of Orthopaedics/Rheumatology, National Hospital Organization, Osaka Minami Medical Center, Osaka, Japan
| | - Norihiro Nishimoto
- Osaka Rheumatology Clinic, Osaka, Japan.,Department of Molecular Regulation for Intractable Diseases Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
| | - Hideki Yoshikawa
- Department of Orthopaedics, Osaka University Graduate School of Medicine, Osaka, Japan
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16
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Fujimoto S, Koga T, Kawakami A, Kawabata H, Okamoto S, Mizuki M, Yano S, Ide M, Uno K, Yagi K, Kojima T, Mizutani M, Tokumine Y, Nishimoto N, Fujiwara H, Nakatsuka SI, Shiozawa K, Iwaki N, Masaki Y, Yoshizaki K. Tentative diagnostic criteria and disease severity classification for Castleman disease: A report of the research group on Castleman disease in Japan. Mod Rheumatol 2017; 28:161-167. [PMID: 28880697 DOI: 10.1080/14397595.2017.1366093] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 12/17/2022]
Abstract
OBJECTIVES To determine the tentative diagnostic criteria and disease severity classification for Castleman disease (CD) and describe the clinical and pathologic features among human herpesvirus 8 (HHV-8) negative idiopathic multicentric CD (iMCD) in the Japanese population. METHODS We established the working groups for the research of CD in Japan and had meetings to discuss and define the tentative diagnostic criteria and disease severity classification for CD. We subsequently analyzed 142 patients classified into iMCD by using the nationwide Japanese patient registry. RESULTS We proposed the preliminary diagnostic criteria and disease severity classification for CD based on our discussion. In addition, we made a proposal for the disease activity score. We identified clinical and pathological features of patients with iMCD diagnosed by these diagnostic criteria. In the disease severity classification, 37, 33 and 30% patients were categorized into mild, moderate and severe diseases, respectively. CONCLUSION This is the first proposal for diagnosis and classification of CD by the Japanese group. Further studies are required to validate whether they can distinguish CD from other inflammatory diseases and to determine their sensitivity and specificity.
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Affiliation(s)
- Shino Fujimoto
- a Division of Hematology and Immunology, Medicine , Kanazawa Medical University , Ishikawa , Japan
| | - Tomohiro Koga
- b Unit of Advanced Preventive Medical Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,c Center for Bioinformatics and Molecular Medicine , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Atsushi Kawakami
- b Unit of Advanced Preventive Medical Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Hiroshi Kawabata
- a Division of Hematology and Immunology, Medicine , Kanazawa Medical University , Ishikawa , Japan
| | - Shinichiro Okamoto
- d Division of Hematology, Department of Medicine , Keio University School of Medicine , Tokyo , Japan
| | - Masao Mizuki
- e Chemotherapy and Oncology Center , Osaka University Hospital , Osaka , Japan
| | - Shingo Yano
- f Division of Clinical Oncology and Hematology, Department of Internal Medicine , Jikei University School of Medicine , Tokyo , Japan
| | - Makoto Ide
- g Department of Hematology , Takamatsu Red Cross Hospital , Japan
| | - Kazuko Uno
- h Louis Pasteur Center for Medical Research , Kyoto , Japan
| | - Katsumi Yagi
- h Louis Pasteur Center for Medical Research , Kyoto , Japan
| | - Toshiyuki Kojima
- i Department of Emergency , Japanese Red Cross Nagoya Daiichi Hospital , Nagoya , Japan
| | - Minoru Mizutani
- j Department of Hematology , JA Mie Kouseiren Matsusaka Central General Hospital , Matsusaka , Japan
| | | | | | - Hiroshi Fujiwara
- m Department of Respiratory Medicine , Yodogawa Christian Hospital , Osaka , Japan
| | - Shin-Ichi Nakatsuka
- n Department of Pathology , Kansai Rosai Hospital , Hyogo , Japan.,o Department of Diagnostic Pathology , Cytology Osaka International Cancer Institute Hospital , Osaka , Japan
| | - Kazuko Shiozawa
- p Rheumatic Diseases Center , Hohnan Kakogawa Hospital , Kakogawa , Japan
| | - Noriko Iwaki
- q Hematology/Respiratory Medicine Kanazawa University Faculty of Medicine , Institute of Medical Pharmaceutical and Health Sciences , Kanazawa , Japan
| | - Yasufumi Masaki
- a Division of Hematology and Immunology, Medicine , Kanazawa Medical University , Ishikawa , Japan
| | - Kazuyuki Yoshizaki
- r Department of Organic Fine Chemicals , The Institute of Scientific and Industrial Research, Osaka University , Osaka , Japan
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17
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Terasaki Y, Ikushima S, Matsui S, Hebisawa A, Ichimura Y, Izumi S, Ujita M, Arita M, Tomii K, Komase Y, Owan I, Kawamura T, Matsuzawa Y, Murakami M, Ishimoto H, Kimura H, Bando M, Nishimoto N, Kawabata Y, Fukuda Y, Ogura T. Comparison of clinical and pathological features of lung lesions of systemic IgG4-related disease and idiopathic multicentric Castleman's disease. Histopathology 2017; 70:1114-1124. [PMID: 28207938 DOI: 10.1111/his.13186] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 09/19/2016] [Revised: 01/30/2017] [Accepted: 02/11/2017] [Indexed: 12/11/2022]
Abstract
AIMS The lung lesion [immunoglobulin (Ig)G4-L] of IgG4-related disease (IgG4-RD) is a condition that occurs together with IgG4-RD and often mimics the lung lesion [idiopathic multicentric Castleman's disease (iMCD-L)] of idiopathic multicentric Castleman's disease (iMCD). Because no clinical and pathological studies had previously compared features of these diseases, we undertook this comparison with clinical and histological data. METHODS AND RESULTS Nine patients had IgG4-L (high levels of serum IgG4 and of IgG4+ cells in lung specimens; typical extrapulmonary manifestations). Fifteen patients had iMCD-L (polyclonal hyperimmunoglobulinaemia, elevated serum interleukin-6 levels and polylymphadenopathy with typical lymphadenopathic lesions). Mean values for age, serum haemoglobin levels and IgG4/IgG ratios were higher in the IgG4-L group and C-reactive protein levels were higher in the iMCD-L group. All IgG4-RD lung lesions showed myxomatous granulation-like fibrosis (active fibrosis), with infiltration of lymphoplasmacytes and scattered eosinophils within the perilymphatic stromal area, such as interlobular septa and pleura with obstructive vasculitis. All 15 lung lesions of iMCD, however, had marked accumulation of polyclonal lymphoplasmacytes in lesions with lymphoid follicles and dense fibrosis, mainly in the alveolar area adjacent to interlobular septa and pleura without obstructive vasculitis. CONCLUSIONS Although both lesions had lymphoplasmacytic infiltration, lung lesions of IgG4-RD were characterized by active fibrosis with eosinophilic infiltration within the perilymphatic stromal area with obstructive vasculitis, whereas lung lesions of iMCD had lymphoplasmacyte proliferating lesions mainly in the alveolar area adjacent to the perilymphatic stromal area. These clinicopathological features may help to differentiate the two diseases.
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Affiliation(s)
- Yasuhiro Terasaki
- Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan
| | - Soichiro Ikushima
- Department of Respiratory Medicine, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Shoko Matsui
- Health Administration Center, University of Toyama, Toyama, Japan
| | - Akira Hebisawa
- Division of Clinical Pathology, NHO Tokyo National Hospital, Tokyo, Japan
| | - Yasunori Ichimura
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masuo Ujita
- Department of Radiology, Nishigunma National Hospital, Shibukawa, Japan
| | - Machiko Arita
- Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yuko Komase
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Isoko Owan
- Department of Respiratory Medicine, National Hospital Organization Okinawa National Hospital, Ginowan, Okinawa, Japan
| | - Tetsuji Kawamura
- Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, Hyogo, Japan
| | - Yasuo Matsuzawa
- Department of Respiratory Medicine, Toho University Medical Center-Sakura Hospital, Chiba, Japan
| | - Miho Murakami
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Osaka, Japan.,Osaka Rheumatology Clinic, Osaka, Japan
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroshi Kimura
- Department of Respiratory Medicine, Nara Medical University, Nara, Japan
| | - Masashi Bando
- Department of Respiratory Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Norihiro Nishimoto
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Osaka, Japan.,Osaka Rheumatology Clinic, Osaka, Japan
| | - Yoshinori Kawabata
- Division of Diagnostic Pathology, Saitama Prefectural Cardiovascular and Respiratory Center, Saitama, Japan
| | - Yuh Fukuda
- Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan
| | - Takashi Ogura
- Division of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
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18
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Sekiguchi M, Fujii T, Matsui K, Murakami K, Morita S, Ohmura K, Kawahito Y, Nishimoto N, Mimori T, Sano H. Differences in Predictive Factors for Sustained Clinical Remission with Abatacept Between Younger and Elderly Patients with Biologic-naive Rheumatoid Arthritis: Results from the ABROAD Study. J Rheumatol 2016; 43:1974-1983. [PMID: 27585689 DOI: 10.3899/jrheum.160051] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To differentiate predictive factors for sustained clinical remission between elderly and younger patients with rheumatoid arthritis (RA) receiving abatacept (ABA) as an initial biological disease-modifying antirheumatic drug. METHODS The study involved 277 biologic-naive patients with RA with high or moderate disease activity, who were treated with intravenous ABA and evaluated for 48 weeks in 43 Japanese hospitals and rheumatology clinics (the ABatacept Research Outcomes as a First-line Biological Agent in the Real WorlD study: UMIN000004651). Predictive factors associated with sustained clinical remission defined by the 28-joint Disease Activity Score with C-reactive protein (DAS28-CRP) during the 24-48-week or 36-48-week periods were determined in elderly (≥ 65 yrs, n = 148) and younger patient groups (< 65 yrs, n = 129) using logistic regression analysis. RESULTS Clinical remission was achieved at 24 and 48 weeks in 35.1% and 36.5% of patients in the elderly group and 34.9% and 43.4% in the younger group, respectively. In elderly patients, anticitrullinated protein antibody (ACPA) positivity and a lower DAS28-CRP score were significantly associated with sustained clinical remission; however, a lower Health Assessment Questionnaire-Disability Index (HAQ-DI) score was not related to sustained clinical remission. In younger patients, lower DAS28-CRP and HAQ-DI scores were predictive factors for sustained clinical remission, whereas ACPA positivity was not a useful predictive factor for sustained clinical remission. CONCLUSION Although the effectiveness of ABA in biologic-naive patients with RA was equally recognized in elderly and younger patients, the baseline clinical characteristics associated with sustained clinical remission were substantially different.
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Affiliation(s)
- Masahiro Sekiguchi
- From the Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Rheumatology and Clinical Immunology, and the Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University; Department of Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto; Osaka Rheumatology Clinic and Institute of Medical Science, Osaka; Tokyo Medical University, Tokyo, Japan. .,M. Sekiguchi, MD, PhD, Hyogo College of Medicine; T. Fujii, MD, PhD, Graduate School of Medicine, Kyoto University; K. Matsui, MD, PhD, Hyogo College of Medicine; K. Murakami, MD, PhD, Graduate School of Medicine, Kyoto University; S. Morita, MD, PhD, Graduate School of Medicine, Kyoto University; K. Ohmura, MD, PhD, Graduate School of Medicine, Kyoto University; Y. Kawahito, MD, PhD, Graduate School of Medical Science, Kyoto Prefectural University of Medicine; N. Nishimoto, MD, PhD, Osaka Rheumatology Clinic and Institute of Medical Science, Tokyo Medical University; T. Mimori, MD, PhD, Graduate School of Medicine, Kyoto University; H. Sano, MD, PhD, Hyogo College of Medicine. Dr. Sekiguchi and Dr. Fujii contributed equally to this study.
| | - Takao Fujii
- From the Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Rheumatology and Clinical Immunology, and the Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University; Department of Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto; Osaka Rheumatology Clinic and Institute of Medical Science, Osaka; Tokyo Medical University, Tokyo, Japan.,M. Sekiguchi, MD, PhD, Hyogo College of Medicine; T. Fujii, MD, PhD, Graduate School of Medicine, Kyoto University; K. Matsui, MD, PhD, Hyogo College of Medicine; K. Murakami, MD, PhD, Graduate School of Medicine, Kyoto University; S. Morita, MD, PhD, Graduate School of Medicine, Kyoto University; K. Ohmura, MD, PhD, Graduate School of Medicine, Kyoto University; Y. Kawahito, MD, PhD, Graduate School of Medical Science, Kyoto Prefectural University of Medicine; N. Nishimoto, MD, PhD, Osaka Rheumatology Clinic and Institute of Medical Science, Tokyo Medical University; T. Mimori, MD, PhD, Graduate School of Medicine, Kyoto University; H. Sano, MD, PhD, Hyogo College of Medicine. Dr. Sekiguchi and Dr. Fujii contributed equally to this study
| | - Kiyoshi Matsui
- From the Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Rheumatology and Clinical Immunology, and the Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University; Department of Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto; Osaka Rheumatology Clinic and Institute of Medical Science, Osaka; Tokyo Medical University, Tokyo, Japan.,M. Sekiguchi, MD, PhD, Hyogo College of Medicine; T. Fujii, MD, PhD, Graduate School of Medicine, Kyoto University; K. Matsui, MD, PhD, Hyogo College of Medicine; K. Murakami, MD, PhD, Graduate School of Medicine, Kyoto University; S. Morita, MD, PhD, Graduate School of Medicine, Kyoto University; K. Ohmura, MD, PhD, Graduate School of Medicine, Kyoto University; Y. Kawahito, MD, PhD, Graduate School of Medical Science, Kyoto Prefectural University of Medicine; N. Nishimoto, MD, PhD, Osaka Rheumatology Clinic and Institute of Medical Science, Tokyo Medical University; T. Mimori, MD, PhD, Graduate School of Medicine, Kyoto University; H. Sano, MD, PhD, Hyogo College of Medicine. Dr. Sekiguchi and Dr. Fujii contributed equally to this study
| | - Kosaku Murakami
- From the Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Rheumatology and Clinical Immunology, and the Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University; Department of Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto; Osaka Rheumatology Clinic and Institute of Medical Science, Osaka; Tokyo Medical University, Tokyo, Japan.,M. Sekiguchi, MD, PhD, Hyogo College of Medicine; T. Fujii, MD, PhD, Graduate School of Medicine, Kyoto University; K. Matsui, MD, PhD, Hyogo College of Medicine; K. Murakami, MD, PhD, Graduate School of Medicine, Kyoto University; S. Morita, MD, PhD, Graduate School of Medicine, Kyoto University; K. Ohmura, MD, PhD, Graduate School of Medicine, Kyoto University; Y. Kawahito, MD, PhD, Graduate School of Medical Science, Kyoto Prefectural University of Medicine; N. Nishimoto, MD, PhD, Osaka Rheumatology Clinic and Institute of Medical Science, Tokyo Medical University; T. Mimori, MD, PhD, Graduate School of Medicine, Kyoto University; H. Sano, MD, PhD, Hyogo College of Medicine. Dr. Sekiguchi and Dr. Fujii contributed equally to this study
| | - Satoshi Morita
- From the Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Rheumatology and Clinical Immunology, and the Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University; Department of Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto; Osaka Rheumatology Clinic and Institute of Medical Science, Osaka; Tokyo Medical University, Tokyo, Japan.,M. Sekiguchi, MD, PhD, Hyogo College of Medicine; T. Fujii, MD, PhD, Graduate School of Medicine, Kyoto University; K. Matsui, MD, PhD, Hyogo College of Medicine; K. Murakami, MD, PhD, Graduate School of Medicine, Kyoto University; S. Morita, MD, PhD, Graduate School of Medicine, Kyoto University; K. Ohmura, MD, PhD, Graduate School of Medicine, Kyoto University; Y. Kawahito, MD, PhD, Graduate School of Medical Science, Kyoto Prefectural University of Medicine; N. Nishimoto, MD, PhD, Osaka Rheumatology Clinic and Institute of Medical Science, Tokyo Medical University; T. Mimori, MD, PhD, Graduate School of Medicine, Kyoto University; H. Sano, MD, PhD, Hyogo College of Medicine. Dr. Sekiguchi and Dr. Fujii contributed equally to this study
| | - Koichiro Ohmura
- From the Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Rheumatology and Clinical Immunology, and the Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University; Department of Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto; Osaka Rheumatology Clinic and Institute of Medical Science, Osaka; Tokyo Medical University, Tokyo, Japan.,M. Sekiguchi, MD, PhD, Hyogo College of Medicine; T. Fujii, MD, PhD, Graduate School of Medicine, Kyoto University; K. Matsui, MD, PhD, Hyogo College of Medicine; K. Murakami, MD, PhD, Graduate School of Medicine, Kyoto University; S. Morita, MD, PhD, Graduate School of Medicine, Kyoto University; K. Ohmura, MD, PhD, Graduate School of Medicine, Kyoto University; Y. Kawahito, MD, PhD, Graduate School of Medical Science, Kyoto Prefectural University of Medicine; N. Nishimoto, MD, PhD, Osaka Rheumatology Clinic and Institute of Medical Science, Tokyo Medical University; T. Mimori, MD, PhD, Graduate School of Medicine, Kyoto University; H. Sano, MD, PhD, Hyogo College of Medicine. Dr. Sekiguchi and Dr. Fujii contributed equally to this study
| | - Yutaka Kawahito
- From the Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Rheumatology and Clinical Immunology, and the Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University; Department of Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto; Osaka Rheumatology Clinic and Institute of Medical Science, Osaka; Tokyo Medical University, Tokyo, Japan.,M. Sekiguchi, MD, PhD, Hyogo College of Medicine; T. Fujii, MD, PhD, Graduate School of Medicine, Kyoto University; K. Matsui, MD, PhD, Hyogo College of Medicine; K. Murakami, MD, PhD, Graduate School of Medicine, Kyoto University; S. Morita, MD, PhD, Graduate School of Medicine, Kyoto University; K. Ohmura, MD, PhD, Graduate School of Medicine, Kyoto University; Y. Kawahito, MD, PhD, Graduate School of Medical Science, Kyoto Prefectural University of Medicine; N. Nishimoto, MD, PhD, Osaka Rheumatology Clinic and Institute of Medical Science, Tokyo Medical University; T. Mimori, MD, PhD, Graduate School of Medicine, Kyoto University; H. Sano, MD, PhD, Hyogo College of Medicine. Dr. Sekiguchi and Dr. Fujii contributed equally to this study
| | - Norihiro Nishimoto
- From the Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Rheumatology and Clinical Immunology, and the Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University; Department of Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto; Osaka Rheumatology Clinic and Institute of Medical Science, Osaka; Tokyo Medical University, Tokyo, Japan.,M. Sekiguchi, MD, PhD, Hyogo College of Medicine; T. Fujii, MD, PhD, Graduate School of Medicine, Kyoto University; K. Matsui, MD, PhD, Hyogo College of Medicine; K. Murakami, MD, PhD, Graduate School of Medicine, Kyoto University; S. Morita, MD, PhD, Graduate School of Medicine, Kyoto University; K. Ohmura, MD, PhD, Graduate School of Medicine, Kyoto University; Y. Kawahito, MD, PhD, Graduate School of Medical Science, Kyoto Prefectural University of Medicine; N. Nishimoto, MD, PhD, Osaka Rheumatology Clinic and Institute of Medical Science, Tokyo Medical University; T. Mimori, MD, PhD, Graduate School of Medicine, Kyoto University; H. Sano, MD, PhD, Hyogo College of Medicine. Dr. Sekiguchi and Dr. Fujii contributed equally to this study
| | - Tsuneyo Mimori
- From the Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Rheumatology and Clinical Immunology, and the Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University; Department of Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto; Osaka Rheumatology Clinic and Institute of Medical Science, Osaka; Tokyo Medical University, Tokyo, Japan.,M. Sekiguchi, MD, PhD, Hyogo College of Medicine; T. Fujii, MD, PhD, Graduate School of Medicine, Kyoto University; K. Matsui, MD, PhD, Hyogo College of Medicine; K. Murakami, MD, PhD, Graduate School of Medicine, Kyoto University; S. Morita, MD, PhD, Graduate School of Medicine, Kyoto University; K. Ohmura, MD, PhD, Graduate School of Medicine, Kyoto University; Y. Kawahito, MD, PhD, Graduate School of Medical Science, Kyoto Prefectural University of Medicine; N. Nishimoto, MD, PhD, Osaka Rheumatology Clinic and Institute of Medical Science, Tokyo Medical University; T. Mimori, MD, PhD, Graduate School of Medicine, Kyoto University; H. Sano, MD, PhD, Hyogo College of Medicine. Dr. Sekiguchi and Dr. Fujii contributed equally to this study
| | - Hajime Sano
- From the Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Rheumatology and Clinical Immunology, and the Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University; Department of Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto; Osaka Rheumatology Clinic and Institute of Medical Science, Osaka; Tokyo Medical University, Tokyo, Japan.,M. Sekiguchi, MD, PhD, Hyogo College of Medicine; T. Fujii, MD, PhD, Graduate School of Medicine, Kyoto University; K. Matsui, MD, PhD, Hyogo College of Medicine; K. Murakami, MD, PhD, Graduate School of Medicine, Kyoto University; S. Morita, MD, PhD, Graduate School of Medicine, Kyoto University; K. Ohmura, MD, PhD, Graduate School of Medicine, Kyoto University; Y. Kawahito, MD, PhD, Graduate School of Medical Science, Kyoto Prefectural University of Medicine; N. Nishimoto, MD, PhD, Osaka Rheumatology Clinic and Institute of Medical Science, Tokyo Medical University; T. Mimori, MD, PhD, Graduate School of Medicine, Kyoto University; H. Sano, MD, PhD, Hyogo College of Medicine. Dr. Sekiguchi and Dr. Fujii contributed equally to this study
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Ishiguro N, Atsumi T, Harigai M, Mimori T, Nishimoto N, Sumida T, Takeuchi T, Tanaka Y, Nakasone A, Takagi N, Yamanaka H. Effectiveness and safety of tocilizumab in achieving clinical and functional remission, and sustaining efficacy in biologics-naive patients with rheumatoid arthritis: The FIRST Bio study. Mod Rheumatol 2016; 27:217-226. [PMID: 27414105 DOI: 10.1080/14397595.2016.1206507] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 10/21/2022]
Abstract
OBJECTIVE To evaluate effectiveness and safety of tocilizumab (TCZ) in biologic-naive Japanese patients with rheumatoid arthritis (RA) in real-world settings, and to analyze the relationship between disease duration and clinical outcomes. METHODS The FIRST Bio study was a postmarketing surveillance study of intravenous TCZ in biologics-naive patients who had a prior inadequate response or were intolerant to ≥1 conventional synthetic disease-modifying antirheumatic drug (csDMARD). Effectiveness, safety, and concomitant csDMARD administration were assessed. RESULTS Of the 839 patients analyzed, 72.3% completed 52 weeks of treatment. The Clinical Disease Activity Index (CDAI) remission rate at week 52 was 36.8%. Contributing factors for CDAI remission were younger age, early disease stage, and no comorbidities. Health Assessment Questionnaire Disability Index ≤0.5 was achieved in 65.1% of patients, and was significantly associated with disease duration. Discontinuation of concomitant methotrexate (MTX) and glucocorticoids (GCs) was possible in 19.3% and 34.1% of patients, respectively, without decreasing remission rate. The incidence (events/100 patient-years) of serious adverse events was 18.09, the most common being infection. CONCLUSION These data validate the importance of TCZ treatment in the early stages of RA in biologic-naive patients to achieve increased effectiveness. The safety profile of TCZ was reconfirmed. Furthermore, TCZ therapy may allow discontinuation of concomitant MTX and GCs without affecting remission.
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Affiliation(s)
- Naoki Ishiguro
- a Department of Orthopedic Surgery , Nagoya University Graduate School & Faculty of Medicine , Nagoya , Japan
| | - Tatsuya Atsumi
- b Hokkaido University Graduate School of Medicine , Sapporo , Japan
| | - Masayoshi Harigai
- c Department of Pharmacovigilance , Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo , Japan
| | - Tsuneyo Mimori
- d Department of Rheumatology and Clinical Immunology , Kyoto University , Kyoto , Japan
| | | | - Takayuki Sumida
- f Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine , University of Tsukuba , Tsukuba , Japan
| | - Tsutomu Takeuchi
- g Division of Rheumatology, Department of Internal Medicine , Keio University , Minato , Japan
| | - Yoshiya Tanaka
- h The First Department of Internal Medicine , School of Medicine, University of Occupational and Environmental Health , Kitakyushu , Japan
| | - Ayako Nakasone
- i Pharmacovigilance Department , Chugai Pharmaceutical Co. Ltd. , Tokyo , Japan
| | - Nobuhiro Takagi
- j Medical Science Department , Chugai Pharmaceutical Co. Ltd. , Tokyo , Japan , and
| | - Hisashi Yamanaka
- k Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan
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20
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Murakami M, Kuritani T, Nishimoto N. SAT0176 IL-6 Blockade with Tocilizumab Does Not Suppress CD4+T Cell Activation at 48 Weeks of The Treatment. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5222] [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: 11/03/2022]
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Abstract
To understand the risk of particle formation in glass vials, we investigated the correlation between vial surface condition and alminum (Al) or silicon (Si) elution using various suppliers' vials with or without surface treatment. The elution of Si, which can also be an indicator of Al elution, consists of two phases; the first phase is influenced by roughness of the glass surface at the time of filling, and the second phase is dependent on the fundamental elution rate from the glass tube. When vials were filled with citrate buffer at pH 7, vials with varied surface conditions showed the most obvious differences in Al and Si elution. Sulfur-treated vials showed slightly lower Al and Si elution than the non-treated vials. It is considered that this effect of the sulfur treatment on elution is due to the surface being smoothed during heat treatment after the washing process. Different from the sulfur treatment, silicon dioxide (SiO2)-coated vials hardly showed any Al elution as long as the surface was fully coated with the SiO2 layer. It was found that the protective effect of the SiO2 layer against Al elution is more effective in a vial filled with a solution having a lower pH, due to the lower Si dissolving rate occurring at a lower pH. As shown above, pre-measuring the Si and Al present in a citrate buffer at pH 7 placed within a glass container can be a useful tool for selecting the appropriate container for liquid drugs.
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Affiliation(s)
- Toru Ogawa
- Formulation Technology Research Laboratories, Daiichi Sankyo Co., Ltd
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22
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Murakami M, Nishimoto N. [IL-6 inhibitors prevent bone loss and cartilage degeneration in rheumatoid arthritis]. Clin Calcium 2015; 25:1851-1857. [PMID: 26608861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Dysregulation of cytokines, including interleukin-6 (IL-6), is involved in joint destruction in rheumatoid arthritis (RA). The concentration of IL-6 is increased not only in the affected joints but also in the serum. Locally, IL-6 provides the formation of pannus through the synthesis of vascular endothelial growth factor (VEGF). In addition, IL-6 contributes to the production of matrix metalloproteinases which digest collagen and proteoglycan of cartilage. Furthermore, IL-6 induces the differentiation and activation of osteoclasts. IL-6 can be delivered systemically to a similar extent as hormones, may induce systemic osteoporosis. Tocilizumab (TCZ), a humanized anti-IL-6 receptor antibody, inhibiting IL-6 signaling, has provided beneficial outcomes, such as achievement of clinical remission, protective effects against bone and cartilage destruction. Because of the beneficial outcomes, new drugs inhibiting IL-6 signaling are developed, and the clinical trials are ongoing.
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Affiliation(s)
- Miho Murakami
- Department of Molecular Regulation for Intractable Diseases,Institute of Medical Science, Tokyo Medical University, Japan.Osaka Rheumatology Clinic, Japan
| | - Norihiro Nishimoto
- Department of Molecular Regulation for Intractable Diseases,Institute of Medical Science, Tokyo Medical University, Japan.Osaka Rheumatology Clinic, Japan
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23
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Fujihara J, Tongu M, Hashimoto H, Fujita Y, Nishimoto N, Yasuda T, Takeshita H. Pro-inflammatory responses and oxidative stress induced by ZnO nanoparticles in vivo following intravenous injection. Eur Rev Med Pharmacol Sci 2015; 19:4920-4926. [PMID: 26744884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To determine the toxicological effect of ZnO nanoparticles (NPs), inflammatory responses, serum biological parameters and oxidative stress markers of Superoxide dismutase (SOD) were evaluated followed by intravenous treatment of ZnO NPs in mice. MATERIALS AND METHODS Inflammatory responses induced by a dose of 0.2 mg/kg ZnO NPs, followed by a single intravenous treatment were examined in mice. In addition, the serum biological parameters and oxidative stress markers were evaluated. Blood and spleen were collected following treatment. The mRNA transcript levels of inflammatory-related genes (TNF-α and IL1-β) were elevated in the spleen cells of mice treated with ZnO NPs at 12h. RESULTS The elevated levels of TNF-α and IL1-β in supernatants of spleen cell cultures of mice treated with ZnO NPs were also observed at 24h. The serum aspartate aminotransferase, glutamate pyruvate alanine aminotransferase, and lactate dehydrogenase levels significantly increased at 6h and 12h in ZnO NPs treated group, indicating liver cell injury and tissue damage. On the other hand, no elevation was observed in BUN and Cre, biochemical markers of kidney damage. SOD activities were significantly elevated at 24 h and 48 h. CONCLUSIONS This study shows the ZnO induced pro-inflammatory response in vivo, that this response may be related to oxidative stress, and to show hepatic damage at an early stage.
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Affiliation(s)
- J Fujihara
- Department of Legal Medicine, Shimane University Faculty of Medicine, Izumo, Japan.
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24
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Sekiguchi M, Fujii T, Kitano M, Matsui K, Hashimoto H, Yokota A, Miki K, Yamamoto A, Fujimoto T, Hidaka T, Shimmyo N, Maeda K, Kuroiwa T, Yoshii I, Murakami K, Ohmura K, Morita S, Kawahito Y, Nishimoto N, Mimori T, Sano H. AB0472 Predicting Factors Associated with Sustained Clinical Remission by Abatacept are Different Between in Younger and Elderly Patients with Biologic-Naïve Rheumatoid Arthritis (Abroad Study). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mimori T, Atsumi T, Harigai M, Nishimoto N, Sumida T, Takeuchi T, Tanaka Y, Yamanaka H, Nakasone A, Takagi N, Ishiguro N. SAT0211 Effectiveness and Safety of Tocilizumab in Biologics Naïve RA Patients – PMS for Investigating Success in Achieving Clinical and Functional Remission and Sustaining Efficacy with Tocilizumab in Biologics-Naïve RA Patients (First Bio) Study: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1829] [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: 11/04/2022]
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Ito M, Murakami M, Ochi K, Shimaoka Y, Ochi T, Nishimoto N. THU0014 Composition of Dendritic Cell and NK Cell-Related Network with Abnormally Expressed Glycosylation-Related Molecules in the Bone Marrow Cells from Patients with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3232] [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: 11/04/2022]
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Mimori T, Atsumi T, Harigai M, Nishimoto N, Sumida T, Takeuchi T, Tanaka Y, Yamanaka H, Nakasone A, Takagi N, Ishiguro N. AB0486 Effect of Baseline Disease Duration on Development of Clinical Remission in the RA Patients Receiving Tocilizumab – Data from PMS with Tocilizumab in Biologics-Naïve RA Patients (First Bio) Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1295] [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: 11/03/2022]
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Ito M, Murakami M, Saito M, Niwa A, Osawa M, Nakahata T, Nishimoto N. AB0100 Monocytes Differentiated from IPS Cells Derived from Rheumatoid Arthritis Patients Express More M-Scf-Receptor Together with Rank Than Those from Healthy Donors Resulting in the Accelerated Osteoclastgenesis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3229] [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: 11/03/2022]
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Tanaka Y, Hirata S, Amano K, Atsumi T, Yamamoto K, Sumida T, Takeuchi T, Kohsaka H, Mimori T, Kawakami A, Nishimoto N, Tanaka E, Kaneko Y, Yasuoka H, Fukuyo S, Saito K. AB0513 Treatment Strategy Targeting Structural Remission in Patients with Early Rheumatoid Arthritis: A Multi-Central, Prospective, Comparative Study Targeting Joint Damage to Zero (Zero-J Study). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2544] [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: 11/03/2022]
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Quartuccio L, Corazza L, Ramos-Casals M, Retamozo S, Ragab G, Ferraccioli G, Gremese E, Tzioufas A, Voulgarelis M, Vassilopoulos D, Koutsianas C, Scarpato S, Salvarani C, Guillevin L, Terrier B, Cacoub P, Saccardo F, Gabrielli A, Fraticelli P, Tomsic M, Tavoni A, Nishimoto N, Filippini D, Scaini P, Zignego A, Ferri C, Sansonno D, Monti G, Pietrogrande M, Galli M, Bombardieri S, De Vita S. OP0274 Cryoglobulinemic Vasculitis and Primary sjögren's Syndrome are Independent Risk Factors for Lymphoma in a Large Worldwide Population of Patients with Positive Serum Cryoglobulins. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3300] [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: 11/04/2022]
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Ogata A, Amano K, Dobashi H, Inoo M, Ishii T, Kasama T, Kawai S, Kawakami A, Koike T, Miyahara H, Miyamoto T, Munakata Y, Murasawa A, Nishimoto N, Ogawa N, Ojima T, Sano H, Shi K, Shono E, Suematsu E, Takahashi H, Tanaka Y, Tsukamoto H, Nomura A. Longterm Safety and Efficacy of Subcutaneous Tocilizumab Monotherapy: Results from the 2-year Open-label Extension of the MUSASHI Study. J Rheumatol 2015; 42:799-809. [PMID: 25834203 DOI: 10.3899/jrheum.140665] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate the longterm safety and efficacy of subcutaneous tocilizumab (TCZ-SC) as monotherapy in patients with rheumatoid arthritis (RA). METHODS Of 346 patients who received 24 weeks of double-blind treatment with either TCZ-SC monotherapy, 162 mg every 2 weeks (q2w); or intravenous TCZ (TCZ-IV) monotherapy, 8 mg/kg every 4 weeks; 319 patients continued to receive TCZ-SC q2w in the 84-week open-label extension (OLE) of the MUSASHI study (JAPICCTI-101117). Efficacy, safety, and immunogenicity were evaluated for all patients treated with TCZ during 108 weeks. RESULTS The proportions of patients who achieved American College of Rheumatology 20/50/70 responses, low disease activity [28-joint Disease Activity Score (DAS28) ≤ 3.2], or remission (DAS28 < 2.6) at Week 24 were maintained until Week 108. The incidences of adverse events and serious adverse events were 498.3 and 16.9 per 100 patient-years (PY), respectively. The overall safety of TCZ-SC monotherapy was similar to that of TCZ-IV monotherapy. Rates of injection site reactions (ISR) through 108 weeks remained similar to rates through 24 weeks. ISR were mild and did not cause any patient withdrawals. No serious hypersensitivity events (including anaphylactic reactions) occurred. Anti-TCZ antibodies were present in 2.1% of patients treated with TCZ-SC monotherapy. CONCLUSION TCZ-SC monotherapy maintained a favorable safety profile and consistent efficacy throughout the 108-week study. Like TCZ-IV, TCZ-SC could provide an additional treatment option for patients with RA.
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Affiliation(s)
- Atsushi Ogata
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Koichi Amano
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Hiroaki Dobashi
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Masayuki Inoo
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Tomonori Ishii
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Tsuyoshi Kasama
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Shinichi Kawai
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Atsushi Kawakami
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Tatsuya Koike
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Hisaaki Miyahara
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Toshiaki Miyamoto
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Yasuhiko Munakata
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Akira Murasawa
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Norihiro Nishimoto
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Noriyoshi Ogawa
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Tomohiro Ojima
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Hajime Sano
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Kenrin Shi
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Eisuke Shono
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Eiichi Suematsu
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Hiroki Takahashi
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Yoshiya Tanaka
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Hiroshi Tsukamoto
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
| | - Akira Nomura
- From the Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine and Department of Immunopathology, WPI Immunology Frontier Research Center, Osaka University, Osaka; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama; Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University; Department of Rheumatology, Utazu-Hama Clinic, Kagawa; Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai; Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo; Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rheumatosurgery, Osaka City University, Graduate School of Medicine, Osaka; Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka; Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka; Munakata Yasuhiko Clinic, Miyagi; Department of Rheumatology, Niigata Rheumatic Center, Niigata; Osaka Rheumatology Clinic, Osaka; Third Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka; Department of Orthopedic Surgery, Fukui General Hospital, Fukui; Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo; Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka; Shono Rheumatology Clinic, Fukuoka; First Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka; Department of Medicine and Biosy
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Hiraizumi S, Nishinomiya H, Oikawa T, Sakagami N, Sano F, Nishino O, Kurahara T, Nishimoto N, Ishiyama O, Hasegawa Y, Hashiyada Y. Superovulatory response in Japanese Black cows receiving a single subcutaneous porcine follicle-stimulating hormone treatment or six intramuscular treatments over three days. Theriogenology 2014; 83:466-73. [PMID: 25476823 DOI: 10.1016/j.theriogenology.2014.09.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 07/23/2013] [Revised: 09/09/2014] [Accepted: 09/11/2014] [Indexed: 11/16/2022]
Abstract
To reduce labor for superovulation treatment by twice-daily intramuscular (im) administration of FSH for more than 3 to 4 days, we investigated the superovulatory responses of Japanese Black cows to porcine FSH (pFSH) used as a single subcutaneous (sc) administration at two different doses in two different volumes of saline. In experiment 1, 20 Armour units (AU) of pFSH dissolved in either 10 mL (treatment A; n = 14) or 50 mL (treatment B; n = 14) of saline was administered subcutaneously in the neck region. In experiment 2, 30 AU of pFSH dissolved in either 10 mL (treatment C; n = 15) or 50 mL (treatment D; n = 15) of saline was administered subcutaneously in the neck region. The control animals in experiment 1 (n = 14) and experiment 2 (n = 15) received 20 AU of pFSH administered intramuscularly twice daily in decreasing doses for more than 3 days. In experiment 1, mean (±SEM) numbers of CL (15.4 ± 2.5, 18.1 ± 3.4, and 17.2 ± 2.6), total number of ova and embryos (12.9 ± 1.4, 15.9 ± 3.5, and 16.2 ± 2.8), and transferable embryos (7.5 ± 2.0, 10.4 ± 2.8, and 8.0 ± 2.1) did not differ among treatments A, B, and control. In experiment 2, mean (±SEM) numbers of CL (20.5 ± 4.3, 20.4 ± 2.7, and 20.1 ± 3.4), total number of ova and embryos (21.7 ± 4.2, 17.3 ± 3.4, and 16.5 ± 3.2), and transferable embryos (8.1 ± 1.6, 9.3 ± 2.2, and 9.5 ± 1.9) did not differ among treatments C, D, and control. Although there were no differences in serum pFSH concentrations among the three treatments at each of the time points in experiment 1, in experiment 2, the serum pFSH concentration at 6 and 8 hours after pFSH administration in treatment C (3.1 ± 0.8, 2.7 ± 0.5 ng/mL, mean ± SEM) was significantly greater (P < 0.05) than in the control (0.7 ± 0.1, 1.1 ± 0.2 ng/mL). At 10 hours after administration, the pFSH concentration had decreased and there were no differences among the three treatments at subsequent time points. These results suggest that increasing the volume of saline or the dose of pFSH does not affect the absorption pattern of pFSH administered as a single sc administration. In conclusions, single sc administration of pFSH at a dose of 20 or 30 AU dissolved in 10 or 50 mL of saline is able to induce a superovulatory response comparable with that obtained by twice-daily im administration in Japanese Black cows.
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Affiliation(s)
- S Hiraizumi
- Aomori Prefectural Industrial Technology Research Center, Livestock Research Institute, Noheji, Aomori, Japan.
| | - H Nishinomiya
- Livestock Experiment Station, Akita Prefectural Agriculture Forestry and Fisheries Research Center, Akita, Japan
| | - T Oikawa
- Miyagi Prefectural Livestock Experiment Station, Miyagi, Japan
| | - N Sakagami
- Kanagawa Prefectural Livestock Technology Center, Kanagawa, Japan
| | - F Sano
- Shizuoka Prefectural Research Institute of Animal Industry, Shizuoka, Japan
| | - O Nishino
- Nara prefectural Livestock Technology Center, Nara, Japan
| | - T Kurahara
- Oita Prefectural Agriculture, Forestry and Fisheries Research Center Livestock Research Institute, Oita, Japan
| | - N Nishimoto
- Aomori Prefectural Industrial Technology Research Center, Livestock Research Institute, Noheji, Aomori, Japan
| | - O Ishiyama
- Aomori Prefectural Industrial Technology Research Center, Livestock Research Institute, Noheji, Aomori, Japan
| | - Y Hasegawa
- Laboratory of Experimental Animal Science, Kitasato University, Towada Aomori, Japan
| | - Y Hashiyada
- National Livestock Breeding Center, Fukushima, Japan
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Ohtsuji M, Lin Q, Nishikawa K, Ohtsuji N, Okazaki H, Tsurui H, Amano H, Shirai T, Nishimoto N, Nishimura H, Hirose S. IL-6 signal blockade ameliorates the enhanced osteoclastogenesis and the associated joint destruction in a novel FcγRIIB-deficient rheumatoid arthritis mouse model. Mod Rheumatol 2014; 25:270-7. [PMID: 25159156 DOI: 10.3109/14397595.2014.950035] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 11/13/2022]
Abstract
OBJECTIVE We earlier found that TNFα but not interleukin (IL)-17 is indispensable in the pathogenesis of spontaneously occurring rheumatoid arthritis (RA)-like disease in our newly established FcγRIIB-deficient C57BL/6 (B6) mouse model, designated KO1. Here, we examined the role of IL-6 in the pathogenesis of RA features in KO1, with particular reference to cartilage and bone destruction in arthritic joints. METHODS To evaluate the preventive effect of MR16-1, a rat anti-mouse IL-6 receptor (IL-6R) mAb, 4-month-old preclinical KO1 mice were divided into three groups: the first treated with MR16-1 for 6 months, the second treated with normal rat IgG, as a control, and the third left untreated. The incidence and severity of arthritis, immunological abnormalities, and transcription levels of receptor activator of NF-κB ligand (RANKL), osteoprotegerin (OPG), and inflammatory cytokines/chemokines in ankle joint tissues were compared among the three groups. The therapeutic effect of MR16-1 was examined by treating 7-month-old KO1 mice in the early stages of arthritis for 2 months. RESULTS Compared with the findings in the KO1 mice left untreated or treated with normal rat IgG, the development of arthritis was markedly suppressed in mice with MR16-1 treatment started from preclinical stages. The suppression was associated with the decrease in production of autoantibodies, rheumatoid factors (RF), and anti-cyclic citrullinated peptide (CCP). Histologically, marked synovitis, pannus formation, and cartilage and bone destruction associated with the increase in tartrate-resistant acid phosphatase (TRAP)-positive osteoclast generation were evident in the two control groups; however, these findings were virtually absent in MR16-1-treated mice. Real-time PCR analysis revealed that the up-regulated expression levels of MCP-1, IL-6, and TNFα, and the aberrantly high RANKL/OPG expression ratio in synovial joint tissues from the two control groups of mice with overt arthritis were significantly suppressed in MR16-1-treated mice. In mice with therapeutic MR16-1 treatment, there was no progression in arthritis score and the RANKL/OPG ratio in joint tissues was significantly suppressed. CONCLUSIONS Administration of an anti-IL-6R mAb ameliorated spontaneously occurring RA-like disease features, indicating that IL-6, as well as TNFα, plays a pivotal role in the pathogenesis of RA in KO1 mice. Current studies showed that, in addition to the role in enhancing autoantibody production, IL-6 promotes synovial tissue inflammation and osteoclastogenesis, leading to the severe synovitis with pannus formation and the progressive cartilage and bone destruction in multiple joints.
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Affiliation(s)
- Mareki Ohtsuji
- Department of Biomedical Engineering, Toin Human Science and Technology Center, Toin University of Yokohama , Yokohama , Japan
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Nishimoto N, Amano K, Hirabayashi Y, Horiuchi T, Ishii T, Iwahashi M, Iwamoto M, Kohsaka H, Kondo M, Matsubara T, Mimura T, Miyahara H, Ohta S, Saeki Y, Saito K, Sano H, Takasugi K, Takeuchi T, Tohma S, Tsuru T, Ueki Y, Yamana J, Hashimoto J, Matsutani T, Murakami M, Takagi N. Drug free REmission/low disease activity after cessation of tocilizumab (Actemra) Monotherapy (DREAM) study. Mod Rheumatol 2014; 24:17-25. [PMID: 24261754 DOI: 10.3109/14397595.2013.854079] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To investigate the duration of remission and low disease activity (LDA) after cessation of tocilizumab (TCZ) treatment in rheumatoid arthritis patients who showed remission or LDA as assessed by DAS28 in response to preceding TCZ monotherapy, and to explore the factors contributing to prolonged efficacy duration. METHODS Disease activity was monitored for 56 weeks. The rate of continued efficacy was estimated by Kaplan-Meier curves. RESULTS A total of 187 patients were eligible. At baseline of this study, median disease duration was 7.8 years, preceding TCZ treatment period was 4.0 years and DAS28 was 1.5. The rate of continued LDA at 52 weeks was 13.4 % according to the Kaplan-Meier estimate. 19 patients (10 %) were completely drug-free and 17 patients (9.1 %) fulfilled DAS28 remission at 52 weeks. Multivariate Cox regression analysis identified low serum IL-6 and normalisation of MMP-3 levels at cessation of TCZ as independent predictive markers for longer duration of LDA. In patients with low serum IL-6 (<12.9 pg/mL) and normal MMP-3 levels, the rate of continued LDA reached 38.0 % at 52 weeks. CONCLUSIONS TCZ monotherapy may induce biologics-free remission or LDA without concomitant use of synthetic DMARDs. Serum levels of IL-6 and MMP-3 are useful markers for identifying patients who could discontinue TCZ without acute disease flare.
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Affiliation(s)
- Norihiro Nishimoto
- Osaka Rheumatology Clinic , Tatsuno-Sinsaibashi-Building 5th Floor, 4-4-10 Minamisenba Chuo-ku, Osaka 542-0081 , Japan
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Quartuccio L, Isola M, Corazza L, Ramos-Casals M, Retamozo S, Ragab GM, Zoheir MN, El-Menyawi MAM, Salem MN, Sansonno D, Ferraccioli G, Gremese E, Tzioufas A, Voulgarelis M, Vassilopoulos D, Scarpato S, Pipitone N, Salvarani C, Guillevin L, Terrier B, Cacoub P, Filippini D, Saccardo F, Gabrielli A, Fraticelli P, Sebastiani M, Tomsic M, Tavoni A, Mazzaro C, Pioltelli P, Nishimoto N, Scaini P, Zignego AL, Ferri C, Monti G, Pietrogrande M, Bombardieri S, Galli M, De Vita S. Validation of the classification criteria for cryoglobulinaemic vasculitis. Rheumatology (Oxford) 2014; 53:2209-13. [DOI: 10.1093/rheumatology/keu271] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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Affiliation(s)
- Shigeki Inui
- Department of Regenerative Dermatology; Graduate School of Medicine; Osaka University; Suita
- Osaka Rheumatology Clinic; Osaka Japan
| | - Satoshi Itami
- Department of Regenerative Dermatology; Graduate School of Medicine; Osaka University; Suita
| | - Miho Murakami
- Osaka Rheumatology Clinic; Osaka Japan
- Department of Molecular Regulation for Intractable Diseases; Institute of Medical Science; Tokyo Medical University; Osaka Japan
| | - Norihiro Nishimoto
- Osaka Rheumatology Clinic; Osaka Japan
- Department of Molecular Regulation for Intractable Diseases; Institute of Medical Science; Tokyo Medical University; Osaka Japan
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Affiliation(s)
- T. Takemoto
- Pharmazeutisches Institut, Universität Tohoku, Kita-4-bancho, Sendai, Japan
| | - S. Ogawa
- Pharmazeutisches Institut, Universität Tohoku, Kita-4-bancho, Sendai, Japan
| | - N. Nishimoto
- Pharmazeutisches Institut, Universität Tohoku, Kita-4-bancho, Sendai, Japan
| | - H. Hoffmeister
- Pharmazeutisches Institut, Universität Tohoku, Kita-4-bancho, Sendai, Japan
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Murakami M, Ito M, Sekiguchi M, Matsui K, Kitano M, Imura Y, Ohmura K, Fujii T, Kuroiwa T, Maeda K, Morita S, Kawahito Y, Mimori T, Sano H, Nishimoto N. SAT0239 T Cell CD80/Cd86 Co-Stimulatory Blockade Effectively Suppresses CD25 (+) in CD4 (+) T Cell Subpopulation but not the ACPA Titers in the Course of 48-Week Treatment of Patients with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3997] [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: 11/03/2022]
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Nishimoto N, Murakami M, Ito M, Saito M, Niwa A, Nakahata T. AB0049 Appearance of CD14+CD15+ Poplulation During the Differentiation from RA-IPS Cells into Monocytes. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Murakami M, Ito M, Sekiguchi M, Matsui K, Kitano M, Imura Y, Ohmura K, Fujii T, Kuroiwa T, Maeda K, Morita S, Kawahito Y, Mimori T, Sano H, Nishimoto N. AB0439 T Cell CD80/Cd86 Co-Stimulatory Blockade Does not Suppress CD8 (+) Subpopulation in the Course of 48-Week Treatment of Patients with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4014] [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: 11/03/2022]
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Yokota S, Imagawa T, Mori M, Miyamae T, Takei S, Iwata N, Umebayashi H, Murata T, Miyoshi M, Tomiita M, Nishimoto N, Kishimoto T. Longterm Safety and Effectiveness of the Anti-interleukin 6 Receptor Monoclonal Antibody Tocilizumab in Patients with Systemic Juvenile Idiopathic Arthritis in Japan. J Rheumatol 2014; 41:759-67. [DOI: 10.3899/jrheum.130690] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.To assess the longterm safety and effectiveness of tocilizumab (TCZ) in systemic-onset juvenile idiopathic arthritis (sJIA).Methods.The longterm extension phase of 2 pivotal studies (phase II with 11 patients and phase III with 56 patients) in patients with active sJIA was analyzed. Patients received open-label TCZ (8 mg/kg, every 2 weeks) without concomitant use of disease-modifying antirheumatic drugs.Results.In total, 67 patients were enrolled. All patients received corticosteroid at baseline. Median duration of exposure to TCZ was 3.4 years. Nine patients withdrew from the study [4 because of adverse events (AE), 4 because of the development of anti-TCZ antibodies, and 1 because of inadequate response]. Rates of AE and serious AE were 803.7/100 patient-years (PY) and 34.7/100 PY, respectively. The most common serious AE were infections (13.2/100 PY). No cases of malignancy or death were reported. Two serious infusion reactions were reported in patients testing negative for anti-TCZ antibodies. One definite macrophage activation syndrome (MAS) case and 1 potential MAS case were identified. American College of Rheumatology (ACR) response rates attained early in the TCZ treatment period were maintained throughout the study: at Week 168, JIA ACR 30, 50, 70, 90, and 100 response rates were 80.3%, 80.3%, 75.4%, 60.7%, and 18.0%, respectively. In total, 22 of 67 patients (32.8%) completely discontinued corticosteroids without flare.Conclusion.TCZ has demonstrated durability of effectiveness in the longterm treatment of children with sJIA and has shown good tolerability and a low discontinuation rate associated with AE, development of anti-TCZ antibodies, or inadequate response. (ClinicalTrials.govNCT00144599 and NCT00144612).(First Release March 15 2014; J Rheumatol 2014;41:759-67; doi:10.3899/jrheum.130690)
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Nishimoto N. [Programs for continuing medical education: a session; 8. Pharmacotherapy of rheumatoid arthritis--interleukin-6 blocker made in Japan]. Nihon Naika Gakkai Zasshi 2014; 103:665-73. [PMID: 24796134 DOI: 10.2169/naika.103.665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
MESH Headings
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/pharmacology
- Antibodies, Monoclonal, Humanized/therapeutic use
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/genetics
- Bone Resorption
- Clinical Trials, Phase III as Topic
- Drug Discovery
- Education, Medical, Continuing
- Humans
- Inflammation Mediators
- Interleukin-6/antagonists & inhibitors
- Interleukin-6/physiology
- Japan
- Molecular Targeted Therapy
- Osteoclasts/physiology
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Fujita R, Kawano F, Ohira T, Nakai N, Shibaguchi T, Nishimoto N, Ohira Y. Anti-interleukin-6 receptor antibody (MR16-1) promotes muscle regeneration via modulation of gene expressions in infiltrated macrophages. Biochim Biophys Acta Gen Subj 2014; 1840:3170-80. [PMID: 24440156 DOI: 10.1016/j.bbagen.2014.01.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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: 08/25/2013] [Revised: 01/06/2014] [Accepted: 01/08/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Although rat anti-mouse IL-6 receptor (IL-6R) antibody (MR16-1) has been reported to effectively ameliorate various tissue damages, its effect on skeletal muscle regeneration has not been determined. Moreover, the localization, persistence and duration of action of this reagent in damaged tissues after systemic administration have not been assessed. METHODS The MR16-1 was administered i.p. immediately after cardiotoxin (CTX)-induced muscle damage on mice. RESULTS MR16-1 administered i.p. was observed only to the damaged muscle. This delivered MR16-1 was dramatically decreased from 3 to 7days post-injury concomitantly with a reduction of IL-6R expression. This reduction of the MR16-1 level in the damaged muscle was not rescued by additional administration of MR16-1, suggesting the short half-life of MR16-1 was not the factor for the remaining levels. In addition, a significant inhibitory effect of MR16-1 on phosphorylation of the signal transducer and activator of transcription 3 was observed in the macrophage-enriched area of damaged muscle 3days after injury. Finally, the acceleration of muscle regeneration observed at day 7 post-injury following MR16-1 treatment was associated with reduced expression of fibrosis-related genes, such as interleukin-10 and arginase, in the infiltrated macrophages. CONCLUSIONS These results suggest that MR16-1 which was found primarily localized in infiltrated macrophages in the damaged muscle might facilitate muscle regeneration via immune modulation. GENERAL SIGNIFICANCE These findings are deemed to provide further insight into the understanding not only of MR16-1 treatment on muscle regeneration, but also of the other anti-cytokine treatment on the cytokine-related disease.
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Affiliation(s)
- Ryo Fujita
- Graduate School of Medicine, Osaka University, Japan
| | | | - Takashi Ohira
- Graduate School of Frontier Bioscience, Osaka University, Japan
| | - Naoya Nakai
- Graduate School of Medicine, Osaka University, Japan
| | | | | | - Yoshinobu Ohira
- Graduate School of Medicine, Osaka University, Japan; Graduate School of Frontier Bioscience, Osaka University, Japan.
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Ozaki S, Atsumi T, Hayashi T, Ishizu A, Kobayashi S, Kumagai S, Kurihara Y, Kurokawa MS, Makino H, Nagafuchi H, Nakabayashi K, Nishimoto N, Suka M, Tomino Y, Yamada H, Yamagata K, Yoshida M, Yumura W. Severity-based treatment for Japanese patients with MPO-ANCA-associated vasculitis: the JMAAV study. Mod Rheumatol 2014. [DOI: 10.3109/s10165-011-0525-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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46
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Mori S, Tokuda H, Sakai F, Johkoh T, Mimori A, Nishimoto N, Tasaka S, Hatta K, Matsushima H, Kaise S, Kaneko A, Makino S, Minota S, Yamada T, Akagawa S, Kurashima A. Radiological features and therapeutic responses of pulmonary nontuberculous mycobacterial disease in rheumatoid arthritis patients receiving biological agents: a retrospective multicenter study in Japan. Mod Rheumatol 2014. [DOI: 10.3109/s10165-011-0577-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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47
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Nakahara H, Mima T, Yoshio-Hoshino N, Matsushita M, Hashimoto J, Nishimoto N. A case report of a patient with refractory adult-onset Still’s disease who was successfully treated with tocilizumab over 6 years. Mod Rheumatol 2014. [DOI: 10.3109/s10165-008-0116-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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48
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Nishimoto N, Miyasaka N, Yamamoto K, Kawai S, Takeuchi T, Azuma J, Kishimoto T. Study of active controlled tocilizumab monotherapy for rheumatoid arthritis patients with an inadequate response to methotrexate (SATORI): significant reduction in disease activity and serum vascular endothelial growth factor by IL-6 receptor inhibition therapy. Mod Rheumatol 2014. [DOI: 10.3109/s10165-008-0125-1] [Citation(s) in RCA: 209] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Imagawa T, Yokota S, Mori M, Miyamae T, Takei S, Imanaka H, Nerome Y, Iwata N, Murata T, Miyoshi M, Nishimoto N, Kishimoto T. Safety and efficacy of tocilizumab, an anti-IL-6-receptor monoclonal antibody, in patients with polyarticular-course juvenile idiopathic arthritis. Mod Rheumatol 2014. [DOI: 10.3109/s10165-011-0481-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hashimoto J, Garnero P, Heijde D, Miyasaka N, Yamamoto K, Kawai S, Takeuchi T, Yoshikawa H, Nishimoto N. A combination of biochemical markers of cartilage and bone turnover, radiographic damage and body mass index to predict the progression of joint destruction in patients with rheumatoid arthritis treated with disease-modifying anti-rheumatic drugs. Mod Rheumatol 2014. [DOI: 10.3109/s10165-009-0170-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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