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Mochizuki T, Koenuma N, Yano K, Ikari K, Hiroshima R, Okazaki K. Intensive treatment for the progression of joint damage in rheumatoid arthritis patients with low disease activity or remission. Mod Rheumatol 2024; 34:329-333. [PMID: 37267207 DOI: 10.1093/mr/road041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/13/2023] [Accepted: 04/21/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To investigate the effects of intensive treatment on joint damage in patients with rheumatoid arthritis (RA) showing progression of joint damage and low disease activity or remission. METHODS Eighty-nine patients who had change in the van der Heijde modified total Sharp score (TSS) of >0.5 points at baseline when compared with the score 1 year ago were enrolled and categorized into two groups to receive intensive (intensive group) or current (current group) treatment. The intensive and current groups were compared for change (Δ) from baseline to 1 year of erosion score, joint space narrowing score, and TSS. RESULTS The ΔTSS values at 1 year in the intensive and current groups were 0.67 ± 1.09 and 1.79 ± 1.70, respectively (P < 0.001). In the intensive and current groups, the ΔTSS ≤ 0.5 at 1 year were 66.7% and 32.4%, respectively (P = 0.010). CONCLUSIONS The intensive treatment was more effective at suppressing joint damage than the current treatment. The progression of joint damage is an important target to consider for intensive treatment.
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Affiliation(s)
- Takeshi Mochizuki
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Naoko Koenuma
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Koichiro Yano
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsunori Ikari
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
- Division of Multidisciplinary Management of Rheumatic Diseases, Tokyo Women's Medical University, Tokyo, Japan
| | - Ryo Hiroshima
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Ken Okazaki
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
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Mochizuki T, Yano K, Ikari K, Hiroshima R, Okazaki K. Comparison of Romosozumab Versus Denosumab Treatment on Bone Mineral Density After One Year in Rheumatoid Arthritis Patients with Severe Osteoporosis: A Randomized Clinical Pilot Study. Mod Rheumatol 2022; 33:490-495. [PMID: 35689558 DOI: 10.1093/mr/roac059] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/26/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To investigate the effect of romosozumab versus denosumab treatment on bone mineral density (BMD), disease activity, and joint damage in patients with rheumatoid arthritis (RA) and severe osteoporosis. METHODS Fifty-one postmenopausal women were enrolled and randomized equally into two groups to receive either romosozumab or the denosumab. Changes (Δ) in the BMD (at lumbar spine, total hip, and femoral neck), disease activity score in 28 joints (DAS28)-erythrocyte sedimentation rate (ESR), and van der Heijde-modified Total Sharp Score (TSS) from baseline to 12 months after treatment were evaluated. RESULTS The ΔBMD at 12 months in the romosozumab and denosumab groups were 10.2 ± 5.6% and 5.0 ± 3.1% (p = 0.002) for the lumbar spine, 3.7 ± 4.9% and 3.5 ± 3.0% (p = 0.902) for total hip, and 3.6 ± 4.7% and 3.2 ± 4.9% (p = 0.817) for femoral neck, respectively. The ΔDAS28-ESR at 12 months in the romosozumab and denosumab groups was 0.14 and 0.22 (p = 0.643), respectively, whereas, the ΔTSS at 12 months was 0.33 and 0.29 (p = 0.927), respectively. CONCLUSIONS Our results suggest that romosozumab treatment was more effective in increasing the BMD at the lumbar spine than denosumab, and may be selected for patients who require a significant increase in the lumbar spine BMD. Moreover, romosozumab may be not affect disease activity and joint damage in patients with RA.
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Affiliation(s)
- Takeshi Mochizuki
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Koichiro Yano
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsunori Ikari
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.,Division of Multidisciplinary Management of Rheumatic Diseases, Tokyo Women's Medical University, Tokyo, Japan
| | - Ryo Hiroshima
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Ken Okazaki
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
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Mochizuki T, Nasu Y, Yano K, Ikari K, Hiroshima R, Okazaki K. Foot and ankle functions and deformities focus on posterior tibial tendon dysfunction using magnetic resonance imaging in patients with rheumatoid arthritis. Mod Rheumatol 2021; 32:885-890. [PMID: 34918140 DOI: 10.1093/mr/roab084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/09/2021] [Accepted: 09/16/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Posterior tibial tendon dysfunction (PTTD) affects the support of the medial longitudinal arch and stability of the hindfoot. The purpose of this study was to assess the relationships of PTTD with foot and ankle functions and foot deformities in patients with rheumatoid arthritis (RA). METHODS A total of 129 patients (258 feet) who underwent magnetic plain and contrast-enhanced magnetic resonance imaging were enrolled in this study. Positive magnetic resonance imaging findings were defined as tenosynovitis and incomplete and complete rupture of the posterior tibial tendon. Foot and ankle functions were assessed using the Japanese Society for Surgery of the Foot standard rating system for the RA foot and ankle scale (JSSF-RA) and self-administered foot evaluation questionnaire. Plain radiographs were examined for the hallux valgus angle, first metatarsal and second metatarsal angle, lateral talo-first metatarsal angle, and calcaneal pitch angle. RESULTS PTTD was associated with motion in the JSSF-RA (p = .024), activities of daily living in JSSF-RA (p = .017), and pain and pain-related factors in the self-administered foot evaluation questionnaire (p = .001). The calcaneal pitch angle was significantly lower in the feet with PTTD than in those without PTTD (median: 16.2° vs. 18.0°; p = .007). CONCLUSIONS The present study shows that PTTD was associated with foot and ankle functions and flatfoot deformity. Thus, a better understanding of PTTD in patients with RA is important for the management of foot and ankle disorders in clinical practice.
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Affiliation(s)
- Takeshi Mochizuki
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Yuki Nasu
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Koichiro Yano
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsunori Ikari
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.,Division of Multidisciplinary Management of Rheumatic Diseases, Tokyo Women's Medical University, Tokyo, Japan
| | - Ryo Hiroshima
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Ken Okazaki
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
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Yamaji J, Hiroshima R, Mori Y. NEW INSIGHTS INTO CELLULAR OR MUSCLE FUNCTION. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.332] [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: 11/16/2022]
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Mochizuki T, Yano K, Ikari K, Hiroshima R, Fukagawa S, Nasu Y, Okazaki K. Association between low back pain and quality of life in patients with rheumatoid arthritis according to patient-reported outcomes using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ): A cross-sectional study. Mod Rheumatol 2020; 31:992-996. [PMID: 33084458 DOI: 10.1080/14397595.2020.1840047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/07/2023]
Abstract
OBJECTIVES To evaluate factors associated with low back pain (LBP) and effect on quality of life (QOL) using patient-reported outcome in patients with rheumatoid arthritis (RA). METHODS Overall, 414 patients with RA who answered the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were included in this study. LBP-positive was defined a visual analog scale (VAS) of LBP (LBP VAS) of ≥ 30 mm. RESULTS The rate of LBP-positive group was 24.9%. Body mass index (BMI) (odds ratio [OR]: 1.116), tender joint count (TJC) (OR: 1.598), global VAS (OR: 1.016), and Health Assessment Questionnaire Disability Index (HAQ-DI) (OR: 2.392) were found as significant LBP-associated factors. When adjusted for sex and van der Heijde-modified total Sharp score, BMI (OR: 1.120), TJC (OR: 1.619), global VAS (OR: 1.016), pain VAS (OR: 1.015), and HAQ-DI (OR: 2.312) were found to be the significant factors associated with LBP. Moreover, LBP VAS had relatively high correlations in all domains of the JOABPEQ scores (correlation coefficient: LBP, -0.601; lumbar function, -0.624; walking ability, -0.548; social life function, -0.479; and mental health, -0.463). CONCLUSIONS This study investigated the effect of LBP in patients with RA. The results of this study indicate that LBP is associated with the physical function and QOL in patients with RA. We believe that our results will be useful for physical function and QOL assessments in patients with RA with LBP.
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Affiliation(s)
- Takeshi Mochizuki
- Department of Orthopedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Koichiro Yano
- Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsunori Ikari
- Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Ryo Hiroshima
- Department of Orthopedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Shingo Fukagawa
- Department of Orthopedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Yuki Nasu
- Department of Orthopedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Ken Okazaki
- Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
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Mochizuki T, Yano K, Ikari K, Hiroshima R, Nasu Y, Okazaki K. Three-year results of denosumab treatment for osteoporosis in women with rheumatoid arthritis and primary osteoporosis: A clinical observational study. Mod Rheumatol 2020; 31:600-606. [PMID: 32815449 DOI: 10.1080/14397595.2020.1812793] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION This study investigated the results of 3 years of denosumab treatment for osteoporosis in women with rheumatoid arthritis (RA) and primary osteoporosis (PO). MATERIALS AND METHODS This study enrolled 112 women with RA (RA group) and 104 women with a PO group who received 60 mg denosumab for 3 years. Bone mineral densitiy (BMD) of the lumbar spine, total hip and femoral neck as well as levels of bone turnover markers [N-terminal propeptide of type I procollagen (P1NP) and tartrate-resistant acid phosphatase-5b (TRACP-5b)] were measured at years 1, 2, and 3. RESULTS The percent changes (Δ) in BMD values at years 1, 2, and 3 were as follows: RA group: 6.7 ± 6.2%, 8.9 ± 6.5%, and 9.8 ± 8.2% and PO group: 6.0 ± 4.8%, 8.9 ± 7.5%, and 12.6 ± 8.7% for the lumbar spine; RA group: 4.5 ± 4.6%, 5.2 ± 5.1%, and 6.8 ± 5.9% and PO group: 3.8 ± 4.5%, 4.6 ± 7.4%, and 6.8 ± 4.6% for the total hip; and RA group: 2.7 ± 5.1%, 4.1 ± 6.8%, and 4.3 ± 6.7% and PO group: 3.6 ± 8.0%, 4.5 ± 10.9%, and 5.7 ± 10.5% for the femoral neck, respectively. The ΔBMD for the lumbar spine, total hip, and femoral neck as well as ΔP1NP and ΔTRACP-5b did not differ significantly between the two groups at any time points. CONCLUSION Denosumab treatment for osteoporosis had a similar efficacy over 3 years among women with RA and PO. A better understanding of denosumab treatment for this patient population is important in clinical practice.
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Affiliation(s)
- Takeshi Mochizuki
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Koichiro Yano
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsunori Ikari
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Ryo Hiroshima
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Yuki Nasu
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Ken Okazaki
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
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Mochizuki T, Yano K, Ikari K, Hiroshima R, Ishibashi M, Okazaki K. Change of ARASHI scores for large joints in rheumatoid arthritis patients treated with abatacept for three years: A clinical observational study. Arch Rheumatol 2020; 36:10-18. [PMID: 34046564 PMCID: PMC8140878 DOI: 10.46497/archrheumatol.2021.7727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 02/03/2020] [Indexed: 11/18/2022] Open
Abstract
Objectives
This study aims to investigate large joint damage progression using the assessment of rheumatoid arthritis by scoring of large joint destruction and healing in radiographic imaging (ARASHI) score in patients with rheumatoid arthritis (RA) treated with abatacept for three years. Patients and methods
A total of 71 consecutive patients with RA (7 males, 64 females; median age 68 years; range, 41 to 81 years) and joint lesions (141 shoulders, 139 elbows, 141 hips, 134 knees, and 142 ankles) treated with abatacept for three years were examined. Radiographic changes were assessed using the ARASHI score, and factors associated with radiographic progressive damage of large joints were analyzed using multivariate logistic regression. Results
The three-year radiographic progressive damage rates for the upper and lower limb large joints were 18.3% and 22.5%, respectively. Rates for the shoulder and knee decreased significantly (p=0.025 and 0.039, respectively), whereas rate for the ankle increased significantly (p=0.043). Multivariate logistic regression analysis identified the baseline ARASHI status score as an independent predictor of progressive damage of upper limb large joints within three years (p=0.004; odds ratio, 1.17). The cutoff value of the ARASHI status score for the upper limb large joints was 4, as determined from the receiver operating characteristics curve. No significant predictors of progressive damage were identified in the lower limb large joints within three years. Conclusion The greatest suppression of the radiographic progressive damage of large joints was achieved for the shoulders and knees. Meanwhile, ankle damage progressed. Therefore, ankle joint damage should be monitored even in patients treated with abatacept. In the upper limbs, prescribing abatacept to patients with RA depending on their state of upper limb large joint damage may suppress damage progression.
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Affiliation(s)
- Takeshi Mochizuki
- Department of Orthopedic Surgery, Kamagaya General Hospital, Kamagaya, Japan
| | - Koichiro Yano
- Department of Orthopedic Surgery, Tokyo Women's Medical University, Shinjyuku, Japan
| | - Katsunori Ikari
- Department of Orthopedic Surgery, Tokyo Women's Medical University, Shinjyuku, Japan
| | - Ryo Hiroshima
- Department of Orthopedic Surgery, Kamagaya General Hospital, Kamagaya, Japan
| | - Mina Ishibashi
- Department of Orthopedic Surgery, Kamagaya General Hospital, Kamagaya, Japan
| | - Ken Okazaki
- Department of Orthopedic Surgery, Tokyo Women's Medical University, Shinjyuku, Japan
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Mochizuki T, Yano K, Shirahata T, Ikari K, Hiroshima R, Nasu Y, Okazaki K. Spinal sagittal balance associated with age, vertebral fracture, and functional disability in patients with rheumatoid arthritis: A cross-sectional study. Mod Rheumatol 2019; 30:1002-1008. [DOI: 10.1080/14397595.2019.1702247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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)
- Takeshi Mochizuki
- Department of Orthopedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Koichiro Yano
- Department of Orthopedic Surgery, Tokyo Women’s Medical University, Tokyo, Japan
| | - Toshiyuki Shirahata
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Katsunori Ikari
- Department of Orthopedic Surgery, Tokyo Women’s Medical University, Tokyo, Japan
| | - Ryo Hiroshima
- Department of Orthopedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Yuki Nasu
- Department of Orthopedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Ken Okazaki
- Department of Orthopedic Surgery, Tokyo Women’s Medical University, Tokyo, Japan
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Mochizuki T, Yano K, Ikari K, Hiroshima R, Okazaki K. Effect on patellar kinematics of the different patellar component designs in total knee arthroplasty: intraoperative measurement of dome type versus anatomic type. Eur J Orthop Surg Traumatol 2019; 30:419-424. [DOI: 10.1007/s00590-019-02586-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
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Mochizuki T, Yano K, Ikari K, Hiroshima R, Ishibashi M, Okazaki K. Relationship of callosities of the forefoot with foot deformity, Health Assessment Questionnaire Disability Index, and joint damage score in patients with rheumatoid arthritis. Mod Rheumatol 2019; 30:287-292. [DOI: 10.1080/14397595.2019.1589921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Takeshi Mochizuki
- Department of Orthopedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Koichiro Yano
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
- Department of Orthopedic Surgery, Tokyo Women’s Medical University, Tokyo, Japan
| | - Katsunori Ikari
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
- Department of Orthopedic Surgery, Tokyo Women’s Medical University, Tokyo, Japan
| | - Ryo Hiroshima
- Department of Orthopedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Mina Ishibashi
- Department of Orthopedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Ken Okazaki
- Department of Orthopedic Surgery, Tokyo Women’s Medical University, Tokyo, Japan
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Mochizuki T, Ikari K, Yano K, Hiroshima R, Ishibashi M, Okazaki K. Outcome of Direct Oral Anticoagulant Treatment for Acute Lower Limb Deep Venous Thrombosis After Total Knee Arthroplasty Or Total Hip Arthroplasty. Mod Rheumatol 2018; 29:682-686. [PMID: 30041559 DOI: 10.1080/14397595.2018.1504396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/28/2022]
Abstract
Objective: The aim of this study was to examine the treatment outcomes of edoxaban and apixaban on deep venous thrombosis (DVT) in Japanese patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA). Methods: We examined 100 patients receiving edoxaban or apixaban to treat lower limb DVT. The primary efficacy outcome was defined as the disappearance of DVT at three months post-treatment. The primary safety outcome was the change in hemoglobin (Hb) value after two and seven days of treatment compared with baseline, which was the start of treatment with edoxaban or apixaban. Results: The primary efficacy outcome occurred in 61 of the 70 patients (87.1%) in the edoxaban group and in 28 of the 30 patients (93.3%) in the apixaban group. There was no significant difference between the edoxaban and apixaban groups in the disappearance of DVT at three months (p = .497). The change in Hb value from baseline to two days post-treatment was -0.53 ± 0.98 in the edoxaban group and -0.06 ± 0.75 in the apixaban group (p = .010). At seven days post-treatment, the changes in Hb were -0.03 ± 1.60 and 0.30 ± 0.68 (p = .007) in the edoxaban and apixaban groups, respectively. Conclusion: Edoxaban and apixaban were equivalent in efficacy. However, apixaban was superior to edoxaban in terms of the change in Hb value. In cases of major bleeding, both edoxaban and apixaban need to be used carefully when treating DVT.
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Affiliation(s)
- Takeshi Mochizuki
- a Department of Orthopedic Surgery , Kamagaya General Hospital , Kamagaya , Japan
| | - Katsunori Ikari
- b Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku , Japan
| | - Koichiro Yano
- b Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku , Japan
| | - Ryo Hiroshima
- a Department of Orthopedic Surgery , Kamagaya General Hospital , Kamagaya , Japan
| | - Mina Ishibashi
- a Department of Orthopedic Surgery , Kamagaya General Hospital , Kamagaya , Japan
| | - Ken Okazaki
- c Department of Orthopaedic Surgery , Tokyo Women's Medical University , Kamagaya , Japan
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Mochizuki T, Yano K, Ikari K, Kawakami K, Hiroshima R, Koenuma N, Ishibashi M, Momohara S. Effects of denosumab treatment on bone mineral density and joint destruction in patients with rheumatoid arthritis. J Bone Miner Metab 2018; 36:431-438. [PMID: 28681148 DOI: 10.1007/s00774-017-0848-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 05/15/2017] [Indexed: 01/01/2023]
Abstract
We aimed to investigate the efficacy of denosumab for rheumatoid arthritis (RA). This study enrolled 70 RA patients who received denosumab 60 mg subcutaneous injection at baseline and at 6 months. Bone mineral densities (BMD) of the lumbar spine, total hip, femoral neck, and hand were measured by dual energy X-ray absorptiometry. Changes in total modified Sharp score (mTSS), erosion (EN) score, and joint space narrowing score at baseline from 12 months before and at 12 months from baseline. The mean values of BMD of the lumbar spine, total hip, femoral neck, and hand significantly increased by 7.3, 4.7, 3.9, and 5.4%, respectively, at 12 months. At 12 months from baseline, there were significant decreases in the values of mTSS (1.13 vs. 0.59; p = 0.002) and EN score (0.40 vs. 0.07; p < 0.001), compared with the values at baseline from 12 months before. The existing combined modality therapy with denosumab might be effective for osteoporosis and joint destruction in patients with RA.
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Affiliation(s)
- Takeshi Mochizuki
- Department of Orthopaedic Surgery, Kamagaya General Hospital, 929-6 Hatsutomi, Kamagaya, Chiba, 273-0121, Japan.
| | - Koichiro Yano
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsunori Ikari
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kosei Kawakami
- Department of Orthopaedic Surgery, Kamagaya General Hospital, 929-6 Hatsutomi, Kamagaya, Chiba, 273-0121, Japan
| | - Ryo Hiroshima
- Department of Orthopaedic Surgery, Kamagaya General Hospital, 929-6 Hatsutomi, Kamagaya, Chiba, 273-0121, Japan
| | - Naoko Koenuma
- Department of Orthopaedic Surgery, Kamagaya General Hospital, 929-6 Hatsutomi, Kamagaya, Chiba, 273-0121, Japan
| | - Mina Ishibashi
- Department of Orthopaedic Surgery, Kamagaya General Hospital, 929-6 Hatsutomi, Kamagaya, Chiba, 273-0121, Japan
| | - Shigeki Momohara
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
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Mochizuki T, Yano K, Ikari K, Kawakami K, Hiroshima R, Momohara S. Relationship between achievement of physical activity goal and characteristics of patients with rheumatoid arthritis. Mod Rheumatol 2017; 28:606-610. [DOI: 10.1080/14397595.2017.1371104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Takeshi Mochizuki
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Koichiro Yano
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - Katsunori Ikari
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - Kosei Kawakami
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Ryo Hiroshima
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Shigeki Momohara
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
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Mochizuki T, Yano K, Ikari K, Hiroshima R, Kawakami K, Koenuma N, Ishibashi M, Momohara S. The efficacy of abatacept focusing on anti-CCP antibody in Japanese patients with rheumatoid arthritis for 104 weeks. Mod Rheumatol 2017; 28:575-577. [PMID: 28837415 DOI: 10.1080/14397595.2017.1365805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Takeshi Mochizuki
- a Department of Orthopaedic Surgery , Kamagaya General Hospital , Japan
| | - Koichiro Yano
- b Institute of Rheumatology , Tokyo Women's Medical University , Tokyo , Japan
| | - Katsunori Ikari
- b Institute of Rheumatology , Tokyo Women's Medical University , Tokyo , Japan
| | - Ryo Hiroshima
- a Department of Orthopaedic Surgery , Kamagaya General Hospital , Japan
| | - Kosei Kawakami
- a Department of Orthopaedic Surgery , Kamagaya General Hospital , Japan
| | - Naoko Koenuma
- a Department of Orthopaedic Surgery , Kamagaya General Hospital , Japan
| | - Mina Ishibashi
- a Department of Orthopaedic Surgery , Kamagaya General Hospital , Japan
| | - Shigeki Momohara
- c Department of Orthopaedic Surgery , Keio University , Tokyo , Japan
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Mochizuki T, Yano K, Ikari K, Kawakami K, Hiroshima R, Koenuma N, Ishibashi M, Shirahata T. Hip structure analysis by DXA of teriparatide treatment: A 24-month follow-up clinical study. J Orthop 2016; 13:414-8. [PMID: 27656075 DOI: 10.1016/j.jor.2016.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/02/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE The objective of this study was to perform a hip structure analysis (HSA) of teriparatide (TPTD) treatment in women with postmenopausal osteoporosis. METHODS The study included 96 patients with postmenopausal osteoporosis and received 20 μg TPTD daily. HSA was performed by dual-energy X-ray absorptiometry. RESULTS The percent changes from baseline for the cross-sectional moment of inertia, section modulus, buckling ratio, and femoral strength index based on HSA results were 9.8% (p < 0.01), 10.7%, 3.3%, and 14.9% (p < 0.01), respectively, at 24 months. CONCLUSION Based on the HSA results obtained with DXA, TPTD was effective for hip structures.
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Affiliation(s)
- Takeshi Mochizuki
- Department of Rheumatology and Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Koichiro Yano
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsunori Ikari
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kosei Kawakami
- Department of Rheumatology and Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Ryo Hiroshima
- Department of Rheumatology and Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Naoko Koenuma
- Department of Rheumatology and Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Mina Ishibashi
- Department of Rheumatology and Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
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Mochizuki T, Yano K, Ikari K, Hiroshima R, Takaoka H, Kawakami K, Koenuma N, Ishibashi M, Shirahata T, Momohara S. Tramadol hydrochloride/acetaminophen combination versus non-steroidal anti-inflammatory drug for the treatment of perioperative pain after total knee arthroplasty: A prospective, randomized, open-label clinical trial. J Orthop Sci 2016; 21:625-9. [PMID: 27531573 DOI: 10.1016/j.jos.2016.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 11/11/2015] [Accepted: 06/09/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND While many of the commonly used treatments for perioperative pain after total knee arthroplasty (TKA) have been recognized as effective, there is still insufficient evidence for oral medication. In orthopedics, non-steroidal anti-inflammatory drugs (NSAIDs) have been commonly used for perioperative pain; however, serious adverse events have been reported. Conversely, tramadol hydrochloride/acetaminophen combination (TRAM/APAP) therapy has been shown to reduce pain, particularly for chronic pain in Japan. This study aimed to determine TRAM/APAP efficacy in comparison with NSAIDs for perioperative pain after TKA. METHODS Two hundred eighty patients were enrolled in this study; 137 patients were treated with TRAM/APAP, and 143 patients were treated with NSAID from postoperative (PO) day 2. The primary endpoint was a comparison between the pain visual analog scale (VAS) change from baseline (PO day 2) and PO day 4, day 7, day 10, and day 14. The second endpoint was the number of days until the patient achieved independence from cane walking. RESULTS Analysis of endpoints included 130 and 139 patients in the TRAM/APAP and NSAID groups, respectively. The pain VAS change in the TRAM/APAP group on any of the measurement days was significantly improved compared with the NSAID group (P < 0.01). Similarly, the TRAM/APAP group achieved cane-walking independence significantly faster than the NSAID group (P < 0.01). CONCLUSION Efficacy for perioperative pain management after TKA of TRAM/APAP was shown to be superior to that of NSAID; TRAM/APAP was also effective in improving the progress of rehabilitation.
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Affiliation(s)
- Takeshi Mochizuki
- Department of Orthopaedic Surgery, Kamagaya General Hospital, 929-6 Hatsutomi, Kamagaya, Chiba, 273-0121, Japan.
| | - Koichiro Yano
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsunori Ikari
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Ryo Hiroshima
- Department of Orthopaedic Surgery, Kamagaya General Hospital, 929-6 Hatsutomi, Kamagaya, Chiba, 273-0121, Japan
| | - Hiromitsu Takaoka
- Department of Orthopaedic Surgery, Kamagaya General Hospital, 929-6 Hatsutomi, Kamagaya, Chiba, 273-0121, Japan
| | - Kosei Kawakami
- Department of Orthopaedic Surgery, Kamagaya General Hospital, 929-6 Hatsutomi, Kamagaya, Chiba, 273-0121, Japan
| | - Naoko Koenuma
- Department of Orthopaedic Surgery, Kamagaya General Hospital, 929-6 Hatsutomi, Kamagaya, Chiba, 273-0121, Japan
| | - Mina Ishibashi
- Department of Orthopaedic Surgery, Kamagaya General Hospital, 929-6 Hatsutomi, Kamagaya, Chiba, 273-0121, Japan
| | | | - Shigeki Momohara
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
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Mochizuki T, Yano K, Ikari K, Hiroshima R, Takaoka H, Kawakami K, Koenuma N, Shirahata T, Momohara S. The efficacy of abatacept in Japanese patients with rheumatoid arthritis: 104 weeks radiographic and clinical results in clinical practice. Mod Rheumatol 2015; 26:499-506. [DOI: 10.3109/14397595.2015.1109578] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Takeshi Mochizuki
- Department of Orthopedic Surgery, Kamagaya General Hospital, Kamagaya, Japan,
| | - Koichiro Yano
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan, and
| | - Katsunori Ikari
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan, and
| | - Ryo Hiroshima
- Department of Orthopedic Surgery, Kamagaya General Hospital, Kamagaya, Japan,
| | - Hiromitsu Takaoka
- Department of Orthopedic Surgery, Kamagaya General Hospital, Kamagaya, Japan,
| | - Kosei Kawakami
- Department of Orthopedic Surgery, Kamagaya General Hospital, Kamagaya, Japan,
| | - Naoko Koenuma
- Department of Orthopedic Surgery, Kamagaya General Hospital, Kamagaya, Japan,
| | | | - Shigeki Momohara
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan, and
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Mochizuki T, Ikari K, Hiroshima R, Takaoka H, Kawakami K, Koenuma N, Ishibashi M, Momohara S. Negative pressure wound therapy and skin grafting for necrotizing fasciitis in a patient with rheumatoid arthritis treated with abatacept: A case report. Mod Rheumatol 2015; 28:358-360. [PMID: 26457807 DOI: 10.3109/14397595.2015.1106645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Herein, we present a case of necrotizing fasciitis (NF) in a patient with rheumatoid arthritis (RA) treated with abatacept. Cultures of the patient's leg effusion revealed group A Streptococcus. Treatment included antibiological drugs, repeat debridement, negative pressure wound therapy (NPWT), and skin grafting. This case highlights the need for suspicion of severe bacterial infection for early diagnosis and effective treatment. NF with RA can be treated effectively with repeat debridement and NPWT.
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Affiliation(s)
- Takeshi Mochizuki
- a Department of Orthopedic Surgery , Kamagaya General Hospital , Chiba , Japan and
| | - Katsunori Ikari
- b Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan
| | - Ryo Hiroshima
- a Department of Orthopedic Surgery , Kamagaya General Hospital , Chiba , Japan and
| | - Hiromitsu Takaoka
- a Department of Orthopedic Surgery , Kamagaya General Hospital , Chiba , Japan and
| | - Kosei Kawakami
- a Department of Orthopedic Surgery , Kamagaya General Hospital , Chiba , Japan and
| | - Naoko Koenuma
- a Department of Orthopedic Surgery , Kamagaya General Hospital , Chiba , Japan and
| | - Mina Ishibashi
- a Department of Orthopedic Surgery , Kamagaya General Hospital , Chiba , Japan and
| | - Shigeki Momohara
- b Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan
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Mochizuki T, Yano K, Ikari K, Hiroshima R, Takaoka H, Kawakami K, Koenuma N, Ishibashi M, Shirahata T, Momohara S. Scoliosis-related factors in patients with rheumatoid arthritis: A cross-sectional study. Mod Rheumatol 2015; 26:352-7. [PMID: 26395420 DOI: 10.3109/14397595.2015.1097016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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
OBJECTIVES This study aimed to identify the prevalence of scoliosis and scoliosis-related factors of rheumatoid arthritis (RA). METHODS In this study, 411 patients who underwent coronal total spine and lower limb radiography were enrolled. Patients with a Cobb angle ≥10° were diagnosed with scoliosis. Statistical analysis was performed to compare between patients with and those without scoliosis, and between patients without scoliosis and those with a Cobb angle >20°. RESULTS The prevalence of scoliosis in patients with RA was 30.7%. The mean Cobb angles were 8.5° ± 7.2° in all the patients, 16.1° ± 8.6° in patients with scoliosis, and 5.1° ± 2.3° in patients without scoliosis. According to a multivariate analysis, the scoliosis-related factors of RA were age and vertebral fracture. Significant differences in age, corticosteroid use, and malalignment of lower limbs were observed between patients with a Cobb angle >20° and those without scoliosis. CONCLUSIONS With RA treatment, the need for corticosteroid use is reduced and vertebral fracture is prevented. Moreover, the joints and spinal and lower limb alignments should be examined.
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Affiliation(s)
- Takeshi Mochizuki
- a Department of Orthopaedic Surgery , Kamagaya General Hospital , Chiba , Japan
| | - Koichiro Yano
- b Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan , and
| | - Katsunori Ikari
- b Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan , and
| | - Ryo Hiroshima
- a Department of Orthopaedic Surgery , Kamagaya General Hospital , Chiba , Japan
| | - Hiromitsu Takaoka
- a Department of Orthopaedic Surgery , Kamagaya General Hospital , Chiba , Japan
| | - Kosei Kawakami
- a Department of Orthopaedic Surgery , Kamagaya General Hospital , Chiba , Japan
| | - Naoko Koenuma
- a Department of Orthopaedic Surgery , Kamagaya General Hospital , Chiba , Japan
| | - Mina Ishibashi
- a Department of Orthopaedic Surgery , Kamagaya General Hospital , Chiba , Japan
| | - Toshikatsu Shirahata
- c Department of Orthopaedic Surgery , Chibanishi General Hospital , Chiba , Japan
| | - Shigeki Momohara
- b Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan , and
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Kawakami K, Hiroshima R, Takaoka H, Koenuma N, Mochizuki T. AB0497 Risk Factors Affecting Length of Hospital Stay After Total Knee Arthroplasty in Rheumatoid Arthritis and Osteoarthritis Patients. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1114] [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: 11/04/2022]
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Hiroshima R, Yamaji J, Mori Y. Messenger RNA and protein analysis of MHC and HSP70 in rat soleus muscle recovering from disuse atrophy. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mori Y, Yamaji J, Hiroshima R, Nakano T, Miyazaki A, Watanabe M. G.P.203. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Yamaji J, Mori Y, Hiroshima R, Watanabe M, Miyazaki A. G.P.32. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Momohara S, Kawakami K, Iwamoto T, Yano K, Sakuma Y, Hiroshima R, Imamura H, Masuda I, Tokita A, Ikari K. Prosthetic joint infection after total hip or knee arthroplasty in rheumatoid arthritis patients treated with nonbiologic and biologic disease-modifying antirheumatic drugs. Mod Rheumatol 2014. [DOI: 10.3109/s10165-011-0423-x] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Shigeki Momohara
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Kosei Kawakami
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Takuji Iwamoto
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Koichiro Yano
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Yu Sakuma
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Ryo Hiroshima
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Hitoshi Imamura
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Ikuko Masuda
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Asami Tokita
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Katsunori Ikari
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
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Hiroshima R, Kawakami K, Iwamoto T, Tokita A, Yano K, Sakuma Y, Ikari K, Momohara S. Analysis of C-reactive protein levels and febrile tendency after joint surgery in rheumatoid arthritis patients treated with a perioperative 4-week interruption of tocilizumab. Mod Rheumatol 2014. [DOI: 10.3109/s10165-010-0343-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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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Yano K, Ikari K, Iwamoto T, Saito A, Naito Y, Kawakami K, Suzuki T, Imamura H, Sakuma Y, Hiroshima R, Momohara S. Proximal rotational closing-wedge osteotomy of the first metatarsal in rheumatoid arthritis: clinical and radiographic evaluation of a continuous series of 35 cases. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0776-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [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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27
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Yano K, Ikari K, Inoue E, Tokita A, Sakuma Y, Hiroshima R, Iwamoto T, Kawakami K, Taniguchi A, Yamanaka H, Momohara S. Effect of total knee arthroplasty on disease activity in patients with established rheumatoid arthritis: 3-year follow-up results of combined medical therapy and surgical intervention. Mod Rheumatol 2014. [DOI: 10.3109/s10165-010-0309-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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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Momohara S, Inoue E, Ikari K, Yano K, Tokita A, Suzuki T, Sakuma Y, Hiroshima R, Kawakami K, Masuda I, Iwamoto T, Taniguchi A, Yamanaka H. Efficacy of total joint arthroplasty in patients with established rheumatoid arthritis: improved longitudinal effects on disease activity but not on health-related quality of life. Mod Rheumatol 2014. [DOI: 10.3109/s10165-011-0432-9] [Citation(s) in RCA: 23] [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: 11/13/2022]
Affiliation(s)
- Shigeki Momohara
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Eisuke Inoue
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Katsunori Ikari
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Koichiro Yano
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Asami Tokita
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Taku Suzuki
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Yu Sakuma
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Ryo Hiroshima
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Kosei Kawakami
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Ikuko Masuda
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Takuji Iwamoto
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Atsuo Taniguchi
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
| | - Hisashi Yamanaka
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University,
10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
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Momohara S, Inoue E, Ikari K, Yano K, Tokita A, Honjo Y, Sakuma Y, Hiroshima R, Iwamoto T, Seto Y, Tanaka E, Taniguchi A, Yamanaka H. Comparison of characteristics and therapeutic efficacy in rheumatoid arthritis patients treated by rheumatologists and those treated by orthopedic surgeons under a team medicine approach at the same institute. Mod Rheumatol 2014. [DOI: 10.3109/s10165-011-0495-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Yano K, Ikari K, Iwamoto T, Saito A, Naito Y, Kawakami K, Suzuki T, Imamura H, Sakuma Y, Hiroshima R, Momohara S. Proximal rotational closing-wedge osteotomy of the first metatarsal in rheumatoid arthritis: clinical and radiographic evaluation of a continuous series of 35 cases. Mod Rheumatol 2012; 23:953-8. [PMID: 23070360 DOI: 10.1007/s10165-012-0776-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 09/20/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The introduction of powerful antirheumatic drugs has dramatically improved the treatment of rheumatoid arthritis (RA), leading clinicians to reconsider the benefits of joint preservation for rheumatoid forefoot deformities. We have employed joint-preserving forefoot surgeries, including rotational closing-wedge osteotomy of the first metatarsal. The aim of our study is to assess the short-term results of this procedure. METHODS From January 2011 through December 2011, 35 feet were treated with this procedure. Subjective, functional, and radiographic outcomes were surveyed. RESULTS The mean Japanese Society for Surgery of the Foot improved from a preoperative level of 52.6 to 68.7 postoperatively. The average hallux valgus and intermetatarsal angles improved from 47.3° preoperatively to 17.5° postoperatively, and from 16.7° preoperatively to 9.0° postoperatively, respectively. To assess the repositioning of pronation deformities of the first metatarsal, the position of the medial sesamoid was also surveyed according to the measurement system proposed by Hardy and Clapham. All feet except two were classified as grade V or higher preoperatively; 25 of these were grade IV or lower at the latest follow-up. CONCLUSIONS Rotational closing-wedge osteotomy of the first metatarsal was beneficial for correcting forefoot deformities in RA over the short term.
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Affiliation(s)
- Koichiro Yano
- Department of Orthopedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada, Shinjuku, Tokyo, 162-0054, Japan
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Momohara S, Ikari K, Kawakami K, Iwamoto T, Inoue E, Yano K, Sakuma Y, Hiroshima R, Tokita A, Taniguchi A, Yamanaka H. The increasing disease duration of patients at the time of orthopaedic surgery for rheumatoid arthritis. Rheumatol Int 2011; 32:3323-4. [DOI: 10.1007/s00296-011-2101-x] [Citation(s) in RCA: 3] [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] [Received: 03/24/2011] [Accepted: 08/21/2011] [Indexed: 11/29/2022]
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32
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Momohara S, Inoue E, Ikari K, Yano K, Tokita A, Honjo Y, Sakuma Y, Hiroshima R, Iwamoto T, Seto Y, Tanaka E, Taniguchi A, Yamanaka H. Comparison of characteristics and therapeutic efficacy in rheumatoid arthritis patients treated by rheumatologists and those treated by orthopedic surgeons under a team medicine approach at the same institute. Mod Rheumatol 2011; 22:209-15. [PMID: 21761229 DOI: 10.1007/s10165-011-0495-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 06/14/2011] [Indexed: 10/18/2022]
Abstract
The treatment of rheumatoid arthritis (RA) has improved dramatically with the advent of the latest generation of disease-modifying antirheumatic drugs. Despite these advances, in some patients inflammation is not diminished sufficiently to prevent irreversible musculoskeletal damage, thereby necessitating surgical intervention to reduce pain and improve function. For RA treatment, Japanese orthopedic surgeons also prescribe medication. In this study, we examined whether this Japanese system is effective for RA treatment. We analyzed the clinical condition of RA patients treated by rheumatologists and those treated by orthopedists in a linked registry study using information from a large observational cohort of RA patients followed every half year from 2000 to 2010 (the IORRA cohort). Two groups of patients were compared: patients treated by rheumatologists (rheumatologic group) and patients treated by orthopedists (orthopedic group). The results revealed that patients in the orthopedic group were older, more likely to be female, and had a longer disease duration than patients in the rheumatologic group. The proportion of patients with a history of joint surgery was also much higher in the orthopedic group than in the rheumatologic group. The average scores on the Japanese version of the Health Assessment Questionnaire, and the remission ratio determined using a Boolean-based definition gradually increased from 2000 until 2010, and these findings were consistently better in the rheumatologic group than in the orthopedic group. These data suggest that patients treated primarily by orthopedists are more likely to have long-standing RA compared to patients treated by rheumatologists. Therefore, it is critical for rheumatologists and orthopedists to complement each other medically in the treatment of RA patients.
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Affiliation(s)
- Shigeki Momohara
- Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan.
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Hiroshima R, Kawakami K, Iwamoto T, Tokita A, Yano K, Sakuma Y, Ikari K, Momohara S. Analysis of C-reactive protein levels and febrile tendency after joint surgery in rheumatoid arthritis patients treated with a perioperative 4-week interruption of tocilizumab. Mod Rheumatol 2010; 21:109-11. [PMID: 20824299 DOI: 10.1007/s10165-010-0343-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Accepted: 07/26/2010] [Indexed: 11/27/2022]
Affiliation(s)
- Ryo Hiroshima
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada, Shinjuku, Tokyo, 162-0054, Japan
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Yano K, Ikari K, Inoue E, Tokita A, Sakuma Y, Hiroshima R, Iwamoto T, Kawakami K, Taniguchi A, Yamanaka H, Momohara S. Effect of total knee arthroplasty on disease activity in patients with established rheumatoid arthritis: 3-year follow-up results of combined medical therapy and surgical intervention. Mod Rheumatol 2010; 20:452-7. [PMID: 20490599 DOI: 10.1007/s10165-010-0309-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Accepted: 04/07/2010] [Indexed: 11/28/2022]
Abstract
Though excellent clinical results have been reported for total knee arthroplasty (TKA) in rheumatoid arthritis (RA) patients, the medium-term effect of TKA on RA disease activity remains unknown. This analysis aimed to assess changes in disease activity after TKA in patients with established RA. We analyzed the systemic effects of TKA on RA disease activity 3 years after intervention. Routine clinical and laboratory assessments were recorded at baseline, less than less than 0.5 years after TKA, and 3 years after TKA. Of the registered RA patients, 130 TKA patients were followed for 3 years after surgery. RA disease activity was measured using the Disease Activity Score 28 (DAS28). Patients were divided into three groups by preoperative baseline DAS28: low (DAS28 ≤ 3.2, n = 8), moderate (DAS28 > 3.2 but ≤5.1, n = 68), and high (DAS28 > 5.1, n = 54) disease activity. The postoperative DAS28 (<0.5 years [DAS1] and 3 years [DAS3] after surgery) scores of each patient were compared to their baseline (DAS0) scores using the paired t-test. The mean DAS28 decreased from 4.85 (DAS0) to 4.14 (DAS1; P = 1.07E-12), and this decrease was sustained at 3 years (DAS3 = 3.97; P = 4.73E-15). Subanalysis results revealed a systemic effect of TKA on disease activity in patients with moderate or high disease activity (DAS0 = 4.33; DAS1 = 3.72 [P = 5.94E-06]; DAS3 = 3.81 [P = 7.89E-06]; and DAS0 = 5.79; DAS1 = 4.86 [P = 1.14E-08]; DAS3 = 4.37 [P = 1.03E-11], respectively). While no significant changes in medication were noted, the average dose of prednisolone tended to decrease over time. We conclude that TKA, which is known to result in good clinical outcomes for damaged knees, has a secondary systemic effect on RA disease activity. Combination therapy consisting of medical treatment and surgical intervention is thought to effectively improve the condition of RA patients who have destructive arthritis in the knee joint, with the effect lasting for at least 3 years.
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Affiliation(s)
- Koichiro Yano
- Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan.
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