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Todoroki Y, Satoh M, Kubo S, Kosaka S, Fukuyo S, Nakatsuka K, Saito K, Tanaka S, Nakayamada S, Tanaka Y. Anti-survival motor neuron complex antibodies as a novel biomarker for pulmonary arterial hypertension and interstitial lung disease in mixed connective tissue disease. Rheumatology (Oxford) 2024; 63:1068-1075. [PMID: 37421400 DOI: 10.1093/rheumatology/kead341] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/27/2023] [Accepted: 06/17/2023] [Indexed: 07/10/2023] Open
Abstract
OBJECTIVE The presence of anti-U1 RNP antibodies (Abs) is critical for diagnosing MCTD. The aim of this study is to evaluate the clinical relevance of anti-survival motor neuron (SMN) complex Abs, which often coexist with anti-U1 RNP Abs. METHODS A total of 158 newly diagnosed consecutive cases of SLE, SSc or MCTD with anti-U1 RNP Abs were enrolled in this multicentre observational study between April 2014 and August 2022. Serum anti-SMN complex Abs were screened by immunoprecipitation of 35S-methionine-labelled cell extracts, and associations between anti-SMN complex Abs positivity and clinical characteristics were analysed. RESULTS Anti-SMN complex Abs were detected in 36% of MCTD patients, which was significantly higher than that in SLE (8%) or SSc (12%). Among MCTD patients classified based on the combination of the clinical features of SLE, SSc and idiopathic inflammatory myopathies, anti-SMN complex Abs showed the highest prevalence in a subset with clinical features of all three components. Anti-SMN complex Abs-positive MCTD had a higher prevalence of pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD), which are related to poor prognosis, than negative patients. Moreover, all three cases of death within 1 year of the treatment were positive for anti-SMN complex Abs. CONCLUSIONS Anti-SMN complex Abs is the first biomarker of a typical subset of MCTD which bears organ damages such as PAH and ILD.
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Affiliation(s)
- Yasuyuki Todoroki
- First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Department of Molecular Targeted Therapies, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Minoru Satoh
- Department of Human, Information and Life Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Department of Medicine, Kitakyushu Yahata-Higashi Hospital, Kitakyushu, Japan
| | - Satoshi Kubo
- First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Department of Molecular Targeted Therapies, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Shunpei Kosaka
- Department of Internal Medicine, Kitakyushu General Hospital, Kitakyushu, Japan
| | - Shunsuke Fukuyo
- Department of Rheumatology, Wakamatsu Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Keisuke Nakatsuka
- Department of Internal Medicine, Fukuoka Yutaka Central Hospital, Fukuoka, Japan
| | - Kazuyoshi Saito
- Department of Internal Medicine, Tobata General Hospital, Kitakyushu, Japan
| | - Shin Tanaka
- Department of Human, Information and Life Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Shingo Nakayamada
- First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yoshiya Tanaka
- First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Miyazaki Y, Funada M, Nakayamada S, Sonomoto K, Tanaka H, Hanami K, Fukuyo S, Kubo S, Yamaguchi A, Miyagawa I, Todoroki Y, Ueno M, Tanaka Y. Safety and efficacy of anifrolumab therapy in systemic lupus erythematosus in real-world clinical practice: LOOPS registry. Rheumatology (Oxford) 2023:kead568. [PMID: 37934129 DOI: 10.1093/rheumatology/kead568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/21/2023] [Accepted: 10/06/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES To determine the safety and efficacy of anifrolumab in patients with systemic lupus erythematosus (SLE) classified based on the Lupus Low Disease Activity State (LLDAS) in real-world clinical practice. METHODS This retrospective observational study involved SLE patients who started anifrolumab therapy. The primary end point was the retention rate over 26 weeks after initiating anifrolumab therapy; 45 patients followed up for 12 weeks or longer were analyzed in the following groups to determine the safety and efficacy up to week 12 after treatment initiation: 1) non-LLDAS achievement group and 2) minor flare group. Safety and efficacy were compared between the minor flare group and the standard of care (SoC) group (treated by adding glucocorticoids (GCs) or immunosuppressants) after adjustment with inverse probability of treatment weighting using propensity score (PS-IPTW). RESULTS The retention rate of anifrolumab was 89.7% at week 26.The LLDAS achievement rates at week 12 were 42.9% and 66.7% in the non-LLDAS achievement and minor flare groups, respectively. In both groups, GC doses and SELENA-SLEDAI score significantly decreased. When the anifrolumab group with minor flare was compared with the SoC group or the GC dose increase group, the GC dose and SLEDAI score were significantly lower in the anifrolumab group than in both groups; there was no significant difference in LLDAS achievement. CONCLUSIONS At week 26 after initiating anifrolumab therapy, ∼90% patients remained on therapy. Anifrolumab might lower disease activity without initiating GCs and reduce GC doses, especially in patients who experience minor flares after LLDAS achievement.
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Affiliation(s)
- Yusuke Miyazaki
- Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masashi Funada
- Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shingo Nakayamada
- Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Koshiro Sonomoto
- Department of Adult and Gerontological Nursing, Faculty of Nursing, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroaki Tanaka
- Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kentaro Hanami
- Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shunsuke Fukuyo
- Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Satoshi Kubo
- Department of Internal Medicine (molecular targeted therapy), University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Ayako Yamaguchi
- Department of Laboratory and Transfusion Medicine, Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Ippei Miyagawa
- Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yasuyuki Todoroki
- Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masanobu Ueno
- Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshiya Tanaka
- Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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Sonomoto K, Nakayamada S, Fujino Y, Miyata H, Kubo S, Fujita Y, Inoue Y, Matsunaga S, Iwata S, Hanami K, Todoroki Y, Yoshinari-Korekoda H, Kawabe A, Yamaguchi A, Ueno M, Satoh-Kanda Y, Kanda R, Funada M, Ohkubo N, Kusaka K, Kosaka S, Nagayasu A, Fukuyo S, Nawata M, Miyazaki Y, Tokunaga M, Tanaka K, Okada Y, Tanaka Y. Biological/targeted synthetic DMARDs do not arrest bone loss in patients with rheumatoid arthritis: a multicenter prospective observational study. Rheumatology (Oxford) 2023:kead579. [PMID: 37934120 DOI: 10.1093/rheumatology/kead579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/02/2023] [Accepted: 10/18/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVE To elucidate the differential effects of biological/target synthesized DMARDs (b/tsDMARDs) on bone metabolism in patients with rheumatoid arthritis (RA) in a real-world cohort. METHODS This was a multicentre prospective observational study of RA patients enrolled at the time of 1st b/tsDMARDs administration. Bone mineral density (BMD) and bone turnover markers (BTMs) were measured during the 52-week observation. The study was designed to enrol all eligible RA patients. The end-points were differences in changes in BMD according to b/tsDMARD type, and the correlation between BMD and BTMs. RESULTS A total of 1,164 patients were enrolled in this study. b/tsDMARDs improved RA disease activity from mean CDAI 25.5 at baseline to 4.5 at week 26. Patients not receiving anti-osteoporotic agents (anti-OP) at baseline with no history of fracture experienced a significant decrease in both femoral neck (F: mean 0.666-0.655 g/cm3) and radial (R: 0.518-0.514) BMD at week 26. Despite maintaining low CDAI levels during weeks 26-52 (5.3-4.4), there was a continued decline in BMD (F: 0.653, R: 0.509. Weeks 52). None of b/tsDMARDs type preserved BMD. Conversely, patients receiving anti-OP at baseline maintained stable BMD throughout the study (Weeks 0/26/52. F: 0.551/0.551/0.555, R: 0.415/0.416/0.415). Although BTMs were changed by b/tsDMARDs, the changes were unrelated to those in BMD. CONCLUSION Our study suggested the progression of osteoporosis in RA patients during b/tsDMARDs treatment without anti-OP. BTMs may not reflect BMD change. Regular monitoring of BMD in RA should be considered for early management of osteoporosis.
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Affiliation(s)
- Koshiro Sonomoto
- Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Hiroko Miyata
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- JCHO Fukuoka Yutaka Cenrtal Hospital, Nogata, Japan
| | - Satoshi Kubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yuya Fujita
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Saiseikai Yahata General Hospital, Kitakyushu, Japan
| | - Yoshino Inoue
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Kenai Memorial Hospital, Kitakyushu, Japan
| | - Satsuki Matsunaga
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Kitakyushu General Hospital, Kitakyushu, Japan
| | - Shigeru Iwata
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Yamaguchi-ken Saiseikai Shimonoseki General Hospital, Shimonoseki, Japan
- Department of Rheumatology and Clinical Immunology, Wakayama Medical University, Wakayama, Japan
| | - Kentaro Hanami
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - Yasuyuki Todoroki
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Tochiku Hospital, Kitakyushu, Japan
| | - Hiroko Yoshinari-Korekoda
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Akio Kawabe
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Fukuoka Shin Mizumaki Hospital, Kitakyushu, Japan
| | - Ayako Yamaguchi
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Shin-Kokura Hospital, Kitakyushu, Japan
| | - Masanobu Ueno
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yurie Satoh-Kanda
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Ryuichiro Kanda
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Yamaguchi Rosai Hospital, Sanyo-Onoda, Japan
| | - Masashi Funada
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Ashiya Cenrtal Hospital, Kitakyushu, Japan
| | - Naoaki Ohkubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Yoshino Hospital, Kitakyushu, Japan
| | - Katsuhide Kusaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Ohira Medical Care Hospital, Kitakyushu, Japan
| | - Shumpei Kosaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Tobata General Hospital, Kitakyushu, Japan
| | - Atsushi Nagayasu
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Wakamatsu Hospital of the University of the Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | | | - Yusuke Miyazaki
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Steel Memorial Yawata Hospital, Kitakyushu, Japan
| | | | - Kenichi Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yosuke Okada
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Miyata H, Sonomoto K, Fukuyo S, Nakayamada S, Nakano K, Iwata S, Miyazaki Y, Kawabe A, Aoki T, Tanaka Y. Computed tomography for malignancy screening in patients with rheumatoid arthritis before initiation of disease modifying antirheumatic drug. Rheumatology (Oxford) 2023; 62:3339-3349. [PMID: 36782362 DOI: 10.1093/rheumatology/kead075] [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: 11/11/2022] [Revised: 01/14/2023] [Accepted: 02/01/2023] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVES This study aimed to clarify the usefulness of screening for malignancies using CT before the initiation of biologic and targeted synthetic DMARDs (b/tsDMARDs) in patients with active RA. METHODS We examined 2192 patients with RA who underwent plain CT scans prior to the initiation of b/tsDMARDs. The sensitivity for detecting malignancy was measured and compared with that of regular screening (physical examination and X-ray). We then evaluated the clinical characteristics, prognosis and treatment of patients with RA with concomitant malignancies. Additionally, we determined the incidence rate of malignancy in patients with RA who were initiated on b/tsDMARDs after CT screening. RESULTS Of the 2192 patients, 33 (1.5%) were diagnosed with malignancy after CT screening. Whereas regular screening detected only seven malignancies, CT screening further detected 26 (including 19 at the early stage). On the other hand, 86% of the malignancies detectable by regular screening were at an advanced stage. Patients diagnosed with early-stage malignancies received RA treatments that included b/tsDMARDs after curative resection; 80% of these patients achieved low disease activity after 1 year. This rate was comparable to the patients without malignancy detection after screening (70%). The 5 year incidence of malignancy after the initiation of b/tsDMARDs after CT screening was lower than that of the RA cohort without CT screening (standardized incidence ratio: 0.35). CONCLUSION Screening in patients with RA using CT before the initiation of b/tsDMARDs allows for the early detection and treatment of malignancy, resulting in safer and more stable b/tsDMARD treatments.
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Affiliation(s)
- Hiroko Miyata
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Koshiro Sonomoto
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Department of Rheumatology, Wakamatsu Hospital of the University of the Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Department of Rheumatology, Kawasaki Medical School, Okayama, Japan
| | - Shigeru Iwata
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Department of Rheumatology, Wakayama Medical University, Wakayama, Japan
| | - Yusuke Miyazaki
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Akio Kawabe
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Takatoshi Aoki
- Department of Radiology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Fujii R, Yamamoto R, Inoue Y, Fukuyo S, Yamaguchi T, Yoshimura R. An elderly man with mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) without neuropsychiatric sequelae. Clin Case Rep 2023; 11:e7219. [PMID: 37151945 PMCID: PMC10160422 DOI: 10.1002/ccr3.7219] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is less common in the elderly, and most have some sequelae. However, even in the elderly, MERS may have a good prognosis, and a specific treatment is not always required.
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Affiliation(s)
- Rintaro Fujii
- Department of Palliative Care and Hemato‐oncologyWakamatsu Hospital of the University of Occupational and Environmental HealthFukuokaJapan
- Department of PsychiatryUniversity of Occupational and Environmental HealthFukuokaJapan
| | - Ryo Yamamoto
- Department of NeurologyWakamatsu Hospital of the University of Occupational and Environmental HealthFukuokaJapan
| | - Yoshino Inoue
- Department of Rheumatology and DiabetologyWakamatsu Hospital of the University of Occupational and Environmental HealthFukuokaJapan
| | - Shunsuke Fukuyo
- Department of Rheumatology and DiabetologyWakamatsu Hospital of the University of Occupational and Environmental HealthFukuokaJapan
| | - Takahiro Yamaguchi
- Department of Palliative Care and Hemato‐oncologyWakamatsu Hospital of the University of Occupational and Environmental HealthFukuokaJapan
| | - Reiji Yoshimura
- Department of PsychiatryUniversity of Occupational and Environmental HealthFukuokaJapan
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Ueno M, Miyagawa I, Miyazaki Y, Hanami K, Fukuyo S, Kubo S, Nakayamada S, Tanaka Y. Correction: Efficacy and safety of guselkumab and adalimumab for pustulotic arthro-osteitis and their impact on peripheral blood immunophenotypes. Arthritis Res Ther 2023; 25:24. [PMID: 36788609 PMCID: PMC9926818 DOI: 10.1186/s13075-023-03005-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Affiliation(s)
- Masanobu Ueno
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan
| | - Ippei Miyagawa
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan ,grid.5330.50000 0001 2107 3311Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Erlangen, Germany ,grid.411668.c0000 0000 9935 6525Deutsches Zentrum fur Immuntherapie (DZI), FriedrichAlexander-University Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Erlangen, Germany
| | - Yusuke Miyazaki
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan
| | - Kentaro Hanami
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan
| | - Shunsuke Fukuyo
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan
| | - Satoshi Kubo
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan
| | - Shingo Nakayamada
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Kitakyushu, 807-8555, Japan.
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Kusaka K, Nakano K, Fukuyo S, Miyazaki Y, Matsunaga S, Tanaka Y. A case of mixed connective tissue disease complicated by pulmonary hypertension and ascites after addition of pulmonary vasodilators. Mod Rheumatol Case Rep 2022; 6:203-208. [PMID: 35274731 DOI: 10.1093/mrcr/rxac019] [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: 08/10/2021] [Revised: 02/17/2022] [Accepted: 03/03/2022] [Indexed: 06/14/2023]
Abstract
We present the case of a 54-year-old woman with a long history of pulmonary hypertension associated with mixed connective tissue disease. She was being treated with pulmonary vasodilators, including epoprostenol and bosetan, but her mean pulmonary arterial pressure (mPAP) gradually worsened. Although her mPAP began to improve with adding sildenafil, ascites occurred. Discontinuing newly initiated drugs and starting diuretics improved her ascites. This suggested that an intensification of the treatment with vasodilators might have led to ascites (on a background of a probable arteriovenous shunt formation) in this patient with a long history of pulmonary hypertension.
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Affiliation(s)
- Katsuhide Kusaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yusuke Miyazaki
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Satsuki Matsunaga
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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Ueno M, Miyagawa I, Miyazaki Y, Hanami K, Fukuyo S, Kubo S, Nakayamada S, Tanaka Y. Efficacy and safety of guselkumab and adalimumab for pustulotic arthro-osteitis and their impact on peripheral blood immunophenotypes. Arthritis Res Ther 2022; 24:240. [PMID: 36303202 PMCID: PMC9609190 DOI: 10.1186/s13075-022-02934-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 06/18/2022] [Accepted: 10/20/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES We compared the treatment effectiveness between guselkumab and adalimumab in patients with pustulotic arthro-osteitis (PAO). In addition, we performed peripheral blood immunophenotyping to elucidate the immunological background and analyzed the impact of therapeutic drugs to verify the validity of immunological phenotypes as therapeutic targets. METHODS Patients were treated with guselkumab 100 mg (guselkumab group; n = 12) and adalimumab 40 mg (adalimumab group; n = 13). Arthritis disease activity, skin lesion activity, and patient-reported outcomes (PROs) were evaluated and compared between the two groups. The retention rate and adverse events were evaluated. Comprehensive phenotyping of peripheral immune cells was performed in both groups, and phenotypes were compared before and after treatment. RESULTS At 6 months, both groups showed significant improvement in arthritis disease activity and PROs. In the guselkumab group, skin symptoms significantly improved. The 6-month continuation rates were 91.7% (11/12) and 69.2% (9/13) in the guselkumab and adalimumab groups, respectively. Adverse events occurred in 2/12 and 5/13 patients in the guselkumab (16.7%) and adalimumab (38.5%) groups, respectively. Peripheral blood immunophenotyping showed that the proportion of activated T helper (Th) 1 cells was significantly lower in patients with PAO than in healthy controls and that the proportion of activated Th17 cells was significantly higher in patients with PAO, which significantly decreased after treatment with guselkumab. CONCLUSION Although guselkumab and adalimumab have comparable efficacy for PAO, their impact on immunophenotypes varies.
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Affiliation(s)
- Masanobu Ueno
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan
| | - Ippei Miyagawa
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan ,grid.5330.50000 0001 2107 3311Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany ,grid.411668.c0000 0000 9935 6525Deutsches Zentrum für Immuntherapie (DZI), FriedrichAlexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Yusuke Miyazaki
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan
| | - Kentaro Hanami
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan
| | - Shunsuke Fukuyo
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan
| | - Satoshi Kubo
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan
| | - Shingo Nakayamada
- grid.271052.30000 0004 0374 5913The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Kitakyushu, 807-8555 Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Kitakyushu, 807-8555, Japan.
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Ohkubo N, Iwata S, Nakano K, Miyagawa I, Hanami K, Fukuyo S, Miyazaki Y, Kawabe A, Nakayamada S, Tanaka Y. Efficacy and Safety of High-Dose of Mycophenolate Mofetil Compared With Cyclophosphamide Pulse Therapy as Induction Therapy in Japanese Patients with Proliferative Lupus Nephritis. Mod Rheumatol 2021; 32:1077-1085. [PMID: 34915579 DOI: 10.1093/mr/roab113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/19/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To clarify the effectiveness and safety of induction therapy with mycophenolate mofetil (MMF) in patients with lupus nephritis (LN). METHODS Patients with LN administered MMF (n = 35) or IVCY (n = 25) plus high-dose corticosteroids between July 2015 and June 2020 were included. MMF was increased from 2 g/day to 3 g/day, with no adverse events (AEs). The primary endpoint was the 6-month renal remission rate. Secondary endpoints were retention rate and AEs. RESULTS There were no significant differences in age, sex, disease duration, renal histological type, SLEDAI, and UPCR between the two groups. Twenty-six patients (74%) continued with MMF therapy, whereas twelve (48%) completed six IVCY courses. The retention rate was significantly higher in the MMF than in the IVCY group (p = 0.048). Twenty-four and fourteen patients in MMF and IVCY groups, respectively, achieved renal remission with insignificant differences. Grade 3 or higher AEs were observed in eight and fourteen patients in the MMF and IVCY groups, respectively (p = 0.014). CONCLUSIONS The efficacy of high-dose MMF was comparable to that of IVCY in Japanese patients with proliferative LN, with fewer AEs and a higher retention rate than IVCY, suggesting the high tolerability of MMF.
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Affiliation(s)
- Naoaki Ohkubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Kitakyushu, Japan
| | - Shigeru Iwata
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Kitakyushu, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Kitakyushu, Japan
| | - Ippei Miyagawa
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Kitakyushu, Japan
| | - Kentaro Hanami
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Kitakyushu, Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Kitakyushu, Japan
| | - Yusuke Miyazaki
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Kitakyushu, Japan
| | - Akio Kawabe
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Kitakyushu, Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Kitakyushu, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Kitakyushu, Japan
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Nishida T, Nakano K, Satoh M, Fukuyo S, Akashi K, Tanaka Y. A Japanese Patient with Anti-PM/Scl and Centromere Antibody-Positive Scleroderma-Amyopathic Dermatomyositis Overlap Syndrome Who Developed Renal Crisis. Mod Rheumatol Case Rep 2021; 6:69-74. [PMID: 34506625 DOI: 10.1093/mrcr/rxab025] [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: 06/28/2021] [Revised: 08/09/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022]
Abstract
Anti-PM/Scl antibodies are associated with the overlap syndrome of systemic sclerosis and dermatomyositis/polymyositis (SSc-DM/PM), and are found in 50% of SSc-DM/PM cases in Europe and the United States, whereas they are rare in Japan. We report a case of an 80-year-old Japanese female with SSc-amyopathic dermatomyositis (ADM) overlap syndrome, who developed scleroderma renal crisis (SRC), a complication of SSc. She had positive antinuclear antibodies in a discrete-speckled and nucleolar pattern and anticentromere antibodies and anti-PM/Scl antibodies were confirmed by ELISA and immunoprecipitation, respectively. The incidence rate of SRC in SSc patients varies significantly depending on the specificity of autoantibodies, with the highest incidence of ~50% in anti-RNA polymerase III antibody positive patients, followed by ~10% in anti-PM/Scl and lower incidence of 0.45% in anticentromere antibody-positive cases. Anti-PM/Scl antibodies are uncommon in Japanese patients presumably due to its strong association with certain HLA haplotype that is rare in Japanese. Clinical significance of anti-PM/Scl antibodies in Japanese patients will need to be clarified with accumulation of cases in future studies.
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Affiliation(s)
- Tomoya Nishida
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.,Department of Medicine and Biosystemic Science, Kyushu University Faculty of Medicine, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.,Department of Rheumatology, Kawasaki Medical School, Japan
| | - Minoru Satoh
- Department of Clinical Nursing, University of Occupational and Environmental Health, Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Faculty of Medicine, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
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11
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Miyazaki Y, Nakano K, Nakayamada S, Kubo S, Iwata S, Hanami K, Fukuyo S, Miyagawa I, Yamaguchi A, Kawabe A, Saito K, Tanaka Y. Serum TNFα levels at 24 h after certolizumab pegol predict effectiveness at week 12 in patients with rheumatoid arthritis from TSUBAME study. Arthritis Res Ther 2021; 23:154. [PMID: 34074349 PMCID: PMC8167961 DOI: 10.1186/s13075-021-02547-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 05/24/2021] [Indexed: 12/31/2022] Open
Abstract
Objective To estimate the relationship between serum TNFα, IL-6, and serum CZP levels and the clinical response to CZP in RA patients in the TSUBAME study. Methods One hundred patients with RA who received CZP were enrolled and multiple clinical parameters, serum TNFα, IL-6, and CZP levels, were assessed at 0, 24, and 48 h and 12 weeks after first administration of CZP. Results The CZP therapy significantly improved the DAS28(ESR) at 12 weeks. Serum TNFα and IL-6 levels significantly decreased from baseline at 24 h after the first administration of CZP. Serum TNFα levels at baseline were not related to clinical parameters at baseline and improvement in DAS28(ESR) at week 12 of the CZP therapy. However, serum levels of CZP at 24 h were strongly and negatively correlated with TNFα levels at 24 h, which were negatively correlated with improved rate in DAS28(ESR) at week 12. Only serum levels of TNFα, but not IL-6, at 24 h had a negative correlation with achievement of DAS28(ESR)<2.6 at week 12 by the multivariate analysis (odds ratio 0.01, 95% confidence interval 0.04e−2–0.22, p < 0.01). A receiver operating characteristic analysis was conducted to estimate the achievement of DAS28(ESR)<2.6 at week 12 after the CZP therapy and cut-off value of 0.76 pg/ml for serum levels of TNFα at 24 h was yielded (area under the curve=0.75). DAS28(ESR)<2.6 was achieved at week 12 significantly more patients with lower serum TNF levels (≦0.76 pg/ml) at 24 h than those with higher TNF levels. Conclusions CZP was highly effective in RA patients who had low serum TNFα levels at 24 h after the initial administration of CZP. Therefore, we propose that serum TNFα levels at 24 h could serve as a biomarker predicting effectiveness to CZP at week 12 in patients with RA. Trial registration Clinical trial registration number: UMIN ID:000022831 Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02547-2.
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Affiliation(s)
- Yusuke Miyazaki
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Satoshi Kubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Shigeru Iwata
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Kentaro Hanami
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Ippei Miyagawa
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Ayako Yamaguchi
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Akio Kawabe
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Kazuyoshi Saito
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan.,Tobata General Hospital, Kitakyushu, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan.
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12
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Miyazaki Y, Nakano K, Nakayamada S, Kubo S, Iwata S, Hanami K, Fukuyo S, Miyagawa I, Yamaguchi A, Kawabe A, Kazuyoshi S, Tanaka Y. FRI0102 SERUM TNFΑ LEVELS AT 24 HOURS AFTER FIRST ADMINISTRATION OF CERTOLIZUMAB PEGOL PREDICT EFFECTIVENESS AT WEEK 12 IN PATIENTS WITH RHEUMATOID ARTHRITIS FROM TSUBAME STUDY (UMIN ID:0002381). Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:To increase the remission rate of rheumatoid arthritis (RA), it is necessary to determine the efficacy of the tumor necrosis factor (TNF) inhibitor as early as possible. Moreover, the response to certolizumab pegol (CZP) at 12 weeks has been reported to predict its long-term efficacy.Objectives:As part of a prospective single-center observational study (TSUBAME study), we prospectively enrolled patients to be treated with CZP in our institution to evaluate its effectiveness and safety starting at 24 hours after the first dose in clinical settings, while recording blood CZP concentrations and biomarkers over time to examine their correlation with clinical effects.Methods:One hundred patients with RA and inadequate response to MTX who received CZP were enrolled in the TSUBAME study. The changes in serum TNFα, IL-6, and CZP levels at 24 hours after first administration of CZP were measured, and the correlation between serum biomarkers and clinical response was determined.Results:At 24 hours after CZP initiation, significant improvement was observed in the disease activity (baseline and 24 h: 5.4 ± 1.3, 5.0 ± 1.3, respectively, p < 0.01), which was maintained until week 12. (baseline and 12 w: 5.4 ± 1.3, 3.3 ± 1.4, respectively, p < 0.01). Serum TNFα and IL-6 levels significantly decreased at 24 hours after first administration of CZP compared to baseline. No correlation was found between TNFα and IL-6 levels at baseline and the clinical response. According to univariate analysis, low serum TNFα and IL-6 levels and high CZP levels at 24 hours were associated with DAS28 (ESR) remission at 12 weeks. According to multivariate analysis, low serum TNFα levels at 24 hours were significantly associated with DAS28 (ESR) remission at 12 weeks (OR 0.05, 95%CI 0.01, 0.75, p = 0.03). Based on these findings, an ROC curve was created using remission according to the DAS28 (ESR) at week 12 as a dependent variable and TNFα concentration at 24 hours as an independent variable, resulting in a cut-off value of 0.76 pg/ml. From this result, the TNFα concentration at 24 hours was divided into 2 groups according to this cut-off, and the rates of remission according to the DAS28 (ESR) at week 12 were compared. In the group with TNFα concentration at 24 hours below the cut-off value, the rate of remission according to the DAS28 (ESR) at week 12 was significantly higher than in the group with TNFα concentration at 24 hours above the cut-off value (below the cut-off: above the cut-off = 56.3%: 21.6%, p < 0.001). Between the group that achieved remission according to the DAS28(ESR) and the group that did not achieve remission at week 12, there was almost no difference in the distribution of TNFα concentrations at baseline; however, the distribution of TNFα concentrations at 24 hours was lower in the group that achieved remission.Conclusion:CZP was effective where serum TNFα was strongly neutralized within 24 hours. These results suggest that low serum TNFα levels at 24 hours after first administration of CZP may predict the effectiveness of CZP. To increase the remission rate in RA, it is necessary to determine the effectiveness of the molecular targeted drugs used at an early point, in addition to how rapid the onset of action is. CZP is extremely fast-acting, and its effectiveness can be predicted as early as 24 hours after the first dose, suggesting that it may be possible to determine the effectiveness early.Acknowledgments:The authors thank Ms. M. Hirahara for providing excellent technical assistance.Disclosure of Interests:Yusuke Miyazaki Grant/research support from: Astellas Pharma Inc and UCB S.A., Kazuhisa Nakano: None declared, Shingo Nakayamada Grant/research support from: Mitsubishi-Tanabe, Takeda, Novartis and MSD, Speakers bureau: Bristol-Myers, Sanofi, Abbvie, Eisai, Eli Lilly, Chugai, Asahi-kasei and Pfizer, Satoshi Kubo: None declared, Shigeru Iwata: None declared, Kentaro Hanami: None declared, Shunsuke Fukuyo: None declared, Ippei Miyagawa: None declared, Ayako Yamaguchi: None declared, Akio Kawabe: None declared, SAITO KAZUYOSHI: None declared, Yoshiya Tanaka Grant/research support from: Asahi-kasei, Astellas, Mitsubishi-Tanabe, Chugai, Takeda, Sanofi, Bristol-Myers, UCB, Daiichi-Sankyo, Eisai, Pfizer, and Ono, Consultant of: Abbvie, Astellas, Bristol-Myers Squibb, Eli Lilly, Pfizer, Speakers bureau: Daiichi-Sankyo, Astellas, Chugai, Eli Lilly, Pfizer, AbbVie, YL Biologics, Bristol-Myers, Takeda, Mitsubishi-Tanabe, Novartis, Eisai, Janssen, Sanofi, UCB, and Teijin
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13
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Miyagawa I, Nakano K, Nakayamada S, Iwata S, Hanami K, Fukuyo S, Kubo S, Kawabe A, Miyazaki Y, Inoue Y, Ueno M, Ohkubo N, Fujita Y, Tanaka Y. The additive effects of hydroxychloroquine to maintenance therapy with standard of care in patients with systemic lupus erythematosus. Int J Rheum Dis 2020; 23:549-558. [DOI: 10.1111/1756-185x.13792] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 11/26/2019] [Accepted: 12/28/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Ippei Miyagawa
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
| | - Shigeru Iwata
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
| | - Kentaro Hanami
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
| | - Satoshi Kubo
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
| | - Akio Kawabe
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
| | - Yusuke Miyazaki
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
| | - Yoshino Inoue
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
| | - Masanobu Ueno
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
| | - Naoaki Ohkubo
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
| | - Yuya Fujita
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health JapanKitakyushu Japan
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14
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Yamaguchi A, Hirata S, Kubo S, Fukuyo S, Hanami K, Nakano K, Nakayamada S, Saito K, Tanaka Y. 5-year remission rate after the discontinuation of adalimumab in patients with rheumatoid arthritis: Long-term follow-up results of the HONOR study. Mod Rheumatol 2019; 30:799-806. [PMID: 31814496 DOI: 10.1080/14397595.2019.1702141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 01/15/2023]
Abstract
Objectives: To determine the rate and factors associated with remission (disease activity score (DAS) 28-erythrocyte sedimentation rate (ESR) of <2.6) during a 5-year follow-up after the discontinuation of adalimumab (ADA) in patients with rheumatoid arthritis (RA).Methods: 75 patients who had been treated with ADA + methotrexate (MTX) and maintained DAS28-ESR <2.6 for at least 6 months were enrolled. Among them, 52 patients discontinued ADA, and 46 patients completed a 5-year follow-up.Results: During the 5 years, 11 patients had DAS28-ESR <2.6. In 15 patients with DAS28-ESR <3.2, no significant changes were found in the health assessment questionnaire disability index (HAQ-DI) and modified total Sharp score (mTSS). When comparing patients with DAS28-ESR ≤1.61 versus 1.61 <DAS28-ESR <2.6, 50% and 15% of the two groups demonstrated sustained remission, respectively. Remission was more common in patients with shorter disease duration (≤2 years) than those with longer duration (>2 years). Among 31 patients who experienced flare, ADA was restarted in 24 patients, and 17 patients of these achieved DAS28-ESR <3.2 within 1-year.Conclusion: During the 5-year ADA-free period, remission rate was persistent in 21% of the patients. ADA-free remission was possible especially in patients with deeper remission (DAS28-ESR ≤1.61) and shorter disease duration (≤2 years).
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Affiliation(s)
- Ayako Yamaguchi
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shintaro Hirata
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.,Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
| | - Satoshi Kubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kentaro Hanami
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kazuyoshi Saito
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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15
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Miyagawa I, Nakano K, Iwata S, Nakayamada S, Saito K, Hanami K, Fukuyo S, Kubo S, Kawabe A, Miyazaki Y, Tanaka Y. Comparative study of corticosteroid monotherapy, and TNF inhibitors with or without corticosteroid in patients with refractory entero-Behcet's disease. Arthritis Res Ther 2019; 21:151. [PMID: 31228955 PMCID: PMC6589167 DOI: 10.1186/s13075-019-1933-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 01/25/2019] [Accepted: 06/06/2019] [Indexed: 01/31/2023] Open
Abstract
Background Tumor necrosis factor (TNF) inhibitors (TNF-i) are effective in the treatment of entero-Behcet’s disease (BD). However, there is no objective tool for assessment of disease activity in entero-BD; therefore, it is not easy to evaluate treatment effectiveness in the clinical setting. In addition, because corticosteroid (CS) is considered for standard therapy, the effectiveness of TNF-i without CS has not been well examined. In this retrospective study, the effectiveness of CS without TNF-i and the effectiveness of TNF-i with or without CS therapy were investigated and compared. Methods This study included 71 patients with entero-BD who were followed up for 1 year (CS without TNF-i group: n = 22; TNF-i group: n = 49 [with CS: n = 20, without CS: n = 29]). All patients had active ulcerative lesions. The primary endpoint was the ulcer cure rate evaluated by lower gastrointestinal endoscopy. Secondary endpoints were ulcer improvement rate, disease activity improvement based on the quantitative disease activity index for intestinal Behcet’s disease (DAIBD), and CS-sparing effect. Results Ulcer cure rates were 13.6% in the CS without TNF-i group, 60.0% in the TNF-i with CS group, and 44.8% in the TNF-i without CS group. Ulcer improvement rates were 27.2% in the CS without TNF-i group, 60.0% in the TNF-i with CS group, and 51.7% in the TNF-i without CS group. The multivariate analysis revealed that TNF-i was an independent predictive factor for cure of the ulcerative lesions. The DAIBD and concomitant CS dose were significantly decreased in both the CS without TNF-i group (DAIBD 85.2 → 40.5, CS 32.3 → 18.7 mg/day) and the TNF-i group (DAIBD 64.7 → 21.1. CS 18.7 → 3.88 mg/day). The ulcer cure and improvement rates were significantly higher in the TNF-i group. In addition, the proportion of concomitant CS dose less than 7.5 mg was significantly higher in the TNF-i group (CS without TNF-i group 18.2% vs. TNF-i group 85%, P < 0.01). There were no statistically significant differences between the TNF-i with CS group and the TNF-i without CS group in any of the endpoints. Conclusions This study demonstrated that compared to CS alone, TNF-i improve disease activity and possess a higher ulcer healing effect and CS tapering effect with or without concomitant CS.
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Affiliation(s)
- Ippei Miyagawa
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Shigeru Iwata
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Kazuyoshi Saito
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Kentaro Hanami
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Satoshi Kubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Akio Kawabe
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Yusuke Miyazaki
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan.
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Miyagawa I, Nakano K, Nakayamada S, Iwata S, Hanami K, Fukuyo S, Kubo S, Inoue Y, Ueno M, Tanaka Y. Effectiveness and safety of hydroxychloroquine therapy with or without corticosteroid in patients with systemic lupus erythematosus. Int J Rheum Dis 2018; 22:434-442. [DOI: 10.1111/1756-185x.13387] [Citation(s) in RCA: 14] [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] [Received: 04/03/2018] [Revised: 08/06/2018] [Accepted: 08/11/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Ippei Miyagawa
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health Kitakyush Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health Kitakyush Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health Kitakyush Japan
| | - Shigeru Iwata
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health Kitakyush Japan
| | - Kentaro Hanami
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health Kitakyush Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health Kitakyush Japan
| | - Satoshi Kubo
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health Kitakyush Japan
| | - Yoshino Inoue
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health Kitakyush Japan
| | - Masanobu Ueno
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health Kitakyush Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health Kitakyush Japan
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Abstract
An 81-year-old man was admitted with bilateral pleural effusion. A clinical examination showed lymphocytic pleura effusion and elevated serum IgG4 levels, so that IgG4-related disease was suggested, whereas tuberculous pleurisy was suspected because of high adenosine deaminase (ADA) levels in the pleural effusion. A surgical pleural biopsy revealed that there were large numbers of IgG4-positive cells and IgG4/IgG positive cell ratio exceeded 40% in several sites. Accordingly, we diagnosed IgG4-related pleuritis and treated with the patient with glucocorticoid therapy. The ADA levels in pleural effusion can increase in IgG4-related pleuritis, and it is therefore important to perform a pleural biopsy.
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Affiliation(s)
- Atsushi Nagayasu
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Satoshi Kubo
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Shigeru Iwata
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Ippei Miyagawa
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | | | - Yoshiya Tanaka
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
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Fukuyo S, Nakayamada S, Iwata S, Kubo S, Saito K, Tanaka Y. Abatacept therapy reduces CD28+CXCR5+ follicular helper-like T cells in patients with rheumatoid arthritis. Clin Exp Rheumatol 2017; 35:562-570. [PMID: 28516880] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 11/10/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The characteristics of T cells targeted by abatacept (ABT) in cases of rheumatoid arthritis (RA) are still unknown. The goal of the study was to determine the pathogenicity of T cells and the predictors of therapeutic effects of ABT. METHODS We analysed the peripheral T cell phenotype of 34 RA patients via flow cytometry. The correlation of the phenotypes of CD4+ T cells with clinical disease activity and change in CD4+ T cell subsets at baseline and 24 weeks after ABT treatment were evaluated. RESULTS RA patients showed an increase in the proportion of CD28- cells among CD4+ cells, which was significantly high in patients who had not achieved remission after ABT therapy. The proportions of CD4+CXCR5+ T follicular helper-like (Tfh-like) cells increased in RA patients compared to healthy donors. The proportions of Tfh-like cells among CD4+CD28+ cells were significantly higher than those among CD4+CD28- cells. The proportion of Tfh-like cells was higher in anti-cyclic citrullinated peptide antibody (ACPA)-positive patients. By contrast, the proportions of CD4+CXCR3+ T helper 1-like (Th1-like) cells and effector memory phase T cells among CD4+CD28- cells were significantly higher than those among CD4+CD28+ cells, and the proportion of these cells did not correlate with disease activity. After ABT therapy, the proportion of Tfh-like cells among CD4+CD28+ cells was significantly reduced. CONCLUSIONS These results imply that CD4+ CD28+ Tfh-like cells could possibly be the targets of ABT. Conversely, CD4+ CD28- cells may be a potential predictor of treatment resistance.
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Affiliation(s)
- Shunsuke Fukuyo
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Shigeru Iwata
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Satoshi Kubo
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Kazuyoshi Saito
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
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Tanaka Y, Sonomoto K, Kondo M, Oshita K, Zhang XM, Fukuyo S, Yamaoka K. [Mesenchymal stem cells for the treatment and repair of inflammatory arthritis]. ACTA ACUST UNITED AC 2016; 38:86-92. [PMID: 26016635 DOI: 10.2177/jsci.38.86] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Mesenchymal stem cells (MSCs) possess multipotent capacity and exhibit immunoregulatory properties. In particular, MSCs can be easily isolated from various organs, can differentiate into various types of cells and generate regulatory T cells. Using human MSC derived from bone marrow and adipose tissue, we have clarified the following novel findings in vitro. 1) MSCs differentiated into osteoblasts or osteocytes under osteoblast-conditioned medium including the inflammatory stimuli such as IL-1. 2) The combination of IL-6 and soluble IL-6 receptor induced differentiation of MSCs to chondrocyte, whereas IL-17 inhibited their differentiation. 3) MSCs highly produced osteoprotegerin and inhibited osteoclastogenesis. Furthermore, we developed a local delivery system of MSCs by using nano-fiber scaffold. MSCs seeded on nano-fiber scaffold suppressed arthritis and bone destruction due to inhibition of systemic inflammatory reaction and immune response by suppressing T cell proliferation and reducing anti-type II collagen antibody production in vivo. Thus, our data may serve as a new strategy for MSC-based therapy in inflammatory diseases and an alternative delivery method for the treatment of destruction of bone and joints.
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Affiliation(s)
- Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health
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Kubo S, Nakano K, Nakayamada S, Hirata S, Fukuyo S, Sawamukai N, Saito K, Tanaka Y. Clinical, radiographic and functional efficacy of abatacept in routine care for rheumatoid arthritis patients: Abatacept Leading Trial for RA on Imaging Remission (ALTAIR) study. Clin Exp Rheumatol 2016; 34:834-841. [PMID: 27607196] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 01/25/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To investigate the efficacy and safety of abatacept for treating patients with rheumatoid arthritis (RA) in routine clinical practice and to determine the prognostic factors affecting clinical outcomes. METHODS We performed a retrospective study of 194 RA patients treated with abatacept. Clinical outcomes at 1 year after the treatment were assessed. Joint damage was assessed by the van der Heijde-modified total Sharp score (mTSS). RESULTS Of the 194 patients, abatacept was discontinued in 51 patients, resulting in a retention rate at week 52 of 73.7%. At week 52, 23.7% of patients achieved clinical remission (SDAI ≤3.3). Lower SDAI and higher RF titre at baseline were the prognostic factor for SDAI at 52 weeks. Structural remission (ΔmTSS ≤0.5) was achieved in 73.4% of patients. However, clinical relevant radiographic progression which was defined as an increase in ΔmTSS >3 in a year, occurred in 7.6% of patients. Likewise, rapid radiological progression, which was defined as an increase in ΔmTSS >5 in a year, was observed in 6.4% of patients. 16.5% of patients achieved comprehensive disease remission, which was defined as SDAI ≤3.3, HAQ-DI ≤0.5, ΔmTSS ≤0.5, while 22.4% of patients achieved comprehensive disease control (CDC), which was defined as SDAI ≤11.0, HAQ-DI ≤0.5, ΔmTSS ≤0.5. CONCLUSIONS The present results confirm that abatacept is effective and safe in routine clinical practice. It is possible that abatacept is more effective in seropositive RA patients with significant immunological abnormality.
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Affiliation(s)
- Satoshi Kubo
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Shintaro Hirata
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Norifumi Sawamukai
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Kazuyoshi Saito
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
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Nawata M, Saito K, Fukuyo S, Hirata S, Tanaka Y. Clinically relevant radiographic progression in joint destruction in RA patients with abnormal MMP-3 or high levels of CRP despite 1-year treatment with infliximab. Mod Rheumatol 2016; 26:807-812. [PMID: 26915532 DOI: 10.3109/14397595.2016.1158386] [Citation(s) in RCA: 6] [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: 11/13/2022]
Abstract
OBJECTIVE Identify the independently related factors of joint destruction progression in RA patients despite of infliximab treatment. METHODS The subjects were cases who underwent infliximab treatment for one year or longer in our department (n = 244). Patients in which modified total sharp score (mTSS), joint erosion (JE), and joint space narrowing (JSN) had advanced to the standard value (3.0) or more for one year were defined as mTSS- Clinically-Relevant-Rapid Progression (CRRP) (n = 20), JE-CRRP (n = 20), and JSN-CRRP (n = 23), and the respective related factors at baseline and week 54 were defined by multiple logistic regression. RESULTS The median disease duration was 24 months and median mTSS 9.0 at baseline. The median DAS28, CRP, and yearly progression of mTSS improved from 5.8 to 2.6, 1.2 to 0.1 mg/dL, and 4.4 to 0.0 point/year, respectively. The related factor in each of mTSS-CRRP, JE-CRRP, and JSN-CRRP was high CRP levels at baseline. At week 54, the related factor of mTSS-CRRP and JSN-CRRP was high MMP-3 titer; however, the related factor of JE-CRRP was high CRP levels. CONCLUSION High CRP levels at baseline were an independent predictive factor of joint destruction advancement during infliximab treatment. Moreover, it was believed that abnormal MMP-3 at week 54 was the index for mTSS and JSN advancement, while high CRP levels were the index for JE advancement.
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Affiliation(s)
- Masao Nawata
- a The First Department of Internal Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan
| | - Kazuyoshi Saito
- a The First Department of Internal Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan
| | - Shunsuke Fukuyo
- a The First Department of Internal Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan
| | - Shintaro Hirata
- a The First Department of Internal Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan
| | - Yoshiya Tanaka
- a The First Department of Internal Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan
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Hirata S, Li W, Kubo S, Fukuyo S, Mizuno Y, Hanami K, Sawamukai N, Yamaoka K, Saito K, Defranoux NA, Tanaka Y. Association of the multi-biomarker disease activity score with joint destruction in patients with rheumatoid arthritis receiving tumor necrosis factor-alpha inhibitor treatment in clinical practice. Mod Rheumatol 2016; 26:850-856. [DOI: 10.3109/14397595.2016.1153449] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Shintaro Hirata
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan and
| | - Wanying Li
- Crescendo Bioscience Inc., South San Francisco, CA, USA
| | - Satoshi Kubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan and
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan and
| | - Yasushi Mizuno
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan and
| | - Kentaro Hanami
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan and
| | - Norifumi Sawamukai
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan and
| | - Kunihiro Yamaoka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan and
| | - Kazuyoshi Saito
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan and
| | | | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan and
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Kubo S, Nakayamada S, Nakano K, Hirata S, Fukuyo S, Miyagawa I, Hanami K, Saito K, Tanaka Y. Comparison of the efficacies of abatacept and tocilizumab in patients with rheumatoid arthritis by propensity score matching. Ann Rheum Dis 2015; 75:1321-7. [DOI: 10.1136/annrheumdis-2015-207784] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 07/20/2015] [Indexed: 12/21/2022]
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Kubo S, Nakayamada S, Nakano K, Hirata S, Fukuyo S, Miyagawa I, Hanami K, Saito K, Tanaka Y. SAT0207 Comparison of Efficacies of Abatacept and Tocilizumab in Patients with Rheumatoid Arthritis by a Propensity-Score Matching. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2248] [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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25
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Saito K, Nakano K, Nakayamada S, Hirata S, Kubo S, Fukuyo S, Miyagawa I, Sawamukai N, Hanami K, Tanaka Y. FRI0170 The Comparative Effectiveness of Five Biologics as Second-Line Use for Patients with Rheumatoid Arthritis in Daily Clinical Practice. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2020] [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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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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Iwata S, Nakayamada S, Fukuyo S, Kubo S, Yunoue N, Wang SP, Yoshikawa M, Saito K, Tanaka Y. Activation of Syk in Peripheral Blood B Cells in Patients With Rheumatoid Arthritis: A Potential Target for Abatacept Therapy. Arthritis Rheumatol 2014; 67:63-73. [DOI: 10.1002/art.38895] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 09/23/2014] [Indexed: 01/22/2023]
Affiliation(s)
- Shigeru Iwata
- University of Occupational and Environmental Health Japan; Kitakyushu Japan
| | - Shingo Nakayamada
- University of Occupational and Environmental Health Japan; Kitakyushu Japan
| | - Shunsuke Fukuyo
- University of Occupational and Environmental Health Japan; Kitakyushu Japan
| | - Satoshi Kubo
- University of Occupational and Environmental Health Japan; Kitakyushu Japan
| | - Naoki Yunoue
- University of Occupational and Environmental Health Japan; Kitakyushu Japan
| | - Sheau-Pey Wang
- University of Occupational and Environmental Health Japan; Kitakyushu Japan
| | - Maiko Yoshikawa
- University of Occupational and Environmental Health Japan; Kitakyushu Japan
| | - Kazuyoshi Saito
- University of Occupational and Environmental Health Japan; Kitakyushu Japan
| | - Yoshiya Tanaka
- University of Occupational and Environmental Health Japan; Kitakyushu Japan
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Kubo S, Saito K, Hirata S, Fukuyo S, Yamaoka K, Sawamukai N, Nawata M, Iwata S, Mizuno Y, Tanaka Y. Abatacept inhibits radiographic progression in patients with rheumatoid arthritis: a retrospective analysis of 6 months of abatacept treatment in routine clinical practice. The ALTAIR study. Mod Rheumatol 2014; 24:42-51. [PMID: 24261758 DOI: 10.3109/14397595.2013.854051] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Our objectives in this study were to determine the inhibitory effects of abatacept on joint damage and its clinical efficacy and safety in patients with rheumatoid arthritis (RA). METHODS Fifty Japanese patients with RA were treated with abatacept for 24 weeks in routine clinical practice. RESULTS At week 24, 20 % of patients achieved clinical remission [Simplified Disease Activity Index (SDAI) ≤3.3], whereas 50 % were in remission or had a low disease activity. Structural remission [progression of modified total Sharp score (ΔmTSS) ≤0.5] was achieved in 76 % of patients. The ΔmTSS decreased significantly from 7.1 ± 7.3 at baseline to 1.8 ± 5.7 at week 24. C-reactive protein (CRP) was the only independent prognostic factor for joint damage progression at week 24, whereas SDAI and matrix metalloproteinase-3 levels were not. A very high proportion of patients with CRP levels <1.5 mg/dl (88 %) achieved structural remission. In terms of safety, the retention rate for all patients was favorable (80 %), and stomatitis was the only adverse event observed. No patient withdrew from the study because of infections. CONCLUSIONS Abatacept has favorable clinical and structural effects, inhibits radiographic progression, and has a good safety profile in routine clinical practice.
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Affiliation(s)
- Satoshi Kubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , 1-1 Iseigaoka, Yahatanishi-ku, Fukuoka 807-8555 , Japan
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Tanaka Y, Hirata S, Kubo S, Fukuyo S, Hanami K, Sawamukai N, Nakano K, Nakayamada S, Yamaoka K, Saito K. AB0415 A New Prognostic Factor to Sustain Remission for 2 Years after Adalimumab Discontinuation & the Clinical Outcomes in RA Patients: Honor Study 2-Years Results. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4002] [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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Saito K, Miyagawa I, Yamaoka K, Nakayamada S, Nakano K, Hirata S, Fukuyo S, Kubo S, Hanami K, Sawamukai N, Tanaka Y. FRI0474 The Three-Year Outcome of Infliximab (IFX), an Anti-TNF-α Antibody, in Patients with Refractory Intestinal-BehÇEt's Disease (BD). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2805] [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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31
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Sonomoto K, Yamaoka K, Kubo S, Hirata S, Fukuyo S, Maeshima K, Suzuki K, Saito K, Tanaka Y. Effects of tofacitinib on lymphocytes in rheumatoid arthritis: relation to efficacy and infectious adverse events. Rheumatology (Oxford) 2014; 53:914-918. [DOI: 10.1093/rheumatology/ket466] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Fukuyo S, Yamaoka K, Sonomoto K, Oshita K, Okada Y, Saito K, Yoshida Y, Kanazawa T, Minami Y, Tanaka Y. IL-6-accelerated calcification by induction of ROR2 in human adipose tissue-derived mesenchymal stem cells is STAT3 dependent. Rheumatology (Oxford) 2014; 53:1282-90. [PMID: 24599911 DOI: 10.1093/rheumatology/ket496] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [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: 02/06/2023] Open
Abstract
OBJECTIVE The mechanisms of ectopic calcification in inflammatory diseases are poorly understood. We investigated the effects of inflammatory cytokines on the mechanisms of calcification in human adipose tissue-derived mesenchymal stem cells (hADSCs). METHODS The effects of inflammatory cytokines were evaluated using hADSCs cultured in osteoblast induction medium. mRNA expression was measured by real-time PCR and protein levels were measured by western blotting. Cell mineralization was evaluated by Alizarin Red S staining. RESULTS In hADSCs, administration of IL-6/soluble IL-6 receptor (sIL-6R), TNF or IL-1β accelerated calcification through enhanced expression of an osteoblast differentiation marker, runt-related transcription factor 2 (RUNX2). IL-6/sIL-6R had the greatest effect. The transcription of mRNA for receptor tyrosine kinase-like orphan receptor 2 (ROR2), involved in the non-canonical wingless-type (WNT) MMTV integration site pathway, was increased, while β-catenin expression, an essential factor in the canonical WNT signalling pathway for osteoblast differentiation, did not change. Suppression of signal transducer and activator of transcription 3 (STAT3), but not STAT1, by small interfering RNA (siRNA) exerted a strong inhibitory effect on RUNX2 and ROR2 expression, and inhibited accelerated calcification. CONCLUSION IL-6/sIL-6R stimulation accelerated the ROR2/WNT5A pathway in hADSCs in a STAT3-dependent manner, resulting in augmented calcification. These results suggest that the mechanisms of ectopic calcification accelerated by IL-6 in hADSCs may be involved in chronic inflammatory tissues and that IL-6 inhibitors may be beneficial in the treatment of ectopic calcification in inflammatory diseases.
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Affiliation(s)
- Shunsuke Fukuyo
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Pharmacology Research Laboratories I, Research Division, Mitsubishi Tanabe Pharma Corporation, Yokohama, Kanagawa, Department of Immunology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu and Department of Physiology and Cell Biology, Graduate School of Medicine, School of Medicine, Kobe University, Kobe, Japan
| | - Kunihiro Yamaoka
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Pharmacology Research Laboratories I, Research Division, Mitsubishi Tanabe Pharma Corporation, Yokohama, Kanagawa, Department of Immunology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu and Department of Physiology and Cell Biology, Graduate School of Medicine, School of Medicine, Kobe University, Kobe, Japan
| | - Koshiro Sonomoto
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Pharmacology Research Laboratories I, Research Division, Mitsubishi Tanabe Pharma Corporation, Yokohama, Kanagawa, Department of Immunology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu and Department of Physiology and Cell Biology, Graduate School of Medicine, School of Medicine, Kobe University, Kobe, Japan
| | - Koichi Oshita
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Pharmacology Research Laboratories I, Research Division, Mitsubishi Tanabe Pharma Corporation, Yokohama, Kanagawa, Department of Immunology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu and Department of Physiology and Cell Biology, Graduate School of Medicine, School of Medicine, Kobe University, Kobe, Japan.First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Pharmacology Research Laboratories I, Research Division, Mitsubishi Tanabe Pharma Corporation, Yokohama, Kanagawa, Department of Immunology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu and Department of Physiology and Cell Biology, Graduate School of Medicine, School of Medicine, Kobe University, Kobe, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Pharmacology Research Laboratories I, Research Division, Mitsubishi Tanabe Pharma Corporation, Yokohama, Kanagawa, Department of Immunology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu and Department of Physiology and Cell Biology, Graduate School of Medicine, School of Medicine, Kobe University, Kobe, Japan
| | - Kazuyoshi Saito
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Pharmacology Research Laboratories I, Research Division, Mitsubishi Tanabe Pharma Corporation, Yokohama, Kanagawa, Department of Immunology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu and Department of Physiology and Cell Biology, Graduate School of Medicine, School of Medicine, Kobe University, Kobe, Japan
| | - Yasuhiro Yoshida
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Pharmacology Research Laboratories I, Research Division, Mitsubishi Tanabe Pharma Corporation, Yokohama, Kanagawa, Department of Immunology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu and Department of Physiology and Cell Biology, Graduate School of Medicine, School of Medicine, Kobe University, Kobe, Japan
| | - Tamotsu Kanazawa
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Pharmacology Research Laboratories I, Research Division, Mitsubishi Tanabe Pharma Corporation, Yokohama, Kanagawa, Department of Immunology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu and Department of Physiology and Cell Biology, Graduate School of Medicine, School of Medicine, Kobe University, Kobe, Japan
| | - Yasuhiro Minami
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Pharmacology Research Laboratories I, Research Division, Mitsubishi Tanabe Pharma Corporation, Yokohama, Kanagawa, Department of Immunology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu and Department of Physiology and Cell Biology, Graduate School of Medicine, School of Medicine, Kobe University, Kobe, Japan
| | - Yoshiya Tanaka
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Pharmacology Research Laboratories I, Research Division, Mitsubishi Tanabe Pharma Corporation, Yokohama, Kanagawa, Department of Immunology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu and Department of Physiology and Cell Biology, Graduate School of Medicine, School of Medicine, Kobe University, Kobe, Japan.
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Tanaka Y, Hirata S, Kubo S, Fukuyo S, Hanami K, Sawamukai N, Nakano K, Nakayamada S, Yamaoka K, Sawamura F, Saito K. Discontinuation of adalimumab after achieving remission in patients with established rheumatoid arthritis: 1-year outcome of the HONOR study. Ann Rheum Dis 2013; 74:389-95. [PMID: 24288014 PMCID: PMC4316845 DOI: 10.1136/annrheumdis-2013-204016] [Citation(s) in RCA: 132] [Impact Index Per Article: 12.0] [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] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate the possibility of discontinuing adalimumab (ADA) for 1 year without flaring (DAS28-erythrocyte sedimentation rate (ESR) ≥3.2), and to identify factors enabling established patients with rheumatoid arthritis (RA) to remain ADA-free. METHODS Of 197 RA patients treated with ADA+methotrexate (MTX), 75 patients who met the ADA-free criteria (steroid-free and sustained DAS28-ESR remission for 6 months with stable MTX doses) were studied for 1 year. RESULTS The mean disease duration and DAS28-ESR score in 75 patients was 7.5 years and 5.1 at baseline, respectively. The proportion of patients who sustained DAS28-ESR <2.6 (48%) and DAS28-ESR <3.2 (62%) for 1 year were significantly lower in the ADA discontinuation group than in the ADA continuation group; however, in patients with deep remission (DAS28-ESR ≤1.98) identified by receiver operating characteristics analysis following logistic analysis, these rates increased to 68% and 79%, respectively, with no significant difference between both groups. Remarkably, ADA readministration to patients with flare was effective in returning DAS28-ESR to <3.2 within 6 months in 90% and 9 months in 100% patients; among the patients who sustained DAS28-ESR <3.2 during ADA discontinuation, 100% remained in structural remission and 94% in functional remission. CONCLUSIONS The possibility of remaining ADA-free for 1 year was demonstrated in established patients with RA with outcomes that ADA can be discontinued without flaring in 79% patients with deep remission, with similar rates in the ADA continuation group, and showed no functional or structural damage in patients with DAS28-ESR <3.2. ADA readministration to patients with flare during ADA discontinuation was effective.
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Affiliation(s)
- Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Shintaro Hirata
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Satoshi Kubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kentaro Hanami
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Norifumi Sawamukai
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kunihiro Yamaoka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | | | - Kazuyoshi Saito
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Kondo M, Yamaoka K, Sonomoto K, Fukuyo S, Oshita K, Okada Y, Tanaka Y. IL-17 inhibits chondrogenic differentiation of human mesenchymal stem cells. PLoS One 2013; 8:e79463. [PMID: 24260226 PMCID: PMC3829852 DOI: 10.1371/journal.pone.0079463] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 09/23/2013] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Mesenchymal stem cells (MSCs) can differentiate into cells of mesenchymal lineages, such as osteoblasts and chondrocytes. Here we investigated the effects of IL-17, a key cytokine in chronic inflammation, on chondrogenic differentiation of human MSCs. METHODS Human bone marrow MSCs were pellet cultured in chondrogenic induction medium containing TGF-β3. Chondrogenic differentiation was detected by cartilage matrix accumulation and chondrogenic marker gene expression. RESULTS Over-expression of cartilage matrix and chondrogenic marker genes was noted in chondrogenic cultures, but was inhibited by IL-17 in a dose-dependent manner. Expression and phosphorylation of SOX9, the master transcription factor for chondrogenesis, were induced within 2 days and phosphorylated SOX9 was stably maintained until day 21. IL-17 did not alter total SOX9 expression, but significantly suppressed SOX9 phosphorylation in a dose-dependent manner. At day 7, IL-17 also suppressed the activity of cAMP-dependent protein kinase A (PKA), which is known to phosphorylate SOX9. H89, a selective PKA inhibitor, also suppressed SOX9 phosphorylation, expression of chondrogenic markers and cartilage matrix, and also decreased chondrogenesis. CONCLUSIONS IL-17 inhibited chondrogenesis of human MSCs through the suppression of PKA activity and SOX9 phosphorylation. These results suggest that chondrogenic differentiation of MSCs can be inhibited by a mechanism triggered by IL-17 under chronic inflammation.
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Affiliation(s)
- Masahiro Kondo
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
- Pharmacology Research Laboratories I, Research Division, Mitsubishi Tanabe Pharma Corporation, Aoba-ku, Yokohama, Kanagawa, Japan
| | - Kunihiro Yamaoka
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Koshiro Sonomoto
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Koichi Oshita
- Pharmacology Research Laboratories I, Research Division, Mitsubishi Tanabe Pharma Corporation, Aoba-ku, Yokohama, Kanagawa, Japan
| | - Yosuke Okada
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
- * E-mail:
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Tanaka Y, Takeuchi T, Amano K, Saito K, Hanami K, Nawata M, Fukuyo S, Kameda H, Kaneko Y, Kurasawa T, Nagasawa H, Hoshi D, Sato E, Yamanaka H. Effect of interleukin-6 receptor inhibitor, tocilizumab, in preventing joint destruction in patients with rheumatoid arthritis showing inadequate response to TNF inhibitors. Mod Rheumatol 2013; 24:399-404. [PMID: 24252045 DOI: 10.3109/14397595.2013.843757] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To examine the effectiveness of tocilizumab (TCZ) in preventing joint destruction in patients with inadequate response to tumor necrosis factor inhibitors (TNF-IR) by assessing X-rays. METHODS RA patients were extracted from the Retrospective actemra investigation for optimal needs of RA patients (REACTION) study. Parameters and components of disease activity were evaluated during anti-TNF treatment and during TCZ treatment. X-ray images of hands and feet at the beginning of this study during anti-TNF treatment (Pre), at the start point of TCZ treatment (Baseline) and after TCZ treatment (Post) were collected for assessing joint destruction. RESULTS Forty-five patients from the REACTION study fulfilled the criteria of clinical TNF-IR. During anti-TNF treatment, mean DAS28-ESR rose from 5.35 to 5.87 (mean observation duration, 16 months) but improved significantly to 2.94 (P < 0.0001) at 52 weeks after switching to TCZ. Mean change in van der Heijde-modified Sharp score (TSS) during anti-TNF treatment was 3.17 in this TNF-IR population. After switching to TCZ, mean change in TSS was 1.20 (P < 0.05). Rate of radiographic non-progression improved to 66.7% during TCZ treatment from 40.0% during anti-TNF treatment. The predictive factor for no radiographic progression after switching to TCZ was a HAQ disability index (HAQ-DI) score of ≤ 1.88 at switching to TCZ. CONCLUSION TCZ was a good treatment option for improving signs and symptoms and inhibiting progression of joint damage in patients with clinical and structural TNF-IR.
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Affiliation(s)
- Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan , Kitakyushu , Japan
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Fukuyo S, Saito K, Yamaoka K, Sawamukai N, Hirata S, Nawata M, Iwata S, Tanaka Y. Efficacy and safety of reducing duration of infliximab infusion. Mod Rheumatol 2013; 24:275-80. [PMID: 24251990 DOI: 10.3109/14397595.2013.843747] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the safety and efficacy of reducing the duration of infliximab infusion for rheumatoid arthritis (RA) treatment. METHODS The first 6 infliximab infusions were each administered over a 2-h period. If no adverse reaction was observed, infusion times were shortened to 1 h starting with the seventh infusion with further shortening to 30 min starting with the thirteenth infusion. Subjects were divided into two groups: shortened infusion time group, in which infusion times were shortened as above; and constant infusion time group, in which infusion time was 2 h. Incidence of infusion reactions and improvement in disease activity score for 28 joints (DAS-28) erythrocyte sedimentation rate (ESR) for total infusions were compared for the seventh to twelfth and thirteenth to eighteenth infusions. RESULTS The incidences of infusion reactions after the seventh to twelfth and thirteenth to eighteenth infusions in the shortened infusion time group were 0.53% and 0.58%, respectively. In the constant infusion time group, these were 0.70% and 0.67%, respectively. Furthermore, shortening the infusion duration did not affect the DAS-28 (ESR) improvement rate. CONCLUSIONS We established that this stage-wise shortening of infusion duration, first to 1 h and then to 30 min, did not compromise the safety or efficacy of treatment.
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Affiliation(s)
- Shunsuke Fukuyo
- The First Department of Internal Medicine, University of Occupational and Environmental Health , Japan, Kitakyushu , Japan
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Hirata S, Saito K, Kubo S, Fukuyo S, Mizuno Y, Iwata S, Nawata M, Sawamukai N, Nakano K, Yamaoka K, Tanaka Y. Discontinuation of adalimumab after attaining disease activity score 28-erythrocyte sedimentation rate remission in patients with rheumatoid arthritis (HONOR study): an observational study. Arthritis Res Ther 2013; 15:R135. [PMID: 24286472 PMCID: PMC3978613 DOI: 10.1186/ar4315] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 09/11/2013] [Indexed: 11/10/2022] Open
Abstract
Introduction Evidences of biologics-free disease control after discontinuing adalimumab (ADA) in rheumatoid arthritis (RA) patients in clinical practice have not been sufficiently investigated. Purpose of this study is to investigate whether disease activity score 28 (DAS28)- erythrocyte sedimentation rate (ESR) remission was preserved after discontinuation of ADA in patients with RA. Methods This is an observational but not a randomized controlled study. Among 197 RA patients who initiated with combination of ADA with concomitant MTX, 69 (35%) acquired DAS28 (ESR) < 2.6 for at least 24 weeks. Of those 69 patients, 51 went on ADA discontinuation with their consent, and finally 50 of those with follow-up of > 24 weeks were evaluated. The effect of discontinuing ADA on clinical disease activity, functional disability and radiographic progression were evaluated by DAS28 (ESR), the clinical disease activity index (CDAI) and the simplified disease activity index (SDAI), by a health assessment questionnaire-disability index (HAQ-DI) and by the modified total Sharp score (mTSS), respectively. Results The mean age of the participants was 59.5 years with the mean disease duration of 7.1 years. Out of the 50 patients, 29 (58%) were maintained in DAS28 (ESR) < 2.6 at 24 weeks after discontinuing ADA. A logistic regression analysis showed that DAS28 (ESR) at baseline significantly predicted a DAS28 (ESR) < 2.6 maintained after discontinuation of ADA, and a receiver-operating characteristic (ROC) analysis showed that the cut-off value of DAS28 (ESR) at discontinuation was 2.16. The mean HAQ-DI at six months after discontinuing ADA was 0.1 in patients who kept in DAS28 (ESR) < 2.6, and 94.9% (37/39) showed no evidence of radiographic progression (> 0.5 per year of a change in mTSS) at 1 year. Conclusions It was possible to maintain DAS28 (ESR) < 2.6 after discontinuation of ADA without functional and radiographic progression and very low DAS28 (ESR) at the discontinuation was associated with successful ADA-free DAS28 (ESR) < 2.6 in patients with RA. Trial registration University Hospital Medical Information Network Identifier: UMIN000006669.
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Saito K, Miyagawa I, Iwata S, Nawata M, Fukuyo S, Hirata S, Sawamukai N, Yamaoka K, Tanaka Y. FRI0231 Study on the safety and efficacy of infliximab (IFX), an anti-TNF-α antibody, in patients with refractory intestinal-behÇet’s disease (BD). Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2688] [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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Fukuyo S, Yamaoka K, Sonomoto K, Oshita K, Okada Y, Saito K, Tanaka Y. FRI0055 Ectopic calcification is mediated by inflammatory cytokines enhancing differentiation of adipose-derived stem cells into osteoblasts. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2512] [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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Tanaka Y, Takeuchi T, Amano K, Sato E, Nawata M, Nagasawa H, Hoshi D, Saito K, Fukuyo S, Hanami K, Kameda H, Kurasawa T, Kaneko Y, Yamanaka H. AB0586 104-weeks assessments of clinical and structural remission in rheumatoid arthritis patients with tocilizumab from the reaction study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.586] [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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Hirata S, Li W, Defranoux NA, Bolce R, Haney DJ, Sasso EH, Kubo S, Fukuyo S, Mizuno Y, Yamaoka K, Saito K, Tanaka Y. SAT0012 A Multi-Biomarker Disease Activity (VECTRA™ DA Algorithm) Score is Associated with Radiographic Outcomes in RA Patients Treated with TNF Inhibitors. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1738] [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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Kondo M, Yamaoka K, Sonomoto K, Fukuyo S, Oshita K, Okada Y, Saito K, Tanaka Y. OP0307 Inhibitory Effects of IL-17 on Chondrogenic Differentiation of Human Mesenchymal Stem Cells Through the Phosphorylation of Sox9. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.512] [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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Sonomoto K, Yamaoka K, Oshita K, Fukuyo S, Zhang X, Nakano K, Okada Y, Tanaka Y. Interleukin-1β induces differentiation of human mesenchymal stem cells into osteoblasts via the Wnt-5a/receptor tyrosine kinase-like orphan receptor 2 pathway. ACTA ACUST UNITED AC 2013; 64:3355-63. [PMID: 22674197 DOI: 10.1002/art.34555] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Mesenchymal stem cells (MSCs) are considered to be a novel tool for the treatment of rheumatoid arthritis (RA) because of their multipotency to differentiate into osteoblasts and chondrocytes, their immunosuppressive effects, and availability. The aim of this study was to assess the mechanisms of human MSC differentiation into osteoblasts under inflammatory conditions. METHODS Human MSCs were cultured in commercialized osteogenic induction medium with inflammatory cytokines for up to 10 days. Osteoblast differentiation was detected by alkaline phosphatase staining and messenger RNA (mRNA) expression of multiple osteoblast markers. Mineralization was assessed by alizarin red S staining. RESULTS Among the various cytokines tested, interleukin-1β (IL-1β) induced differentiation of human MSCs into osteoblasts, which was confirmed by alkaline phosphatase activity, expression of RUNX2 mRNA, and strong alizarin red S staining. Among various molecules of the Wnt family, Wnt-5a and receptor tyrosine kinase-like orphan receptor 2 (Ror2), a major receptor of Wnt-5a, were significantly induced in human MSCs by IL-1β. Silencing of either WNT5A or ROR2 by small interfering RNA with 2 different sequences reduced alkaline phosphatase activity, RUNX2 expression, and alizarin red S staining of human MSCs induced by IL-1β. CONCLUSION IL-1β effectively and rapidly induced human MSC differentiation into osteoblasts and mineralization, mainly through the noncanonical Wnt-5a/Ror2 pathway. These results suggest potential benefits of IL-1β-treated human MSCs in the treatment of damaged bone as well as in the induction of self-renewal and self-repair of damaged tissue, including osseous tissue.
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Affiliation(s)
- Koshiro Sonomoto
- University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Takeuchi T, Tanaka Y, Amano K, Hoshi D, Nawata M, Nagasawa H, Sato E, Saito K, Kaneko Y, Fukuyo S, Kurasawa T, Hanami K, Kameda H, Yamanaka H. Clinical, radiographic and functional effectiveness of tocilizumab for rheumatoid arthritis patients--REACTION 52-week study. Rheumatology (Oxford) 2011; 50:1908-15. [PMID: 21752873 PMCID: PMC3176715 DOI: 10.1093/rheumatology/ker221] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [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] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES To evaluate the effectiveness and safety of tocilizumab in RA patients in clinical practice. METHODS We observed 232 consecutive RA patients who began tocilizumab in three rheumatology centres in Japan for 52 weeks. Clinical, radiographic and functional status and safety were evaluated. RESULTS Mean age of the 232 patients was 59.1 years, mean duration of disease was 12.4 years and average DAS using the 28-joint count (DAS-28) was 5.6. Although 62.8% of the patients had been treated previously with anti-TNF biologics, clinical remission at Week 52 was achieved in 43.7%, radiographic non-progression in 62.8% and functional remission in 26.4%. Retention rate at Week 52 was 71.1%, and the same for those with or without previous anti-TNF treatment. Adverse drug reactions leading to tocilizumab discontinuation were observed in 15.5% of patients, the most frequent adverse drug reaction being pneumonia in eight cases. On multivariate logistic regression analysis, DAS-28, HAQ-disability index (HAQ-DI), concomitant MTX and concomitant glucocorticoids (GCs) were predictive variables for clinical remission at Week 52 of tocilizumab treatment. In particular, HAQ-DI was found to be a predictive variable for remission of all three types-clinical, radiographic and functional-at Week 52 of tocilizumab treatment. CONCLUSIONS In daily clinical practice, tocilizumab exhibited excellent effectiveness in established RA patients, some of whom had failed to respond to previous anti-TNF treatment. Although further detailed safety findings are required, this study provides valuable real-world findings on the management of RA with tocilizumab.
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Affiliation(s)
- Tsutomu Takeuchi
- Department of Internal Medicine, Division of Rheumatology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
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Oshita K, Yamaoka K, Udagawa N, Fukuyo S, Sonomoto K, Maeshima K, Kurihara R, Nakano K, Saito K, Okada Y, Chiba K, Tanaka Y. Human mesenchymal stem cells inhibit osteoclastogenesis through osteoprotegerin production. ACTA ACUST UNITED AC 2011; 63:1658-67. [DOI: 10.1002/art.30309] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Conca W, Al-Salam S, Ding HJ, Mohd Thabit AA, Hussein H, Koc A, Karatepe AG, Gunaydin R, Kaya T, Lee YH, Park W, Jin Choi H, Jae Hong S, Hee Lee C, Suh CH, Hwang JY, Park SW, Lee J, Wong RH, Shiu LJ, Huang CH, Lee HS, Cheng-Chung Wei J, Surkan E, Fuat ES, Alpaslan A, Gary M, Vijitha DS, Ashraf EM, Robert M, Mbiantcha M, Nguelefack TB, Ndontsa BL, Tane P, Kamanyi A, Karadag O, Yilmaz S, Kisacik B, Kalyoncu U, Tezcan E, Yilmaz S, Ozgen M, Kaskari D, Direskeneli H, Kiraz S, Ertenli I, Dinc A, Capkin E, Karkucak M, Kose MM, Cakmak VA, Turkyilmaz AK, Tosun M, Baykal T, Senel K, Alp F, Erdal A, Ugur M, Ediz L, Tuluce Y, Ozkol H, Hiz O, Gulcu E, Toprak M, Kokkonen H, Mullazehi M, Ronnelid J, Rantapaa-Dahlqvist S, Bodur H, Rezvani A, Andersone D, Bulina I, Jaunalksne I, Batmaz I, Karakoc M, Yazici S, Cevik R, Nas K, Sarac AJ, Atilgan Z, Budak S, Arman MI, Ozcan E, Esmaeilzadeh S, Sen E, Baysak T, Kayikci O, Pamuk ON, Arican O, Donmez S, Pamuk GE, Cakir N, Koyuncu H, Gun K, Uludag M, Ornek NI, Suzen S, Battal H, Karamehmetoglu S, Senel K, Baykal T, Baygutalp F, Kiziltunc A, Ugur M, Yildirim S, Hatemi G, Yurdakul S, Fresko I, Ozdogan H, Ebru T, Murat B, Serdar K, Mert C, Ufuk U, Nurettin T, Smolen JS, Freundlich B, Pavelka K, Nash P, Miranda P, Hammond C, Vlahos B, Pedersen R, Koenig AS, Zinnuroglu M, Erden Z, Gogus F, Yalcin T, Bal A, Dulgeroglu D, Cakci A, Yalcin T, Bal A, Dulgeroglu D, Cakci A, Takeuchi T, Tanaka Y, Amano K, Hoshi D, Nawata M, Nagasawa H, Satoh E, Saito K, Kaneko Y, Fukuyo S, Kurasawa T, Hanami K, Kameda H, Yamanaka H. Thematic stream: inflammatory arthritis (PP01-PP31): PP01. Autoinflammatory Synovitis in Familial Mediterranean Fever is Characterized by Numerous Neutrophils Lacking Myeloperoxidase and Lysozyme, Macrophages, Mast Cells and B Cells, Up-Regulation of Galectin-1, P65 (REL A)/NF-KB and Inos, but not COX-2. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker097] [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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Iwata S, Saito K, Tokunaga M, Yamaoka K, Nawata M, Yukawa S, Hanami K, Fukuyo S, Miyagawa I, Kubo S, Tanaka Y. Phenotypic changes of lymphocytes in patients with systemic lupus erythematosus who are in longterm remission after B cell depletion therapy with rituximab. J Rheumatol 2010; 38:633-41. [PMID: 21159836 DOI: 10.3899/jrheum.100729] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Rituximab has recently emerged as a novel treatment strategy for systemic lupus erythematosus (SLE). We investigated longitudinally the differentiation and phenotypic changes of peripheral B cells and T cells in patients with SLE after rituximab treatment. METHODS Phenotypic changes on B cells and T cells in 10 patients with SLE treated with rituximab were analyzed before, 28 days after, and 2 years after rituximab treatment, and at relapse. RESULTS Rituximab rapidly depleted naive and memory B cells from the peripheral blood. In the patients with prolonged remission, the memory B cells remained depleted while naive B cells recovered within 3-9 months, and the expression levels of CD40 and CD80 remained downregulated for 2 years. There was also a decrease of memory T cells relative to naive T cells, and the expression of CD40L and inducible costimulator (ICOS) on CD4-positive T cells rapidly decreased and remained downregulated for 2 years. In 1 patient, an increase in the number of memory B cells with upregulation of CD40 and CD80 expression was noted just before relapse. In another patient with relapse, however, recovery of CD4-positive memory T cells with upregulation of ICOS expression was noted, with no change in the number of memory B cells. CONCLUSION Our results suggest that the phenotypic changes of peripheral B cells result in inhibition of T cell differentiation and activation mediated by B cells and thereby bring about longterm remission of SLE. Activated memory B cells or ICOS-positive CD4-positive memory T cells reappeared in association with relapse, probably reflecting the heterogeneity of SLE.
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Affiliation(s)
- Shigeru Iwata
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Yahata-nishi, Kitakyushu 807-8555, Japan.
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Oda Y, Iwanari S, Miki Y, Sato J, Fukuyo S, Sekine M, Kudo I. Clinico-statistical observations of orthognathic surgery on 92 patients — Cases of sagittal splitting ramus osteotomy. Int J Oral Maxillofac Surg 1997. [DOI: 10.1016/s0901-5027(97)81424-5] [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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Murakami H, Kamiya M, Fukuyo S, Hashimoto K, Horasawa N, Ito M, Takahashi S. Element solubility from dental implants. Dent Mater J 1986; 5:172-7. [PMID: 3505467 DOI: 10.4012/dmj.5.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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