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Gohda T, Murakoshi M, Suzuki Y, Kagimura T, Wada T, Narita I. Effect of proteinuria on the rapid kidney function decline in chronic kidney disease depends on the underlying disease: A post hoc analysis of the BRIGHTEN study. Diabetes Res Clin Pract 2024:111682. [PMID: 38677368 DOI: 10.1016/j.diabres.2024.111682] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/10/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
AIMS It is unclear whether the effect of proteinuria on rapid kidney function decline is equivalent among diabetic kidney disease (DKD), non-DKD with diabetes (NDKD + DM), and nephrosclerosis without diabetes (NS-DM), particularly in advanced chronic kidney disease patients. METHODS In total, 1038 chronic kidney disease patients who participated in the BRIGHTEN study were included in the present study. A linear mixed effect model was applied to estimate the annual estimated glomerular filtration rate decline in each disease group. RESULTS The prevalence of rapid decliners (rapid kidney function decline, defined as an eGFR loss of > 5 mL/min/1.73 m2/year) in the DKD group (44.6 %) was significantly higher compared with the NDKD + DM (27.9 %) and NS-DM (27.0 %) groups. By contrast, the prevalence of rapid decliners in different urine total protein to creatinine ratio (UPCR) categories (<0.5, 0.5 to < 1.0, 1.0 to < 3.5, and ≥ 3.5 g/g) were equivalent between the DKD and NS-DM groups. Moreover, the prevalence of a UPCR < 1.0 g/g in rapid decliners of the NS-DM group was more than double than in those of the DKD and NDKD + DM groups. CONCLUSIONS The risk of rapid kidney function decline in NS-DM patients with low levels of proteinuria may be greater than initially predicted.
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Affiliation(s)
- Tomohito Gohda
- Department of Nephrology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
| | - Maki Murakoshi
- Department of Nephrology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Yusuke Suzuki
- Department of Nephrology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Tatsuo Kagimura
- Translational Research Centre for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo, Japan
| | | | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Saito Y, Ito H, Fukagawa M, Akizawa T, Kagimura T, Yamamoto M, Kato M, Ogata H. Effect of renin-angiotensin system inhibitors on cardiovascular events in hemodialysis patients with hyperphosphatemia: A post hoc analysis of the LANDMARK trial. Ther Apher Dial 2024; 28:192-205. [PMID: 37921027 DOI: 10.1111/1744-9987.14080] [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: 08/24/2023] [Revised: 09/27/2023] [Accepted: 10/14/2023] [Indexed: 11/04/2023]
Abstract
INTRODUCTION The clinical benefits of renin-angiotensin system inhibitors (RASi) in patients undergoing hemodialysis remain obscure. METHODS This is a post hoc cohort analysis of the LANDMARK trial investigate whether RASi use was associated with cardiovascular events (CVEs) and all-cause mortality. A total of 2135 patients at risk for vascular calcification were analyzed using a Cox proportional hazards model with propensity-score matching. RESULTS The risk of CVEs was similar between participants with RASi use at baseline and those without RASi use at baseline and between participants with RASi use during the study period and those without RASi use during the study period. No clinical benefits of RASi use on all-cause mortality were observed. Serum phosphate levels were significantly associated with the effect of RASi on CVEs. CONCLUSIONS RASi use was not significantly associated with a lower risk of CVEs or all-cause mortality in hemodialysis patients at risk of vascular calcification.
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Affiliation(s)
- Yoshinori Saito
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Hidetoshi Ito
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Masafumi Fukagawa
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tadao Akizawa
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tatsuo Kagimura
- The Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo, Japan
| | - Masahiro Yamamoto
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Masanori Kato
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Hiroaki Ogata
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
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Kato M, Ito H, Yamakawa A, Kagimura T, Fukagawa M, Yamamoto M, Saito Y, Akizawa T, Ogata H. Effect of aspirin on cardiovascular events in patients undergoing hemodialysis with hyperphosphatemia: A post hoc analysis of the LANDMARK trial. Ther Apher Dial 2024. [PMID: 38471797 DOI: 10.1111/1744-9987.14123] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/04/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION The clinical benefits of aspirin in patients undergoing hemodialysis remain unclear. METHODS The secondary analysis of the LANDMARK trial investigated whether aspirin use was associated with cardiovascular events (CVEs) and all-cause mortality was performed. A total of 2135 patients at risk for vascular calcification were analyzed using a Cox proportional hazards model with propensity score matching. RESULTS The risk of CVEs was comparable between participants with aspirin use at baseline and those without at baseline, between participants with aspirin use during the study period and those without during the study period, and between participants with new aspirin prescription and those without aspirin use during the study period. CONCLUSION Aspirin use was not significantly associated with a lower risk of CVEs in participants undergoing hemodialysis patients at risk of vascular calcification.
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Affiliation(s)
- Masanori Kato
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Hidetoshi Ito
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Akane Yamakawa
- The Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo, Japan
| | - Tatsuo Kagimura
- The Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo, Japan
| | - Masafumi Fukagawa
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Masahiro Yamamoto
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Yoshinori Saito
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Tadao Akizawa
- Division of Nephrology, Department of Medicine, Showa University Graduate School of Medicine, Shinagawa, Tokyo, Japan
| | - Hiroaki Ogata
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
- Department of Medical Education, Showa University Graduate School of Medicine, Shinagawa, Tokyo, Japan
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Ozaki T, Yamagami H, Morimoto M, Hatano T, Oishi H, Haraguchi K, Yoshimura S, Sugiu K, Iihara K, Matsumaru Y, Matsumoto Y, Satow T, Hayakawa M, Sakai C, Miyamoto S, Kitagawa K, Daimon T, Kagimura T, Sakai N. Short- versus long-term Dual AntiPlatelet Therapy for Stent-Assisted treatment of CErebral aneurysm (DAPTS ACE): a multicenter, open-label, randomized clinical trial. J Neurointerv Surg 2024; 16:171-176. [PMID: 37068941 PMCID: PMC10850618 DOI: 10.1136/jnis-2022-019867] [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: 11/12/2022] [Accepted: 04/02/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND The optimal duration of dual antiplatelet therapy (DAPT) after stent-assisted coil embolization (SACE) for cerebral aneurysm remains uncertain. This randomized trial of short- versus long-term Dual AntiPlatelet Therapy for Stent-Assisted treatment of CErebral aneurysm (DAPTS ACE) aimed to clarify whether long-term DAPT can reduce the occurrence of ischemic stroke in patients with cerebral aneurysms treated by SACE compared with short-term DAPT. METHODS Patients treated for cerebral aneurysm with SACE were enrolled from 17 hospitals in Japan. Patients were enrolled within 30 days after SACE and assigned in a 1:1 ratio to receive long-term (12 months) or short-term (3 months) DAPT with aspirin and clopidogrel. Randomization was performed centrally through a web-based system. The primary outcome was the time to ischemic stroke event during 3 to 12 months after SACE. This trial was registered with the Japan Registry of Clinical Trials (jRCTs051180141). RESULTS A total of 142 patients were recruited from November 4, 2016 to January 7, 2019. Among them, 65 and 68 patients assigned to the long- and short-term DAPT groups, respectively, were included in the full analysis set. Ischemic stroke occurred in no patients in the long-term DAPT group and in one patient in the short-term DAPT group. The incidence rate did not differ between the groups (0.0 vs 2.1/100 person-years; log rank test, P=0.33). CONCLUSIONS In this multicenter randomized controlled trial, there was not a statistically significant difference in the rate of ischemic strokes between long- and short-term DAPT.
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Affiliation(s)
- Tomohiko Ozaki
- Neurosurgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Hiroshi Yamagami
- Stroke Neurology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Masafumi Morimoto
- Neurosurgery, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Kanagawa, Japan
| | - Taketo Hatano
- Neurosurgery, Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan
| | - Hidenori Oishi
- Neurosurgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
- Neuroendovascular Therapy, Juntendo University, Faculty of Medicine, Tokyo, Japan
| | | | | | - Kenji Sugiu
- Neurosurgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Koji Iihara
- Neurosurgery, National Cerebral and Cardiovascular Center Hospital, Suita, Osaka, Japan
| | - Yuji Matsumaru
- Division of Stroke Prevention and Treatment, Department of Neurosurgery, University of Tsukuba Faculty of Medicine, Tsukuba, Ibaraki, Japan
| | - Yasushi Matsumoto
- Division of Development and Discovery of Interventional Therapy, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Tetsu Satow
- Neurosurgery, Kindai University, Osaka-Sayama, Osaka, Japan
| | - Mikito Hayakawa
- Division of Stroke Prevention and Treatment, Department of Neurosurgery, University of Tsukuba Faculty of Medicine, Tsukuba, Ibaraki, Japan
| | - Chiaki Sakai
- Neurosurgery, Kobe City Medical Center General Hospital, Kobe-city, Japan
| | - Susumu Miyamoto
- Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuo Kitagawa
- Neurology, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Takashi Daimon
- Biostatistics, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innovation at Kobe, Translational Research Center for Medical Innovation, Kobe, Hyogo, Japan
| | - Nobuyuki Sakai
- Neurosurgery, Kobe City Medical Center General Hospital, Kobe-city, Hyogo, Japan
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Kakei Y, Kagimura T, Yamamoto Y, Osaki T, Kajita H, Kojima S, Kowa H, Kawabata M, Hasegawa T, Akashi M, Nagai Y. Tooth Loss as a Predictor of Long-Term Care Requirements in the Elderly: A Study in Kobe City, Japan. Cureus 2023; 15:e49851. [PMID: 38050582 PMCID: PMC10693673 DOI: 10.7759/cureus.49851] [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] [Accepted: 12/02/2023] [Indexed: 12/06/2023] Open
Abstract
INTRODUCTION The Kobe project, which utilizes prospective data from the national health insurance system, focuses on early detection and preventive strategies through the Frail Kenshin health check-up program. Previous research has underscored the correlation between tooth loss and the decline in physical and cognitive functions. In this study, using Kobe project data, we examined the link between remaining teeth and long-term care needs in individuals aged 64-65 years, with primary and secondary objectives involving various health parameters and quality of life. METHODS We analyzed baseline data from a prospective study conducted alongside the Frail Check program for generally healthy individuals aged 64-65 years to examine the relationship between the number of remaining teeth and various health indicators. This study focused on citizens aged 64-65 years to identify those at risk of needing long-term care by the age of 65 years. RESULTS Data from 1,530 participants were obtained, excluding eight individuals for specific reasons. At the end of the follow-up period, 41 (2.7%) individuals required support and 15 (1.0%) needed long-term care alone. The data revealed a significant association between the number of remaining teeth and the need for long-term care or support, as demonstrated by the Cochran-Armitage trend test (p<0.001). Although trends were noted for nutrition and total Cognitive Functional Instrument Self scores, they did not reach statistical significance. Additionally, a decrease in the number of remaining teeth was significantly associated with worse European Quality of Life Five Dimensions (EQ-5D-5L) visual analog scale scores, mobility, and regular activities (p<0.001). CONCLUSION Tooth loss indicates the potential long-term care needs of older adults. Monitoring oral health is crucial for addressing care requirements.
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Affiliation(s)
- Yasumasa Kakei
- Department of Oral and Maxillofacial Surgery, Kobe University Hospital, Kobe, JPN
| | - Tatsuo Kagimura
- Translational Research Centre for Medical Innovation, Foundation for Biomedical Research and Innovation, Kobe, JPN
| | - Yasuji Yamamoto
- Department of Biosignal Pathophysiology, Kobe University Graduate School of Medicine, Kobe, JPN
| | - Tohmi Osaki
- Faculty of Rehabilitation, Kobe Gakuin University, Kobe, JPN
| | - Hiroyuki Kajita
- Faculty of Rehabilitation, Kobe Gakuin University, Kobe, JPN
| | - Shinsuke Kojima
- Translational Research Centre for Medical Innovation, Foundation for Biomedical Research and Innovation, Kobe, JPN
| | - Hisatomo Kowa
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, JPN
| | - Miyuki Kawabata
- Department of Clinical Research Facilitation, Kyoto University Hospital, Kyoto, JPN
| | - Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Hospital, Kobe, JPN
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Hospital, Kobe, JPN
| | - Yoji Nagai
- Department of Clinical Research Facilitation, Kyoto University Hospital, Kyoto, JPN
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Saito S, Suzuki K, Ohtani R, Maki T, Kowa H, Tachibana H, Washida K, Kawabata N, Mizuno T, Kanki R, Sudoh S, Kitaguchi H, Shindo K, Shindo A, Oka N, Yamamoto K, Yasuno F, Kakuta C, Kakuta R, Yamamoto Y, Hattori Y, Takahashi Y, Nakaoku Y, Tonomura S, Oishi N, Aso T, Taguchi A, Kagimura T, Kojima S, Taketsuna M, Tomimoto H, Takahashi R, Fukuyama H, Nagatsuka K, Yamamoto H, Fukushima M, Ihara M. Efficacy and Safety of Cilostazol in Mild Cognitive Impairment: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2344938. [PMID: 38048134 PMCID: PMC10696485 DOI: 10.1001/jamanetworkopen.2023.44938] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/15/2023] [Indexed: 12/05/2023] Open
Abstract
Importance Recent evidence indicates the efficacy of β-amyloid immunotherapy for the treatment of Alzheimer disease, highlighting the need to promote β-amyloid removal from the brain. Cilostazol, a selective type 3 phosphodiesterase inhibitor, promotes such clearance by facilitating intramural periarterial drainage. Objective To determine the safety and efficacy of cilostazol in mild cognitive impairment. Design, Setting, and Participants The COMCID trial (A Trial of Cilostazol for Prevention of Conversion from Mild Cognitive Impairment to Dementia) was an investigator-initiated, double-blind, phase 2 randomized clinical trial. Adult participants were registered between May 25, 2015, and March 31, 2018, and received placebo or cilostazol for up to 96 weeks. Participants were treated in the National Cerebral and Cardiovascular Center and 14 other regional core hospitals in Japan. Patients with mild cognitive impairment with Mini-Mental State Examination (MMSE) scores of 22 to 28 points (on a scale of 0 to 30, with lower scores indicating greater cognitive impairment) and Clinical Dementia Rating scores of 0.5 points (on a scale of 0, 0.5, 1, 2, and 3, with higher scores indicating more severe dementia) were enrolled. The data were analyzed from May 1, 2020, to December 1, 2020. Interventions The participants were treated with placebo, 1 tablet twice daily, or cilostazol, 50 mg twice daily, for up to 96 weeks. Main Outcomes and Measures The primary end point was the change in the total MMSE score from baseline to the final observation. Safety analyses included all adverse events. Results The full analysis set included 159 patients (66 [41.5%] male; mean [SD] age, 75.6 [5.2] years) who received placebo or cilostazol at least once. There was no statistically significant difference between the placebo and cilostazol groups for the primary outcome. The least-squares mean (SE) changes in the MMSE scores among patients receiving placebo were -0.1 (0.3) at the 24-week visit, -0.8 (0.3) at 48 weeks, -1.2 (0.4) at 72 weeks, and -1.3 (0.4) at 96 weeks. Among those receiving cilostazol, the least-squares mean (SE) changes in MMSE scores were -0.6 (0.3) at 24 weeks, -1.0 (0.3) at 48 weeks, -1.1 (0.4) at 72 weeks, and -1.8 (0.4) at 96 weeks. Two patients (2.5%) in the placebo group and 3 patients (3.8%) in the cilostazol group withdrew owing to adverse effects. There was 1 case of subdural hematoma in the cilostazol group, which may have been related to the cilostazol treatment; the patient was successfully treated surgically. Conclusions and Relevance In this randomized clinical trial, cilostazol was well tolerated, although it did not prevent cognitive decline. The efficacy of cilostazol should be tested in future trials. Trial Registration ClinicalTrials.gov Identifier: NCT02491268.
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Affiliation(s)
- Satoshi Saito
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Keisuke Suzuki
- Innovation Center for Translational Research, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ryo Ohtani
- Department of Neurology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takakuni Maki
- Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hisatomo Kowa
- Division of Neurology, Kobe University Hospital, Kobe, Japan
| | | | - Kazuo Washida
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | | | - Toshiki Mizuno
- Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Rie Kanki
- Department of Neurology, Osaka City General Hospital, Osaka, Japan
| | - Shinji Sudoh
- Department of Neurology, National Hospital Organization, Utano National Hospital, Kyoto, Japan
| | - Hiroshi Kitaguchi
- Department of Neurology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Katsuro Shindo
- Department of Neurology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Akihiro Shindo
- Department of Neurology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Nobuyuki Oka
- Department of Neurology, National Hospital Organization Minami Kyoto Hospital, Joyo, Japan
| | - Keiichi Yamamoto
- Internal Medicine and Neurology, Nara Midori Clinic, Nara, Japan
| | - Fumihiko Yasuno
- Department of Psychiatry, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Chikage Kakuta
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Ryosuke Kakuta
- Department of Data Science, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yumi Yamamoto
- Department of Molecular Innovation in Lipidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yorito Hattori
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yukako Takahashi
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yuriko Nakaoku
- Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Tonomura
- Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoya Oishi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshihiko Aso
- Laboratory for Brain Connectomics Imaging, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
| | - Akihiko Taguchi
- Department of Regenerative Medicine Research, Institute of Biomedical Research and Innovation, Kobe, Japan
| | - Tatsuo Kagimura
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan
| | - Shinsuke Kojima
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan
| | - Masanori Taketsuna
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan
| | - Hidekazu Tomimoto
- Department of Neurology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hidenao Fukuyama
- Research and Educational Unit of Leaders for Integrated Medical System, Kyoto University, Kyoto, Japan
| | - Kazuyuki Nagatsuka
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Haruko Yamamoto
- Department of Data Science, National Cerebral and Cardiovascular Center, Suita, Japan
| | | | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
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Kuroda R, Niikura T, Matsumoto T, Fukui T, Oe K, Mifune Y, Minami H, Matsuoka H, Yakushijin K, Miyata Y, Kawamoto S, Kagimura T, Fujita Y, Kawamoto A. Phase III clinical trial of autologous CD34 + cell transplantation to accelerate fracture nonunion repair. BMC Med 2023; 21:386. [PMID: 37798633 PMCID: PMC10557317 DOI: 10.1186/s12916-023-03088-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND We previously demonstrated that CD34 + cell transplantation in animals healed intractable fractures via osteogenesis and vasculogenesis; we also demonstrated the safety and efficacy of this cell therapy in an earlier phase I/II clinical trial conducted on seven patients with fracture nonunion. Herein, we present the results of a phase III clinical trial conducted to confirm the results of the previous phase studies using a larger cohort of patients. METHODS CD34 + cells were mobilized via administration of granulocyte colony-stimulating factor, harvested using leukapheresis, and isolated using magnetic cell sorting. Autologous CD34 + cells were transplanted in 15 patients with tibia nonunion and 10 patients with femur nonunion, who were followed up for 52 weeks post transplantation. The main outcome was a reduction in time to heal the tibia in nonunion patients compared with that in historical control patients. We calculated the required number of patients as 15 based on the results of the phase I/II study. An independent data monitoring committee performed the radiographic assessments. Adverse events and medical device failures were recorded. RESULTS All fractures healed during the study period. The time to radiological fracture healing was 2.8 times shorter in patients with CD34 + cell transplantation than in the historical control group (hazard ratio: 2.81 and 95% confidence interval 1.16-6.85); moreover, no safety concerns were observed. CONCLUSIONS Our findings strongly suggest that autologous CD34 + cell transplantation is a novel treatment option for fracture nonunion. TRIAL REGISTRATION UMIN-CTR, UMIN000022814. Registered on 22 June 2016.
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Affiliation(s)
- Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan.
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Tomoaki Fukui
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Keisuke Oe
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Yutaka Mifune
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Chuo-Ku, Kobe, 650-0017, Japan
| | - Hiroshi Matsuoka
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Chuo-Ku, Kobe, 650-0017, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Chuo-Ku, Kobe, 650-0017, Japan
| | - Yoshiharu Miyata
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Chuo-Ku, Kobe, 650-0017, Japan
| | - Shinichiro Kawamoto
- Department of Transfusion Medicine and Cell Therapy, Kobe University Hospital, Chuo-Ku, Kobe, 650-0017, Japan
| | - Tatsuo Kagimura
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Chuo-Ku, Kobe, 650-0047, Japan
| | - Yasuyuki Fujita
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Chuo-Ku, Kobe, 650-0047, Japan
| | - Atsuhiko Kawamoto
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Chuo-Ku, Kobe, 650-0047, Japan
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Corbaux P, You B, Glasspool RM, Yanaihara N, Tinker AV, Lindemann K, Ray-Coquard IL, Mirza MR, Subtil F, Colomban O, Péron J, Karamouza E, McNeish I, Kelly C, Kagimura T, Welch S, Lewsley LA, Paoletti X, Cook A. Survival and modelled cancer antigen-125 ELIMination rate constant K score in ovarian cancer patients in first-line before poly(ADP-ribose) polymerase inhibitor era: A Gynaecologic Cancer Intergroup meta-analysis. Eur J Cancer 2023; 191:112966. [PMID: 37542936 DOI: 10.1016/j.ejca.2023.112966] [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: 04/26/2023] [Revised: 06/16/2023] [Accepted: 06/28/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND In patients with advanced ovarian cancer, the modelled CA-125 ELIMination rate constant K (KELIM) is an early indicator of the tumour intrinsic chemosensitivity. We assessed the prognostic and surrogate values of KELIM with respect to those of surgery outcome (based on post-operative residual lesions) in the Gynaecologic Cancer Intergroup (GCIG) individual patient data meta-analysis MAOV (Meta-Analysis in OVarian cancer) built before the emergence of poly(ADP-ribose) polymerase (PARP) inhibitors. METHODS The dataset was split into learning and validation cohorts (ratio 1:2). The individual modelled KELIM values were estimated, standardised by the median value, then scored as unfavourable (<1.0) or favourable (≥1.0). Overall survival (OS) and progression-free survival (PFS) analyses were performed with a two-step meta-analytic approach and surrogacy through a two-level meta-analytic model. RESULTS KELIM was assessed in 5884 patients from eight first-line trials (learning, 1962; validation, 3922). A favourable KELIM score was significantly associated with longer OS (validation set, median, 78.8 versus 28.4 months, hazard-ratios [HR] 0.46, 95% confidence interval [CI], 0.41-0.50, C-index 0.68), and longer PFS (validation set, median 30.5 versus 9.8 months, HR 0.49, 95% CI, 0.45-0.54, C-index 0.68), as were International Federation of Gynaecology and Obstetrics (FIGO) stage and debulking surgery outcome. Three prognostic groups were identified based on the surgery outcome and KELIM score, with large differences in OS (105.1, ∼45.0, and 22.1 months) and PFS (58.1, ∼15.0, and 8.0 months). Surrogacy for OS and for PFS was not established. CONCLUSION KELIM is an independent prognostic biomarker for survival, complementary to surgery outcome, representing a new determinant of first-line treatment success.
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Affiliation(s)
- Pauline Corbaux
- EA UCBL/HCL 3738, Centre pour l'lnnovation en Cancérologie de Lyon (CICLY), Faculty of Medicine Lyon-Sud, Claude Bernard University Lyon 1, Lyon, France; Medical Oncology, Institut de Cancérologie et d'Hématologie Universitaire de Saint-Étienne (ICHUSE), Centre Hospitalier Universitaire de Saint-Etienne, France
| | - Benoit You
- EA UCBL/HCL 3738, Centre pour l'lnnovation en Cancérologie de Lyon (CICLY), Faculty of Medicine Lyon-Sud, Claude Bernard University Lyon 1, Lyon, France; Medical Oncology, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), CITOHL, Centre Hospitalier Lyon-Sud, GINECO, GINEGEPS, Lyon, France.
| | - Rosalind M Glasspool
- Beatson West of Scotland Cancer Centre, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Nozomu Yanaihara
- Department of Obstetrics and Gynecologye, The Jikei University School of Medicine, Tokyo, Japan
| | - Anna V Tinker
- Medical Oncology, BC Cancer - Vancouver, Vancouver, Canada
| | - Kristina Lindemann
- Department of Gynaecological Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Mansoor R Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Clinical Trial Unit, Nordic Society of Gynaecological Oncology, Copenhagen, Denmark
| | - Fabien Subtil
- Department of Biostatistics, Hospices Civils de Lyon, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique Santé, CNRS UMR 5558, Claude Bernard University Lyon 1, Lyon, France
| | - Olivier Colomban
- EA UCBL/HCL 3738, Centre pour l'lnnovation en Cancérologie de Lyon (CICLY), Faculty of Medicine Lyon-Sud, Claude Bernard University Lyon 1, Lyon, France
| | - Julien Péron
- Medical Oncology, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), CITOHL, Centre Hospitalier Lyon-Sud, GINECO, GINEGEPS, Lyon, France; Department of Biostatistics, Hospices Civils de Lyon, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique Santé, CNRS UMR 5558, Claude Bernard University Lyon 1, Lyon, France
| | - Eleni Karamouza
- Institut Gustave Roussy, Office of Biostatistics and Epidemiology, Université Paris-Saclay, Villejuif, France; Inserm, Université Paris-Saclay, CESP U1018, Oncostat, labelled Ligue Contre le Cancer, Villejuif, France
| | - Iain McNeish
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Caroline Kelly
- Cancer Research UK Clinical Trial Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innovation at Kobe, Translational Research Center for Medical Innovation, Kobe, Japan
| | - Stephen Welch
- Department of Oncology, London Health Sciences Centre, London, Ontario, Canada
| | - Liz-Anne Lewsley
- Cancer Research UK Clinical Trial Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Adrian Cook
- Medical Research Council Clinical Trials Unit, University College London, London, UK
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9
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Ozaki T, Yamagami H, Morimoto M, Imamura H, Hatano T, Oishi H, Haraguchi K, Yoshimura S, Satow T, Sugiu K, Iihara K, Matsumaru Y, Hayakawa M, Matsumoto Y, Sakai C, Miyamoto S, Kitagawa K, Kagimura T, Sakai N. Relation between duration of dual antiplatelet therapy and risk of ischemic stroke after stent-assisted treatment of cerebral aneurysm (DAPTS ACE-registry). J Neurointerv Surg 2023:jnis-2023-020495. [PMID: 37433663 DOI: 10.1136/jnis-2023-020495] [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: 04/28/2023] [Accepted: 06/18/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND The optimal duration of dual antiplatelet therapy (DAPT) in patients with cerebral aneurysm who undergo stent-assisted coil embolization (SACE) has not been established. We aimed to clarify the association between duration of DAPT and incidence of ischemic stroke in patients with cerebral aneurysm. METHODS We registered patients with cerebral aneurysm who underwent SACE in 27 hospitals in Japan. Those treated with DAPT (aspirin and clopidogrel) were eligible for inclusion in a previously reported randomized control trial (RCT). Patients who were ineligible or refused to participate to the RCT were followed-up for 15 months after SACE as the non-RCT cohort. Our study examined both the RCT and non-RCT cohorts. The primary and secondary outcomes were ischemic stroke and hemorrhagic events. RESULTS Among the 313 patients registered, 296 were included for analysis (of these, 136 were RCT patients and 160 were non-RCT patients). Patients who were treated with DAPT for more than 6 months (n=191) were classified as the long-term DAPT group. Those treated less than 6 months (n=105) were classified as the short-term group. The incidence of ischemic stroke did not significantly differ between the long-term group (2.5 per 100 person-years) and the short-term group (3.2 per 100 person-years); nor did incidence of hemorrhagic events (0.8 and 3.2 per 100 person-years, respectively). The period of DAPT was not significantly associated with incidence rates of ischemic stroke or hemorrhagic events. CONCLUSIONS Duration of DAPT was not associated with the incidence of ischemic stroke in the first 15 months after SACE.
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Affiliation(s)
- Tomohiko Ozaki
- Neurosurgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Hiroshi Yamagami
- Stroke Neurology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Masafumi Morimoto
- Neurosurgery, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Kanagawa, Japan
| | - Hirotoshi Imamura
- Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Taketo Hatano
- Neurosurgery, Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan
| | - Hidenori Oishi
- Department of Neurosurgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
| | | | | | - Tetsu Satow
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kenji Sugiu
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, Japan
| | - Koji Iihara
- Neurosurgery, National Cerebral and Cardiovascular Center Hospital, Suita, Osaka, Japan
| | - Yuji Matsumaru
- Department of Neurology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Mikito Hayakawa
- Department of Neurology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yasushi Matsumoto
- Division of Development and Discovery of Interventional Therapy, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Chiaki Sakai
- Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Susumu Miyamoto
- Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuo Kitagawa
- Neurology, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innovation at Kobe, Translational Research Center for Medical Innovation, Kobe, Hyogo, Japan
| | - Nobuyuki Sakai
- Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
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10
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Karamouza E, Glasspool RM, Kelly C, Lewsley LA, Carty K, Kristensen GB, Ethier JL, Kagimura T, Yanaihara N, Cecere SC, You B, Boere IA, Pujade-Lauraine E, Ray-Coquard I, Proust-Lima C, Paoletti X. CA-125 Early Dynamics to Predict Overall Survival in Women with Newly Diagnosed Advanced Ovarian Cancer Based on Meta-Analysis Data. Cancers (Basel) 2023; 15:1823. [PMID: 36980708 PMCID: PMC10047009 DOI: 10.3390/cancers15061823] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
(1) Background: Cancer antigen 125 (CA-125) is a protein produced by ovarian cancer cells that is used for patients' monitoring. However, the best ways to analyze its decline and prognostic role are poorly quantified. (2) Methods: We leveraged individual patient data from the Gynecologic Cancer Intergroup (GCIG) meta-analysis (N = 5573) to compare different approaches summarizing the early trajectory of CA-125 before the prediction time (called the landmark time) at 3 or 6 months after treatment initiation in order to predict overall survival. These summaries included observed and estimated measures obtained by a linear mixed model (LMM). Their performances were evaluated by 10-fold cross-validation with the Brier score and the area under the ROC (AUC). (3) Results: The estimated value and the last observed value at 3 months were the best measures used to predict overall survival, with an AUC of 0.75 CI 95% [0.70; 0.80] at 24 and 36 months and 0.74 [0.69; 0.80] and 0.75 [0.69; 0.80] at 48 months, respectively, considering that CA-125 over 6 months did not improve the AUC, with 0.74 [0.68; 0.78] at 24 months and 0.71 [0.65; 0.76] at 36 and 48 months. (4) Conclusions: A 3-month surveillance provided reliable individual information on overall survival until 48 months for patients receiving first-line chemotherapy.
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Affiliation(s)
- Eleni Karamouza
- Gustave Roussy, Office of Biostatistics and Epidemiology, Université Paris-Saclay, 94805 Villejuif, France
- Oncostat, Labeled Ligue Contre le Cancer, CESP U1018, Inserm, Université Paris-Saclay, 94805 Villejuif, France
| | - Rosalind M. Glasspool
- Beatson West of Scotland Cancer Centre, NHS Greater Glasgow and Clyde, Glasgow G12 0XH, UK
| | - Caroline Kelly
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow G12 0YN, UK
| | - Liz-Anne Lewsley
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow G12 0YN, UK
| | - Karen Carty
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow G12 0YN, UK
| | - Gunnar B. Kristensen
- Department of Gynecologic Oncology, Institute for Cancer Genetics and Informatics, Oslo University Hospital, 0424 Oslo, Norway
| | - Josee-Lyne Ethier
- Department of Medical Oncology, Cancer Centre of Southeastern Ontario, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innocation, Translational Research Center for Medical Innovation, Kobe 650-0047, Japan
| | | | - Sabrina Chiara Cecere
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Napoli, Italy
| | - Benoit You
- EMR UCBL/HCL 3738, Faculté de Médecine Lyon-Sud, Université Lyon, Université Claude Bernard Lyon 1, 69100 Lyon, France
- Medical Oncology, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), CITOHL, Centre Hospitalier Lyon-Sud, GINECO, GINEGEPS, 69495 Lyon, France
| | - Ingrid A. Boere
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | | | | | - Cécile Proust-Lima
- UMR1219, Bordeaux Population Health Research Center, Inserm, University of Bordeaux, 33000 Bordeaux, France
| | - Xavier Paoletti
- Faculty of Medicine, University of Versailles Saint-Quentin, Université Paris Saclay, 78000 Versailles, France
- INSERM U900, Statistics for Personalized Medicine, Institut Curie, 92210 Saint-Cloud, France
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11
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Yoshihara K, Baba T, Tokunaga H, Nishino K, Sekine M, Takamatsu S, Matsumura N, Yoshida H, Kajiyama H, Shimada M, Kagimura T, Oda K, Sasajima Y, Yaegashi N, Okamoto A, Sugiyama T, Enomoto T. Homologous Recombination Inquiry Through Ovarian Malignancy Investigations: JGOG3025 study. Cancer Sci 2023. [PMID: 36747324 DOI: 10.1111/cas.15747] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/14/2023] [Accepted: 01/29/2023] [Indexed: 02/08/2023] Open
Abstract
TCGA network has clarified that approximately 50% of high-grade serous ovarian cancers show homologous recombination deficiency (HRD). However, the frequency of HRD in Japanese patients with ovarian cancer remains unclear. We aimed to identify the frequency of HR-associated gene mutations in Japanese patients with ovarian cancer. The JGOG3025 study is a multicenter collaborative prospective observational study involving 65 study sites throughout Japan. We recruited 996 patients who were clinically diagnosed with ovarian cancer before surgery from March 2017 to March 2019, and 701 patients were eligible according to the criteria. We used frozen tumor tissues to extract DNA and performed next generation sequencing for 51 targeted genes (including 29 HR-associated genes) in 701 ovarian cancers (298 high-grade serous cases, 189 clear cell cases, 135 endometrioid cases, 12 mucinous cases, 3 low-grade serous cases, and 64 others). HRD was defined as positive when at least one HR-associated gene was mutated. The frequencies of HRD and tumor BRCA1/2 mutations were 45.2% (317/701) and 18.5% (130/701), respectively, in the full analysis set. Next, we performed multivariate Cox proportional hazards regression analysis for progression-free survival (PFS) and overall survival (OS). Advanced-stage ovarian cancer patients with HRD had adjusted hazard ratios of 0.72 (95% CI, 0.55-0.94) and 0.57 (95% CI, 0.38-0.86) for PFS and OS, respectively, compared to those without HRD (p = 0.016 and 0.007). Our study demonstrated that mutations in HR-associated genes were associated with prognosis. Further studies are needed to investigate the prognostic impact of each HR-associated gene in ovarian cancer.
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Affiliation(s)
- Kosuke Yoshihara
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University, Morioka, Japan
| | - Hideaki Tokunaga
- Department of Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koji Nishino
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masayuki Sekine
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Shiro Takamatsu
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriomi Matsumura
- Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hiroshi Yoshida
- Department of Obstetrics and Gynecology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.,Department of Obstetrics and Gynecology, Tokai University Graduate School of Medicine, Isehara, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Muneaki Shimada
- Department of Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tatsuo Kagimura
- Translational Research Center for Medical Innovation, Kobe, Japan
| | - Katsutoshi Oda
- Division of Integrative Genomics, University of Tokyo, Tokyo, Japan
| | - Yuko Sasajima
- Department of Pathology, Teikyo University Hospital, Tokyo, Japan
| | - Nobuo Yaegashi
- Department of Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Advanced Research Center for Innovations in Next-Generation Medicine, Tohoku University, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, St. Mary's Hospital, Fukuoka, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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12
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Mavragani A, Fujita K, Oki R, Osaki Y, Miyamoto R, Morino H, Nagano S, Atsuta N, Kanazawa Y, Matsumoto Y, Arisawa A, Kawai H, Sato Y, Sakaguchi S, Yagi K, Hamatani T, Kagimura T, Yanagawa H, Mochizuki H, Doyu M, Sobue G, Harada M, Izumi Y. An Exploratory Trial of EPI-589 in Amyotrophic Lateral Sclerosis (EPIC-ALS): Protocol for a Multicenter, Open-Labeled, 24-Week, Single-Group Study. JMIR Res Protoc 2023; 12:e42032. [PMID: 36716091 PMCID: PMC9926342 DOI: 10.2196/42032] [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: 08/24/2022] [Revised: 11/20/2022] [Accepted: 12/08/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder, with its currently approved drugs, including riluzole and edaravone, showing limited therapeutic effects. Therefore, safe and effective drugs are urgently necessary. EPI-589 is an orally available, small-molecule, novel redox-active agent characterized by highly potent protective effects against oxidative stress with high blood-brain barrier permeability. Given the apparent oxidative stress and mitochondrial dysfunction involvement in the pathogenesis of ALS, EPI-589 may hold promise as a therapeutic agent. OBJECTIVE This protocol aims to describe the design and rationale for the EPI-589 Early Phase 2 Investigator-Initiated Clinical Trial for ALS (EPIC-ALS). METHODS EPIC-ALS is an explorative, open-labeled, single-arm trial that evaluates the safety and tolerability of EPI-589 in patients with ALS. This trial consists of 12-week run-in, 24-week treatment, and 4-week follow-up periods. Patients will receive 500 mg of EPI-589 3 times daily over the 24-week treatment period. Clinical assessments include the mean monthly change of Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised total score. The biomarkers are selected to analyze the effect on oxidative stress and neuronal damage. The plasma biomarkers are 8-hydroxy-2'-deoxyguanosine (8-OHdG), 3-nitrotyrosine (3-NT), neurofilament light chain (NfL), phosphorylated neurofilament heavy chain (pNfH), homocysteine, and creatinine. The cerebrospinal fluid biomarkers are 8-OHdG, 3-NT, NfL, pNfH, and ornithine. The magnetic resonance biomarkers are fractional anisotropy in the corticospinal tract and N-acetylaspartate in the primary motor area. RESULTS This trial began data collection in September 2021 and is expected to be completed in October 2023. CONCLUSIONS This study can provide useful data to understand the characteristics of EPI-589. TRIAL REGISTRATION Japan Primary Registries Network jRCT2061210031; tinyurl.com/2p84emu6. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42032.
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Affiliation(s)
| | - Koji Fujita
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Ryosuke Oki
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yusuke Osaki
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Ryosuke Miyamoto
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Hiroyuki Morino
- Department of Medical Genetics, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Seiichi Nagano
- Department of Neurotherapeutics, Osaka University Graduate School of Medicine, Suita, Japan.,Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Naoki Atsuta
- Department of Neurology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yuki Kanazawa
- Department of Biomedical Information Sciences, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yuki Matsumoto
- Department of Radiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Atsuko Arisawa
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hisashi Kawai
- Department of Radiology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasutaka Sato
- Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Satoshi Sakaguchi
- Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Kenta Yagi
- Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | | | - Tatsuo Kagimura
- The Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan
| | - Hiroaki Yanagawa
- Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Hideki Mochizuki
- Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Manabu Doyu
- Department of Neurology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Gen Sobue
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Masafumi Harada
- Department of Radiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yuishin Izumi
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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13
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Narita I, Hayashi T, Maruyama S, Masaki T, Nangaku M, Nishino T, Sato H, Sofue T, Wada T, Imai E, Iwasaki M, Mizuno K, Hase H, Kamouchi M, Yamamoto H, Kagimura T, Tanabe K, Kato H, Wada T, Usui T, Akizawa T, Hirakata H, Tsubakihara Y. Hyporesponsiveness to erythropoiesis-stimulating agent in non-dialysis-dependent CKD patients: The BRIGHTEN study. PLoS One 2022; 17:e0277921. [PMID: 36445882 PMCID: PMC9707758 DOI: 10.1371/journal.pone.0277921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/16/2022] [Indexed: 12/03/2022] Open
Abstract
Among non-dialysis-dependent chronic kidney disease (ND-CKD) patients, a low hematopoietic response to erythropoiesis-stimulating agents (ESAs) is a predictor for poor renal and cardiovascular outcome. To assess the method for evaluating hyporesponsiveness to ESA in patients with ND-CKD, a multicenter, prospective, observational study of 1,980 adult patients with ND-CKD with renal anemia was conducted. Darbepoetin alfa (DA) and iron supplement administrations were provided according to the recommendation of the attached document and the guidelines of JSDT (Japanese Society of Dialysis and Transplantation). The primary outcomes were progression of renal dysfunction and major adverse cardiovascular events. ESA responsiveness was assessed using pre-defined candidate formulae. During the mean follow-up period of 96 weeks, renal and cardiovascular disease (CVD) events occurred in 683 (39.6%) and 174 (10.1%) of 1,724 patients, respectively. Among pre-set candidate formulae, the one expressed by dividing the dose of DA by Hb level at the 12-week DA treatment was statistically significant in predicting renal (hazard ratio [HR], 1.449; 95% confidence interval [CI], 1.231-1.705; P<0.0001) and CVD events (HR, 1.719; 95% CI, 1.239-2.386; P = 0.0010). The optimum cut-off values for both events were close to 5.2. In conclusion, hyporesponsiveness to ESA in ND-CKD cases, which is associated with a risk for renal and CVD events, may be evaluated practicably as the dose of DA divided by the Hb level at the 12-week DA treatment, and the cut-off value of this index is 5.2. A search for the causes of poor response and measures for them should be recommended in such patients. Trial registration: ClinicalTrials. gov Identifier: NCT02136563; UMIN Clinical Trial Registry Identifier: UMIN000013464.
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Affiliation(s)
- Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- * E-mail:
| | - Terumasa Hayashi
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Shoichi Maruyama
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takao Masaki
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masaomi Nangaku
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tomoya Nishino
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroshi Sato
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tadashi Sofue
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takashi Wada
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Enyu Imai
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Manabu Iwasaki
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kyoichi Mizuno
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroki Hase
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masahiro Kamouchi
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroyasu Yamamoto
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tatsuo Kagimura
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kenichiro Tanabe
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hideki Kato
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takehiko Wada
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tomoko Usui
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tadao Akizawa
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hideki Hirakata
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yoshiharu Tsubakihara
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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14
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Ogata H, Fukagawa M, Hirakata H, Kagimura T, Akizawa T. Effect of lanthanum carbonate and calcium carbonate on the progression of coronary artery calcification among hemodialysis patients with vascular calcification risk: a randomized controlled trial. Clin Exp Nephrol 2022; 26:1223-1232. [PMID: 36064876 DOI: 10.1007/s10157-022-02270-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/23/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Coronary artery calcification (CAC) is predictive of cardiovascular events. We assessed whether a non-calcium-based phosphate binder, lanthanum carbonate (LC), could delay CAC progression compared with a calcium-based phosphate binder, calcium carbonate (CC), in hemodialysis patients. METHODS This was a subsidiary of the LANDMARK study, which is a multicenter, open-label, randomized control study comparing LC and CC for cardiovascular events among Japanese hemodialysis patients with hyperphosphatemia who were at risk of vascular calcification. Participants were randomly assigned (1:1) to receive LC or CC. The changes in the total Agatston score of CAC 2 years from baseline were the primary outcome. Secondary outcomes included the changes in the total Agatston score at 1 year from baseline and the changes in serum phosphate, corrected calcium, and intact parathyroid hormone concentrations. RESULTS Of 239 patients, 123 comprised the full analysis set. The median daily drug dose (mg) was 750 [interquartile range (IQR), 750‒1500] in the LC group and 3000 (IQR, 3000‒3000) in the CC group; it remained constant throughout the study period. There was no significant difference in the change in total Agatston score from baseline to 2 years between the LC and CC groups [368 (95% confidence interval, 57-680) in the LC group vs. 611 (105-1118) in the CC group; difference, 243 (- 352-838)]. CONCLUSIONS LC-based treatment for hyperphosphatemia did not delay CAC for 2 years compared with CC-based treatment in hemodialysis patients with at least one risk factor for vascular calcification.
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Affiliation(s)
- Hiroaki Ogata
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Chigasaki-chuo 35-1, Tsuzuki, Yokohama, Kanagawa, 224-8503, Japan.
| | - Masafumi Fukagawa
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | | | - Tatsuo Kagimura
- The Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Chuo-ku, Kobe, Hyogo, Japan
| | - Tadao Akizawa
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Shinagawa, Tokyo, Japan
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15
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Oki R, Izumi Y, Fujita K, Miyamoto R, Nodera H, Sato Y, Sakaguchi S, Nokihara H, Kanai K, Tsunemi T, Hattori N, Hatanaka Y, Sonoo M, Atsuta N, Sobue G, Shimizu T, Shibuya K, Ikeda K, Kano O, Nishinaka K, Kojima Y, Oda M, Komai K, Kikuchi H, Kohara N, Urushitani M, Nakayama Y, Ito H, Nagai M, Nishiyama K, Kuzume D, Shimohama S, Shimohata T, Abe K, Ishihara T, Onodera O, Isose S, Araki N, Morita M, Noda K, Toda T, Maruyama H, Furuya H, Teramukai S, Kagimura T, Noma K, Yanagawa H, Kuwabara S, Kaji R. Efficacy and Safety of Ultrahigh-Dose Methylcobalamin in Early-Stage Amyotrophic Lateral Sclerosis: A Randomized Clinical Trial. JAMA Neurol 2022; 79:575-583. [PMID: 35532908 PMCID: PMC9086935 DOI: 10.1001/jamaneurol.2022.0901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Importance The effectiveness of currently approved drugs for amyotrophic lateral sclerosis (ALS) is restricted; there is a need to develop further treatments. Initial studies have shown ultrahigh-dose methylcobalamin to be a promising agent. Objective To validate the efficacy and safety of ultrahigh-dose methylcobalamin for patients with ALS enrolled within 1 year of onset. Design, Setting, and Participants This was a multicenter, placebo-controlled, double-blind, randomized phase 3 clinical trial with a 12-week observation and 16-week randomized period, conducted from October 17, 2017, to September 30, 2019. Patients were recruited from 25 neurology centers in Japan; those with ALS diagnosed within 1 year of onset by the updated Awaji criteria were initially enrolled. Of those, patients fulfilling the following criteria after 12-week observation were eligible for randomization: 1- or 2-point decrease in the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) total score, a percent forced vital capacity greater than 60%, no history of noninvasive respiratory support and tracheostomy, and being ambulatory. The target participant number was 64 in both the methylcobalamin and placebo groups. Patients were randomly assigned through an electronic web-response system to methylcobalamin or placebo. Interventions Intramuscular injection of methylcobalamin (50-mg dose) or placebo twice weekly for 16 weeks. Main Outcomes and Measures The primary end point was change in ALSFRS-R total score from baseline to week 16 in the full analysis set. Results A total of 130 patients (mean [SD] age, 61.0 [11.7] years; 74 men [56.9%]) were randomly assigned to methylcobalamin or placebo (65 each). A total of 129 patients were eligible for the full analysis set, and 126 completed the double-blind stage. Of these, 124 patients proceeded to the open-label extended period. The least square means difference in ALSFRS-R total score at week 16 of the randomized period was 1.97 points greater with methylcobalamin than placebo (-2.66 vs -4.63; 95% CI, 0.44-3.50; P = .01). The incidence of adverse events was similar between the 2 groups. Conclusions and Relevance Results of this randomized clinical trial showed that ultrahigh-dose methylcobalamin was efficacious in slowing functional decline in patients with early-stage ALS and with moderate progression rate and was safe to use during the 16-week treatment period. Trial Registration ClinicalTrials.gov Identifier: NCT03548311.
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Affiliation(s)
- Ryosuke Oki
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yuishin Izumi
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Koji Fujita
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Ryosuke Miyamoto
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Hiroyuki Nodera
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yasutaka Sato
- Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Satoshi Sakaguchi
- Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Hiroshi Nokihara
- Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Kazuaki Kanai
- Department of Neurology, Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Taiji Tsunemi
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yuki Hatanaka
- Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan
| | - Masahiro Sonoo
- Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan
| | - Naoki Atsuta
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Gen Sobue
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshio Shimizu
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Kazumoto Shibuya
- Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Ken Ikeda
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Osamu Kano
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
| | | | - Yasuhiro Kojima
- Department of Neurology, Takeda General Hospital, Kyoto, Japan
| | - Masaya Oda
- Department of Neurology, Vihara Hananosato Hospital, Miyoshi, Japan
| | - Kiyonobu Komai
- Department of Neurology, National Hospital Organization Iou Hospital, Kanazawa, Japan
| | - Hitoshi Kikuchi
- Department of Neurology, Murakami Karindoh Hospital, Fukuoka, Japan
| | - Nobuo Kohara
- Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Makoto Urushitani
- Department of Neurology, Shiga University of Medical Science, Otsu, Japan
| | - Yoshiaki Nakayama
- Department of Neurology, Wakayama Medical University, Wakayama, Japan
| | - Hidefumi Ito
- Department of Neurology, Wakayama Medical University, Wakayama, Japan
| | - Makiko Nagai
- Department of Neurology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kazutoshi Nishiyama
- Department of Neurology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Daisuke Kuzume
- Department of Neurology, Chikamori Hospital, Kochi, Japan
| | - Shun Shimohama
- Department of Neurology, Sapporo Medical University, Sapporo, Japan
| | - Takayoshi Shimohata
- Department of Neurology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Koji Abe
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Tomohiko Ishihara
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Osamu Onodera
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Sagiri Isose
- Department of Neurology, National Hospital Organization Chibahigashi Hospital, Chiba, Japan
| | - Nobuyuki Araki
- Department of Neurology, National Hospital Organization Chibahigashi Hospital, Chiba, Japan
| | - Mitsuya Morita
- Division of Neurology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Kazuyuki Noda
- Department of Neurology, Juntendo University Shizuoka Hospital, Izunokuni, Japan
| | - Tatsushi Toda
- Department of Neurology, The University of Tokyo, Tokyo, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hirokazu Furuya
- Department of Neurology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Satoshi Teramukai
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tatsuo Kagimura
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Kensuke Noma
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.,Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Hiroaki Yanagawa
- Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Ryuji Kaji
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.,Department of Neurology, National Hospital Organization Utano Hospital, Kyoto, Japan
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Kikawa Y, Kotake T, Tsuyuki S, Kang Y, Takahara S, Fujimoto Y, Yamashiro H, Yoshibayashi H, Takada M, Yasuoka R, Nakatsukasa K, Yamagami K, Suwa H, Okuno T, Nakayama I, Kato T, Ogura N, Moriguchi Y, Ishiguro H, Kagimura T, Taguchi T, Sugie T, Toi M. Effectiveness of eribulin as first-line or second-line chemotherapy for HER2-negative hormone-resistant advanced or metastatic breast cancer: findings from the multi-institutional, prospective, observational KBCRN A001: E-SPEC study. Breast Cancer 2022; 29:796-807. [PMID: 35460066 DOI: 10.1007/s12282-022-01357-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/03/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND The optimal positioning of eribulin treatment remains unclear. This study aimed to investigate the effectiveness of eribulin administration as first- and second-line chemotherapy in patients with endocrine-resistant advanced or metastatic breast cancer (AMBC) in the real-world clinical setting. METHODS This multi-institutional prospective cohort study enrolled patients with triple-negative AMBC or estrogen receptor-positive AMBC refractory to at least one previous endocrine therapy. The overall survival (OS) from the start of first-line (OS1) and second-line chemotherapy (OS2) was assessed. Data analysis included real-world chemotherapy sequences of first- to third-line chemotherapy regimens. The adjusted hazard ratio (HR) with 95% confidence interval (CI) for treatment regimen comparison was calculated using a stratified proportional hazards model. RESULTS Among 201 patients enrolled, 180 were included in the final analysis. Eribulin was administered as first- and second-line chemotherapy to 46 (26.6%) and 70 (47.9%) patients, respectively. Median OS1 and OS2 were 2.25 (95% CI 1.07-2.68) and 1.75 (95% CI, 1.28-2.45) years for first- and second-line eribulin, respectively. Oral 5-FU followed by eribulin had a numerically longer OS1 (2.84 years) than the other sequences. Among patients who proceeded to second-line or later chemotherapy, the median OS1 for those treated with anthracycline or taxane as first- or second-line (n = 98) was 2.56 years (95% CI 2.27-2.74), while it was 2.87 years (95% CI 2.20-4.32) for those who avoided anthracycline and taxane as first- and second-line (n = 48) (adjusted HR, 1.20; 95% CI 0.70-2.06). In the exploratory analysis, OS1 was 2.55 (95% CI 2.14-2.75) and 2.91 years (95% CI 2.61-4.32) for those aged < 65 and ≥ 65 years, respectively (adjusted HR of ≥ 65, 0.91; 95% CI 0.56-1.46). CONCLUSIONS Eribulin or oral 5-FU administration in first- and second-line chemotherapy without anthracycline/taxane was acceptable in the real-world setting. TRIAL REGISTRATION This study is registered with Clinical Trials.gov (NCT 02,551,263).
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Affiliation(s)
- Yuichiro Kikawa
- Department of Breast Surgery, Kansai Medical University, Hirakata-city, Osaka, 573-1191, Japan. .,Department of Breast Surgery, Kobe City Medical Center General Hospital, Kobe-city, Hyogo, 650-0047, Japan.
| | - Takeshi Kotake
- Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto-city, Kyoto, 606-8507, Japan.,Department of Breast Surgery, Kansai Electric Power Hospital, Osaka-city, Osaka, 553-0003, Japan
| | - Shigeru Tsuyuki
- Department of Breast Surgery, Osaka Red Cross Hospital, Osaka-city, Osaka, 543-8555, Japan
| | - Yookija Kang
- Department of Breast Surgery, Osaka Red Cross Hospital, Osaka-city, Osaka, 543-8555, Japan
| | - Sachiko Takahara
- Department of Breast Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka-city, Osaka, 530-8480, Japan
| | - Yuri Fujimoto
- Department of Breast Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka-city, Osaka, 530-8480, Japan
| | - Hiroyasu Yamashiro
- Department of Breast Surgery, Tenri Hospital, Tenri-city, Nara, 632-0018, Japan
| | | | - Masahiro Takada
- Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto-city, Kyoto, 606-8507, Japan
| | - Rie Yasuoka
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto-city, Kyoto, 602-8566, Japan
| | - Katsuhiko Nakatsukasa
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto-city, Kyoto, 602-8566, Japan
| | - Kazuhiko Yamagami
- Department of Breast Surgery, Shinko Hospital, Kobe-city, Hyogo, 651-0072, Japan
| | - Hirofumi Suwa
- Department of Breast Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki-city, Hyogo, 660-8550, Japan
| | - Toshitaka Okuno
- Department of Breast Surgery, Kobe City Nishi-Kobe Medical Center, Kobe-city, Hyogo, 651-2273, Japan
| | - Ichiro Nakayama
- Department of Breast Surgery, Kyoto Min-Iren Chuo Hospital, Kyoto-city, 616-8147, Japan
| | - Tatsushi Kato
- Department of Breast Surgery, Yamato Takada Municipal Hospital, Yamatotakada-city, Nara, 635-8501, Japan
| | - Nobuko Ogura
- Department of Breast Surgery, Kansai Electric Power Hospital, Osaka-city, Osaka, 553-0003, Japan
| | - Yoshio Moriguchi
- Department of Breast Surgery, Kyoto City Hospital, Kyoto-city, Kyoto, 604-8845, Japan
| | - Hiroshi Ishiguro
- Breast Oncology Service, Saitama Medical University International Medical Center, Hidaka-city, Saitama, 350-1298, Japan
| | - Tatsuo Kagimura
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe-city, Hyogo, 650-0047, Japan
| | - Tetsuya Taguchi
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto-city, Kyoto, 602-8566, Japan
| | - Tomoharu Sugie
- Department of Breast Surgery, Kansai Medical University, Hirakata-city, Osaka, 573-1191, Japan
| | - Masakazu Toi
- Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto-city, Kyoto, 606-8507, Japan
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Corbaux P, You B, Glasspool R, Yanaihara N, Tinker A, Lindemann K, Ray-Coquard I, Mirza M, Subtil F, Colomban O, Peron J, Karamouza E, McNeish I, Hinsley S, Kagimura T, Welch S, Lewsley LA, Paoletti X, Cook A. 751P Survival prognostic and surrogate values of the early modeled CA-125 KELIM in newly diagnosed advanced ovarian cancer: Data from the GCIG meta-analysis group. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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18
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Yoshihara K, Baba T, Shimada M, Yoshida H, Okamoto A, Kajiyama H, Kagimura T, Oda K, Sugiyama T, Enomoto T. Frequency of homologous recombination associated gene mutations in Japanese patients with ovarian cancer. Gynecol Oncol 2021. [DOI: 10.1016/s0090-8258(21)00953-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Narisawa H, Inoue Y, Kobayashi M, Okajima I, Kikuchi T, Kagimura T, Matsui K, Inada K, Mishima K. Development and validation of the Benzodiazepine Hypnotics Withdrawal Symptom Scale (BHWSS) based on item response theory. Psychiatry Res 2021; 300:113900. [PMID: 33812220 DOI: 10.1016/j.psychres.2021.113900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/21/2021] [Indexed: 10/21/2022]
Abstract
This study aimed to refine and validate the Benzodiazepine Hypnotics Withdrawal Symptom Scale (BHWSS). The 12-item prototype version of the BHWSS was administered to a sample of 346 patients with chronic insomnia (161 males and 185 females, mean age: 52.8 ± 16.6 years) who had been taking hypnotics (benzodiazepines [BZDs] or BZD receptor agonists) for at least 3 months. The item information curve indicated that two of the 12 BHWSS items should be excluded. As a result of analyzing the 10-item version of the BHWSS (revised-BHWSS), the contribution rate in the case of the factor 1 was 0.49, Cronbach's α was 0.90, and the reliability coefficient ω was 0.91. An analysis of the item information curve for the revised-BHWSS indicated that the information amount per item increased from 3.90 for the original 12-item BHWSS to 4.37 for the 10-item revised-BHWSS. The receiver operating characteristic curve indicated that 6.5 points on the revised-BHWSS was the most appropriate cutoff for estimating moderate or severe withdrawal symptoms using the Benzodiazepine Dependence Self-Report Questionnaire as a reference. These results suggest that the 10-item revised-BHWSS has sufficient reliability and validity for evaluating the severity of withdrawal symptoms after discontinuing BZDs.
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Affiliation(s)
- Hajime Narisawa
- Department of Psychology, Aichi Shukutoku University, 2-9 Katahira, Nagakute-shi, Aichi 480-1197 Japan; Institute of Neuropsychiatry, Japan Somnology Center, Tokyo, Japan, 1-24-6 Yoyogi, Shibuya-ku, Tokyo 151-0053 Japan
| | - Yuichi Inoue
- Institute of Neuropsychiatry, Japan Somnology Center, Tokyo, Japan, 1-24-6 Yoyogi, Shibuya-ku, Tokyo 151-0053 Japan; Department of Somnology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402 Japan; Foundation of Sleep and Health Science, Tokyo, Japan, 1-24-6 Yoyogi, Shibuya-ku, Tokyo 151-0053 Japan.
| | - Mina Kobayashi
- Institute of Neuropsychiatry, Japan Somnology Center, Tokyo, Japan, 1-24-6 Yoyogi, Shibuya-ku, Tokyo 151-0053 Japan; Foundation of Sleep and Health Science, Tokyo, Japan, 1-24-6 Yoyogi, Shibuya-ku, Tokyo 151-0053 Japan
| | - Isa Okajima
- Institute of Neuropsychiatry, Japan Somnology Center, Tokyo, Japan, 1-24-6 Yoyogi, Shibuya-ku, Tokyo 151-0053 Japan; Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, 1-18-1 Kaga, Itabashi-ku, Tokyo 173-8602, Japan
| | - Takashi Kikuchi
- Translational Research Information Center, 1-5-4 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Tatsuo Kagimura
- Translational Research Information Center, 1-5-4 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Kentaro Matsui
- Institute of Neuropsychiatry, Japan Somnology Center, Tokyo, Japan, 1-24-6 Yoyogi, Shibuya-ku, Tokyo 151-0053 Japan; Department of Psychiatry, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo Japan
| | - Ken Inada
- Department of Psychiatry, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo Japan
| | - Kazuo Mishima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita-shi, Akita 010-8543 Japan; International Institute for Integrative Sleep Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki 305-8575 Japan
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20
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Komai S, Inatomi T, Nakamura T, Ueta M, Horiguchi G, Teramukai S, Kimura Y, Kagimura T, Fukushima M, Kinoshita S, Sotozono C. Long-term outcome of cultivated oral mucosal epithelial transplantation for fornix reconstruction in chronic cicatrising diseases. Br J Ophthalmol 2021; 106:1355-1362. [PMID: 34006509 PMCID: PMC9510423 DOI: 10.1136/bjophthalmol-2020-318547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/07/2021] [Accepted: 04/17/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To investigate the long-term outcomes of cultivated oral mucosal epithelial transplantation (COMET) for fornix reconstruction in eyes with chronic cicatrising disease. METHODS This retrospective cohort study involved 16 eyes of 15 patients who underwent COMET for symblepharon release and fornix reconstruction between June 2002 and December 2008. The mean postoperative follow-up period was 102.1±46.0 months (range: 32-183 months). The treated cicatrising disorders included ocular cicatricial pemphigoid (OCP, five eyes), thermal/chemical injury (three eyes) and other chronic diseases (seven eyes; including recurrent pterygium (two eyes), Stevens-Johnson syndrome (one eye) and graft-versus-host disease (one eye)). Ocular-surface appearance was evaluated before surgery, at 1, 4, 12 and 24 weeks postoperative, and then annually based on the previously reported scoring system. Main outcome measures included overall and disease-specific fornix-reconstruction success probabilities analysed by the Kaplan-Meier survival curve. Symblepharon/fornix-shortening recurrence at 24 weeks postoperative, and its relationship to long-term surgical success was also examined. RESULTS At 5 years postoperative, the mean±SD overall fornix-reconstruction success probability was 79.6%±10.7%, and success probability for thermal/chemical injury and OCP was 100% and 53.3%±24.8%, respectively (p=0.53, log-rank test). The 3-year success probability was significantly higher in the no-disease-recurrence group at 24 weeks postoperative (13 eyes) than in the disease-recurrence group (three eyes) (100% and 33.3%±27.2%, respectively) (p=0.0073, log-rank test). CONCLUSION COMET was found to be safe and effective for symblepharon release and long-term fornix reconstruction in eyes with chronic cicatrisation. Although the 5-year success probability differed depend on the underlying disease, ocular-surface appearance at 24 weeks postoperative is a factor for predicting long-term outcome.
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Affiliation(s)
- Seitaro Komai
- Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Tsutomu Inatomi
- Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.,Ophthalmology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Takahiro Nakamura
- Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Mayumi Ueta
- Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Go Horiguchi
- Clinical and Translational Research Center, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satoshi Teramukai
- Biostatistics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yasuko Kimura
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan
| | - Tatsuo Kagimura
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan
| | | | - Shigeru Kinoshita
- Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chie Sotozono
- Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
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21
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Ogata H, Fukagawa M, Hirakata H, Kagimura T, Fukushima M, Akizawa T. Effect of Treating Hyperphosphatemia With Lanthanum Carbonate vs Calcium Carbonate on Cardiovascular Events in Patients With Chronic Kidney Disease Undergoing Hemodialysis: The LANDMARK Randomized Clinical Trial. JAMA 2021; 325:1946-1954. [PMID: 34003226 PMCID: PMC8132143 DOI: 10.1001/jama.2021.4807] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 03/12/2021] [Indexed: 11/14/2022]
Abstract
Importance Among patients with hyperphosphatemia undergoing dialysis, it is unclear whether non-calcium-based phosphate binders are more effective than calcium-based binders for reducing cardiovascular events. Objective To determine whether lanthanum carbonate reduces cardiovascular events compared with calcium carbonate in patients with hyperphosphatemia at risk of vascular calcification undergoing hemodialysis. Design, Setting, and Participants Open-label, randomized, parallel-group clinical trial with blinded end point adjudication performed in 2374 patients with chronic kidney disease from 273 hemodialysis facilities in Japan. Eligible patients had hyperphosphatemia and 1 or more risk factors for vascular calcification (ie, ≥65 years, postmenopausal, diabetes). Enrollment occurred from November 2011 to July 2014; follow-up ended June 2018. Interventions Patients were randomized to receive either lanthanum carbonate (n = 1154) or calcium carbonate (n = 1155) and titrated to achieve serum phosphate levels of between 3.5 mg/dL and 6.0 mg/dL. Main Outcomes and Measures The primary outcome was a composite cardiovascular event (cardiovascular death, nonfatal myocardial infarction or stroke, unstable angina, transient ischemic attack, or hospitalization for heart failure or ventricular arrhythmia). Secondary outcomes included overall survival, secondary hyperparathyroidism-free survival, hip fracture-free survival, and adverse events. Results Among 2309 randomized patients (median age, 69 years; 40.5% women), 1851 (80.2%) completed the trial. After a median follow-up of 3.16 years, cardiovascular events occurred in 147 of 1063 patients in the lanthanum calcium group and 134 of 1072 patients in the calcium carbonate group (incidence rate, 4.80 vs 4.30 per 100 person-years; difference 0.50 per 100 person-years [95% CI, -0.57 to 1.56]; hazard ratio [HR], 1.11 [95%, CI, 0.88 to 1.41], P = .37). There were no significant differences in all-cause death (difference, 0.43 per 100 person-years [95% CI, -0.63 to 1.49]; HR, 1.10 [95% CI, 0.88 to 1.37]; P = .42) or hip fracture (difference, 0.10 per 100 person-years [95% CI, -0.26 to 0.47]; HR, 1.21 [95% CI, 0.62 to 2.35]; P = .58). The lanthanum carbonate group had an increased risk of cardiovascular death (difference, 0.61 per 100 person-years [95% CI, 0.02 to 1.21]; HR, 1.51 [95% CI, 1.01 to 2.27]; P = .045) and secondary hyperparathyroidism (difference, 1.34 [95% CI, 0.49 to 2.19]; HR, 1.62 [95% CI, 1.19 to 2.20]; P = .002). Adverse events occurred in 282 (25.7%) in the lanthanum carbonate group and 259 (23.4%) in the calcium carbonate groups. Conclusions and Relevance Among patients undergoing hemodialysis with hyperphosphatemia and at least 1 vascular calcification risk factor, treatment of hyperphosphatemia with lanthanum carbonate compared with calcium carbonate did not result in a significant difference in composite cardiovascular events. However, the event rate was low, and the findings may not apply to patients at higher risk. Trial Registration ClinicalTrials.gov Identifier: NCT01578200; UMIN Clinical Trial Registry Identifier: UMIN000006815.
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Affiliation(s)
- Hiroaki Ogata
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Tsuzuki, Yokohama, Kanagawa, Japan
| | - Masafumi Fukagawa
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | | | - Tatsuo Kagimura
- The Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Chuo-ku, Kobe, Hyogo, Japan
| | - Masanori Fukushima
- The Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Chuo-ku, Kobe, Hyogo, Japan
| | - Tadao Akizawa
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Shinagawa, Tokyo, Japan
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22
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Arai H, Bujo H, Masuda D, Ishibashi T, Nakagawa S, Tanabe K, Kagimura T, Kang HJ, Kim MH, Sung J, Kim SH, Kim CH, Park JE, Ge J, Oh BH, Kita T, Saito Y, Fukushima M, Matsuzawa Y, Yamashita S. Integrated Analysis of Two Probucol Trials for the Secondary Prevention of Atherosclerotic Cardiovascular Events: PROSPECTIVE and IMPACT. J Atheroscler Thromb 2021; 29:850-865. [PMID: 33867420 PMCID: PMC9174092 DOI: 10.5551/jat.62821] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Aims: In this study, we integrated two randomized control trials, PROSPECTIVE and IMPACT, to address the effect of probucol on cerebrocardiovascular events and carotid intima-media thickness (IMT) in Japanese, Korean, and Chinese patients with coronary artery disease (CAD).
Methods: A total of 1,025 patients from the PROSPECTIVE and IMPACT studies were enrolled. The time to the first major adverse cerebrocardiovascular event, in addition to carotid IMT and lipid levels, was compared between the control and probucol groups.
Results: In the integrated analysis, the adjusted hazard ratio (HR) and 95% confidence interval (CI) were 0.67 and 0.44–1.03, respectively, indicating a tendency to show the effect of probucol on cerebrocardiovascular events in secondary prevention. We also found no significant differences between the control and probucol groups in the mean IMT of the carotid arteries and its changes. However, we found a significant decrease in cerebrocardiovascular events in patients with reduced levels of HDL cholesterol (HDL-C) (≥ 6.25 mg/dL) compared with those with levels <6.25 mg/dL (p=0.024), without any increase in adverse events such as severe ventricular arrhythmias.
Conclusion: We demonstrated a marginal effect of probucol on cerebrocardiovascular events in Asian patients with CAD, with reasonable safety profiles. A larger study may be needed to support the effect of probucol for cardiovascular prevention.
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Affiliation(s)
| | - Hideaki Bujo
- Department of Clinical Laboratory and Experimental Research Medicine, Toho University, Sakura Medical Center
| | - Daisaku Masuda
- Rinku Innovation Center for Wellness Care and Activities (RICWA), Rinku General Medical Center
| | | | - Satoshi Nakagawa
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe
| | - Kenichiro Tanabe
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe
| | - Tatsuo Kagimura
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe
| | - Hyun-Jae Kang
- Department of Internal Medicine, Seoul National University Hospital and University College of Medicine, Seoul National University
| | | | - Jidong Sung
- Division of Cardiology, Heart Stroke & Vascular Institute, Samsung Medical Center
| | - Sang-Hyun Kim
- Department of Internal Medicine, Seoul Boramae Hospital and Seoul National University College of Medicine
| | - Cheol-Ho Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital
| | | | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University
| | - Byung-Hee Oh
- Department of Cardiology, Incheon Sejong Hospital, Incheon
| | | | | | - Masanori Fukushima
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe
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23
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Fujimoto Y, Kikawa Y, Kotake T, Tsuyuki S, Takahara S, Yamashiro H, Yoshibayashi H, Takada M, Yasuoka R, Yamagami K, Suwa H, Okuno T, Nakayama I, Kato T, Ogura N, Moriguchi Y, Ishiguro H, Kagimura T, Taguchi T, Sugie T, Toi M. Abstract PS13-31: Prospective observational study to explore the effectiveness of eribulin as first- or second- line chemotherapy in patients with HER2-negative hormone-resistant advanced or metastatic breast cancer (KBCRN A001: E-SPEC study). Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ps13-31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BackgroundEribulin (E) is a chemotherapeutic drug that prolongs overall survival (OS) of patients with HER2-negative advanced or metastatic breast cancer (AMBC), mainly in multi-line chemotherapy (ChT) or later. However, the effectiveness and optimal scheduling of E remain unclear. We prospectively investigated the impact of E use in 1st- and 2nd-line ChT (early E) for patients with endocrine-resistant AMBC.
Methods In this multi-institutional prospective cohort study, we registered patients with hormone receptor-positive AMBC who relapsed during or within 6 months after ending adjuvant endocrine therapy, were refractory to at least one previous endocrine therapy, or patients with triple negative AMBC. The endpoints were 1st-line OS (OS1), 2nd-line OS (OS2), and 3rd-line OS (OS3), defined as the time from the start of treatment to death. In addition, the time from the start of 1st-line ChT to death was also analyzed for 2nd-line and 3rd-line ChT groups. In addition to E therapy, oral FU-based therapies (FU) and anthracycline or taxane-based therapies (A/T) were also analyzed (ClinicalTrial.gov number, NCT02551263).
Results Between June 2015 and July 2017, a total of 201 patients were enrolled, and full analysis was conducted for 180 patients. The median OS1, OS2, and OS3 of all patients was 2.69, 1.74, and 1.13 years, respectively. Major patient characteristics are described in the Table. Concurrent or maintenance endocrine therapy was used by 14.9%, 31.6%, and 12.9% of patients receiving E, FU and A/T in 1st-line ChT, respectively. The median OS of patients using E was OS1: 2.25 years (N=47), OS2: 1.75 years (N=70) and OS3: 0.94 years (N=16). The median OS of patients using A/T was OS1: 2.60 years (N=70), OS2: 1.69 years (N=44) and OS3: 0.96 years (N=49). The median OS of patients using FU was OS1: 3.49 years (N=57), OS2: 2.33 years (N=27), and OS3: 1.45 years (N=24). The time from the start of 1st-line ChT to death was 2.58 and 3.18 years among patients who received E in 2nd- and 3rd-line ChT, respectively. Multivariate analysis of patients who used 1st-line and 2nd-line E demonstrated that higher LDH (≥300) (HR 3.50, 95% CI 1.78-6.73; p<0.001), brain metastasis (HR 2.64, 95% CI 1.02-6.83; p=0.045) and smoker (HR 2.33, 95% CI 1.20-4.53; p=0.013) were associated with shorter OS. Overall, OS data for E were comparable to those for A/T. While OS tended to be better for FU, patient characteristics for 1st-line ChT showed that FU was often used for patients with less aggressive AMBC. We also present data on second progression-free survival and new metastasis-free survival, prognostic factor analysis and prognostic factor-adjusted comparison, and predictive factor analysis for early E.
Conclusions This prospective observational study of AMBC patients showed that E and A/T had similar survival outcomes in each treatment line. While FU led to relatively longer survival, it was often used for patients with less aggressive AMBC. Analysis data on survival outcomes will also be presented.
Patient characteristics according to 1st-line therapyE (n=47)Oral FU based (n=57)A/T based (n=70)Median age (IQR)61(54-71)64(51-68)59(48-66)Triple negative, n (%)15(31.9)11(19.3)23(32.9)Disease-free interval, n (%)<2 years15(31.9)9(15.8)12(17.1)2-5 years12(25.5)18(31.6)15(21.4)5-8 years4(8.5)9(15.8)9(12.9)>8years3(6.4)10(17.5)8(11.4)Stage49(19.1)9(15.8)23(32.9)(neo) Adjuvant chemotherapy, n (%)30(63.8)36(63.2)32(45.7)Metastatic sites at 1st-line ChT, n (%)Liver16(34.0)12(21.1)22(31.4)Lung15(31.9)17(29.8)25(35.7)Bone24(51.1)27(47.3)36(51.4)Brain6(12.8)1(1.8)2(2.9)
Citation Format: Yuri Fujimoto, Yuichiro Kikawa, Takeshi Kotake, Shigeru Tsuyuki, Sachiko Takahara, Hiroyasu Yamashiro, Hiroshi Yoshibayashi, Masahiro Takada, Rie Yasuoka, Kazuhiko Yamagami, Hirofumi Suwa, Toshitaka Okuno, Ichiro Nakayama, Tatsuji Kato, Nobuko Ogura, Yoshio Moriguchi, Hiroshi Ishiguro, Tatsuo Kagimura, Tetsuya Taguchi, Tomoharu Sugie, Masakazu Toi. Prospective observational study to explore the effectiveness of eribulin as first- or second- line chemotherapy in patients with HER2-negative hormone-resistant advanced or metastatic breast cancer (KBCRN A001: E-SPEC study) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS13-31.
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Affiliation(s)
- Yuri Fujimoto
- 1Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Yuichiro Kikawa
- 2Kansai Medical University Hospital / Kobe City Medical Center General Hospital, Osaka, Japan
| | - Takeshi Kotake
- 3Kyoto University Hospital Breast Surgery Department, Kyoto, Japan
| | | | - Sachiko Takahara
- 1Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | | | | | - Masahiro Takada
- 3Kyoto University Hospital Breast Surgery Department, Kyoto, Japan
| | - Rie Yasuoka
- 7Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Hirofumi Suwa
- 9Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | | | | | - Tatsuji Kato
- 12Yamato Takada Municipal Hospital, Yamatotakada, Japan
| | | | | | - Hiroshi Ishiguro
- 15International University of Health and Welfare Hospital Medical Oncology, Narita, Japan
| | - Tatsuo Kagimura
- 16Translational Research Center for Medical Innovation, Kobe, Japan
| | | | | | - Masakazu Toi
- 3Kyoto University Hospital Breast Surgery Department, Kyoto, Japan
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24
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Kang Y, Kikawa Y, Kotake T, Tsuyuki S, Takahara S, Yamashiro H, Yoshibayashi H, Takada M, Yasuoka R, Yamagami K, Suwa H, Okuno T, Nakayama I, Kato T, Moriguchi Y, Ishiguro H, Kagimura T, Taguchi T, Sugie T, Toi M. 52P Chemotherapy selection in routine clinical practice in Japan for HER2-negative advanced or metastatic breast cancer (KBCRN A001: E-SPEC Study). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.072] [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: 11/30/2022] Open
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25
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Shindo A, Tabei KI, Taniguchi A, Nozaki H, Onodera O, Ueda A, Ando Y, Urabe T, Kimura K, Kitagawa K, Hanyu H, Hirano T, Wakita H, Fukuyama H, Kagimura T, Miyamoto Y, Takegami M, Saito S, Watanabe-Hosomi A, Mizuta I, Ihara M, Mizuno T, Tomimoto H. A Nationwide Survey and Multicenter Registry-Based Database of Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy in Japan. Front Aging Neurosci 2020; 12:216. [PMID: 32765252 PMCID: PMC7381163 DOI: 10.3389/fnagi.2020.00216] [Citation(s) in RCA: 5] [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: 12/03/2019] [Accepted: 06/19/2020] [Indexed: 01/16/2023] Open
Abstract
Objectives Clinical characteristics of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) include migraine, recurrent stroke, white matter lesions, and vascular dementia. CADASIL is one of the most common hereditary cerebral small vessel diseases. Clinical presentation of CADASIL varies and a racial gap may exist between the Asian and Caucasian populations. This is the first nationwide epidemiological survey which aimed to elucidate the clinical features of CADASIL in Japan. Moreover, the registration database of CADASIL was constructed. Methods Subjects included CADASIL patients who visited the hospitals (totally 1,448 hospitals) certified by the Japanese Society of Neurology and/or Japan Stroke Society in 2016. This study consisted of a two-step survey; patients with CADASIL were identified genetically by the first questionnaire, and their clinical features were assessed by the second questionnaire. Selected 6 hospitals registered the data of all CADASIL patients using a Research Electronic Data Capture (REDCap) system for the second questionnaire. Results Based on the criteria, 88 patients (50 male and 38 female) with CADASIL were enrolled. The mean age of symptom onset was 49.5 years. Sixteen (18.2%) patients had an elderly onset (>60 years). Thirteen patients (13.6%) had history of migraine with aura and 33 patients (37.5%) had vascular risk factor(s). From among the 86 patients who were examined using magnetic resonance imaging, abnormal deep white matter lesions were detected in 85 patients (98.8%), WMLs extending to anterior temporal pole in 73 patients (84.9%), and cerebral microbleeds in 41 patients (47.7%). Anti-platelet therapy was received by 65 patients (73.9%). Thirty-eight patients (43.2%) underwent treatment with lomerizine hydrochloride. Thirty-four different mutations of NOTCH3 were found in exons 2, 3, 4, 5, 6, 8, 11, 14, and 19. Most of the mutations existed in exon 4 (n = 44, 60.3%). The prevalence rate of CADASIL was 1.20 to 3.58 per 100,000 adults in Japan. Conclusion This questionnaire-based study revealed clinical features and treatment status in Japanese CADASIL patient, although it may not be an exhaustive search. We have constructed the REDCap database for these CADASIL patients.
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Affiliation(s)
- Akihiro Shindo
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Ken-Ichi Tabei
- Department of Dementia Prevention and Therapeutics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Akira Taniguchi
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hiroaki Nozaki
- Department of Neurology, Clinical Neuroscience Branch, Brain Research Institute, Niigata University, Niigata, Japan
| | - Osamu Onodera
- Department of Neurology, Clinical Neuroscience Branch, Brain Research Institute, Niigata University, Niigata, Japan
| | - Akihiko Ueda
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yukio Ando
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Department of Amyloidosis Research, Nagasaki International University, Nagasaki, Japan
| | - Takao Urabe
- Department of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Kazumi Kimura
- Department of Neurology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
| | - Haruo Hanyu
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Teruyuki Hirano
- Department of Stroke and Cerebrovascular Medicine, Kyorin University, Tokyo, Japan
| | - Hideaki Wakita
- Department of Internal Medicine, Nanakuri Memorial Hospital, Fujita Health University, Tsu, Japan
| | - Hidenao Fukuyama
- Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Tatsuo Kagimura
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan
| | - Yoshihiro Miyamoto
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Satoshi Saito
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Akiko Watanabe-Hosomi
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ikuko Mizuta
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Toshiki Mizuno
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hidekazu Tomimoto
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Japan
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26
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Hosomi N, Kitagawa K, Nagai Y, Nakagawa Y, Aoki S, Nezu T, Kagimura T, Maruyama H, Origasa H, Minematsu K, Uchiyama S, Matsumoto M. Different Influences of Statin Treatment in Preventing At-Risk Stroke Subtypes: A Post Hoc Analysis of J-STARS. J Atheroscler Thromb 2020; 27:449-460. [PMID: 31534062 PMCID: PMC7242230 DOI: 10.5551/jat.50518] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aims: To understand the different influences of statins on the incidence rate of each stroke subtype in association with low-density lipoprotein (LDL) cholesterol levels, we performed a post hoc analysis on the data from the Japan Statin Treatment Against Recurrent Stroke (J-STARS) study. Methods: Subjects (n = 1,578) were divided into three groups according to their mean postrandomized LDL cholesterol level (< 100, 100–120, and ≥ 120 mg/dL) until the last observation before the event or the end of follow-up. A Cox proportional hazard model for time to events was used for calculating adjusted hazard ratios, 95% confidence intervals, and the trend tests. Results: The event rates for atherothrombotic stroke did not decrease in accordance with the postrandomized LDL cholesterol level subgroups of either the control or the pravastatin group (p = 0.15 and 0.33 for the trend, respectively). In the control group, however, no atherothrombotic stroke event was observed in the subgroup of the low postrandomized LDL cholesterol level (less than 100 mg/dL). The event rates for atherothrombotic stroke were lower in the middle postrandomized LDL cholesterol level subgroup (100–120 mg/dL) of the pravastatin group than that of the control group. The event rates for lacunar stroke decreased in the lower postrandomized LDL cholesterol level subgroup of the control group but not of the pravastatin group (p = 0.004 and 0.06 for the trend, respectively). Conclusions: Statins showed different influences on the risks of atherothromobotic and lacunar stroke according to postrandomized LDL cholesterol levels.
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Affiliation(s)
- Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University School of Medicine
| | - Yoji Nagai
- Center for Clinical Research, Kobe University Hospital
| | - Yoko Nakagawa
- Division of Medical Statistics, Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tatsuo Kagimura
- Division of Medical Statistics, Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences
| | | | - Shinichiro Uchiyama
- Clinical Research Center, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.,Sakai City Medical Center, Sakai City Hospital Organization
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27
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Zhou B, Zhao Q, Kojima S, Ding D, Higashide S, Nagai Y, Guo Q, Kagimura T, Fukushima M, Hong Z. One-year Outcome of Shanghai Mild Cognitive Impairment Cohort Study. Curr Alzheimer Res 2020; 16:156-165. [PMID: 30484408 DOI: 10.2174/1567205016666181128151144] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/06/2018] [Accepted: 11/22/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND & OBJECTIVE The purpose of this study is to identify the risk factors associated with the conversion from Mild Cognitive Impairment (MCI) to Alzheimer's Disease (AD) dementia for the early detection of AD. METHODS The study comprised a prospective cohort study that included 400 MCI subjects with annual follow-ups for 3 years. RESULTS During the first 12 months' follow-up, 42 subjects converted to Alzheimer's dementia (21 probable AD and 21 possible AD), two subjects converted to other types of dementia and 56 subjects lost follow. The factors associated with a greater risk of conversion from MCI to AD included gender, whole brain volume, and right hippocampal volume (rt. HV), as well as scores on the Revised Chinese version of the Alzheimer's Disease Assessment Scale-Cognitive subscale 13 (ADAS-Cog-C), Clock Drawing Test (CDT), Symbol Digit Modalities Test (SDMT), and Rey-Osterrieth Complex Figure Test (ROCFT). The risk classification of the combined ADAS-Cog-C and Alzheimer Cognitive Composite (ACC) score with the rt. HV and left Entorhinal Cortex Volume (lt. ECV) showed a conversion difference among the groups. CONCLUSION Early detection of AD and potential selection for clinical trial design should utilize the rt. HV, as well as neuropsychological test scores, including those of the ADAS-Cog-C and ACC.
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Affiliation(s)
- Bin Zhou
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Qianhua Zhao
- Institute of Neurology, Huashan Hospital Fudan University, Shanghai, China.,Department of Neurology, Huashan Hospital Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Shinsuke Kojima
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Ding Ding
- Institute of Neurology, Huashan Hospital Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Satoshi Higashide
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Yoji Nagai
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Qihao Guo
- Department of Neurology, Huashan Hospital Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Tatsuo Kagimura
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Masanori Fukushima
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Zhen Hong
- Institute of Neurology, Huashan Hospital Fudan University, Shanghai, China.,Department of Neurology, Huashan Hospital Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Paoletti X, Lewsley LA, Daniele G, Cook A, Yanaihara N, Tinker A, Kristensen G, Ottevanger PB, Aravantinos G, Miller A, Boere IA, Fruscio R, Reyners AKL, Pujade-Lauraine E, Harkin A, Pignata S, Kagimura T, Welch S, Paul J, Karamouza E, Glasspool RM. Assessment of Progression-Free Survival as a Surrogate End Point of Overall Survival in First-Line Treatment of Ovarian Cancer: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e1918939. [PMID: 31922558 PMCID: PMC6991254 DOI: 10.1001/jamanetworkopen.2019.18939] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/21/2019] [Indexed: 11/20/2022] Open
Abstract
Importance The Gynecologic Cancer InterGroup (GCIG) recommended that progression-free survival (PFS) can serve as a primary end point instead of overall survival (OS) in advanced ovarian cancer. Evidence is lacking for the validity of PFS as a surrogate marker of OS in the modern era of different treatment types. Objective To evaluate whether PFS is a surrogate end point for OS in patients with advanced ovarian cancer. Data Sources In September 2016, a comprehensive search of publications in MEDLINE was conducted for randomized clinical trials of systematic treatment in patients with newly diagnosed ovarian, fallopian tube, or primary peritoneal cancer. The GCIG groups were also queried for potentially completed but unpublished trials. Study Selection Studies with a minimum sample size of 60 patients published since 2001 with PFS and OS rates available were eligible. Investigational treatments considered included initial, maintenance, and intensification therapy consisting of agents delivered at a higher dose and/or frequency compared with that in the control arm. Data Extraction and Synthesis Using the meta-analytic approach on randomized clinical trials published from January 1, 2001, through September 25, 2016, correlations between PFS and OS at the individual level were estimated using the Kendall τ model; between-treatment effects on PFS and OS at the trial level were estimated using the Plackett copula bivariate (R2) model. Criteria for PFS surrogacy required R2 ≥ 0.80 at the trial level. Analysis was performed from January 7 through March 20, 2019. Main Outcomes and Measures Overall survival and PFS based on measurement of cancer antigen 125 levels confirmed by radiological examination results or by combined GCIG criteria. Results In this meta-analysis of 17 unique randomized trials of standard (n = 7), intensification (n = 5), and maintenance (n = 5) chemotherapies or targeted treatments with data from 11 029 unique patients (median age, 58 years [range, 18-88 years]), a high correlation was found between PFS and OS at the individual level (τ = 0.724; 95% CI, 0.717-0.732), but a low correlation was found at the trial level (R2 = 0.24; 95% CI, 0-0.59). Subgroup analyses led to similar results. In the external validation, 14 of the 16 hazard ratios for OS in the published reports fell within the 95% prediction interval from PFS. Conclusions and Relevance This large meta-analysis of individual patient data did not establish PFS as a surrogate end point for OS in first-line treatment of advanced ovarian cancer, but the analysis was limited by the narrow range of treatment effects observed or by poststudy treatment. These results suggest that if PFS is chosen as a primary end point, OS must be measured as a secondary end point.
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Affiliation(s)
- Xavier Paoletti
- Groupe d’investigateurs national des Etudes des Cancers Ovariens (GINECO), Paris, France
- Gustave Roussy Cancer Center and Institut National de la Santé et de la Recherche Medicale Oncostat, Villejuif, France
- Department of Biostatistics, University of Versailles St Quentin, Institut Curie, Saint-Cloud, France
| | - Liz-Anne Lewsley
- Scottish Gynaecological Cancer Trials Group (SGCTG), Cancer Research United Kingdom Clinical Trial Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Gennaro Daniele
- Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO), Clinical Trials Unit, Istituto Nazionale Tumori– Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G. Pascale, Napoli, Italia
| | - Adrian Cook
- Medical Research Counsel Clinical Trials Unit, University College London, London, United Kingdom
| | - Nozomu Yanaihara
- Japanese Gynecologic Oncology Group (JGOG), Jikei University School of Medicine, Tokyo, Japan
| | - Anna Tinker
- Canadian Cancer Trials Group (CCTG), University of British Columbia, Vancouver, British Columbia, Canada
| | - Gunnar Kristensen
- Nordic Society of Gynaecological Oncology, Norwegian Radium Hospital, Oslo, Norway
| | - Petronella B. Ottevanger
- European Organisation for Research and Treatment of Cancer, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Gerasimos Aravantinos
- Hellenic Cooperative Oncology Group, General Oncology Hospital of Kifissia, Nea Kifissia, Greece
| | - Austin Miller
- Gynecologic Oncology Group (GOG), Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Ingrid A. Boere
- Department of Medical Oncology, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands
| | - Robert Fruscio
- University of Milan Bicocca, San Gerardo Hospital, Monza, Italy
| | - Anna K. L. Reyners
- University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Eric Pujade-Lauraine
- Association de Recherche sur les Cancers dont Gynécologiques–GINECO, Université Paris Descartes, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Andrea Harkin
- Scottish Gynaecological Cancer Trials Group (SGCTG), Cancer Research United Kingdom Clinical Trial Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sandro Pignata
- MITO, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G Pascale, Napoli, Italy
| | - Tatsuo Kagimura
- JGOG, Foundation for Biomedical Research and Innovation at Kobe, Translational Research Center for Medical Innovation, Kobe, Japan
| | - Stephen Welch
- CCTG, London Health Sciences Centre, London, Ontario, Canada
| | - James Paul
- Scottish Gynaecological Cancer Trials Group (SGCTG), Cancer Research United Kingdom Clinical Trial Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Rosalind M. Glasspool
- SGCTG, Beatson West of Scotland Cancer Centre, NHS (National Health Service) Greater Glasgow and Clyde, Glasgow, United Kingdom
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29
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Nezu T, Hosomi N, Kitagawa K, Nagai Y, Nakagawa Y, Aoki S, Kagimura T, Maruyama H, Origasa H, Minematsu K, Uchiyama S, Matsumoto M. Effect of Statin on Stroke Recurrence Prevention at Different Infarction Locations: A Post Hoc Analysis of The J-STARS Study. J Atheroscler Thromb 2019; 27:524-533. [PMID: 31554765 PMCID: PMC7355099 DOI: 10.5551/jat.51391] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Aim: Posterior circulation stroke (PCS) has different clinical features and prognosis compared with anterior circulation stroke (ACS), and whether the effect of statin therapy on stroke prevention differs according to infarction location remains unclear. This post hoc analysis of the J-STARS study aimed to compare the usefulness of statin at different infarction locations (i.e., ACS and PCS). Methods: In the J-STARS study, 1578 patients were randomly assigned to the pravastatin or control group. The subjects were divided into two subgroups (ACS and PCS groups) based on the arteries responsible for the infarction. Cox proportional hazards models were used to investigate whether the all stroke recurrence rate was different between the ACS and PCS groups. Results: The PCS group (n = 499) had a significantly higher prevalence of diabetes than the ACS group (n = 1022) (30.7% vs. 19.8%, P < 0.001). During the follow-up (4.9 ± 1.4 years), the incidence of all stroke was significantly lower in the pravastatin group than in the control group among patients with PCS (adjusted hazard ratio [HR] 0.46, 95% confidence interval [CI] 0.25–0.83, P = 0.009); however, the stroke recurrence rates were not significantly different between both groups among patients with ACS (adjusted HR 1.32, 95% CI 0.93–1.88, P = 0.123). A significant interaction between the ACS and PCS groups in terms of pravastatin effects was noted (P = 0.003 for interaction). Conclusions: Pravastatin significantly reduced the recurrence rate of all stroke among patients with PCS. Thus, the effect of statin on the recurrence of stroke may differ according to infarction location.
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Affiliation(s)
- Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University School of Medicine
| | - Yoji Nagai
- Center for Clinical Research, Kobe University Hospital
| | - Yoko Nakagawa
- Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tatsuo Kagimura
- Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences
| | | | - Shinichiro Uchiyama
- Clinical Research Center for Medicine, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.,Sakai City Medical Center, Sakai City Hospital Organization
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30
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Watanabe M, Nakamura Y, Yoshiyama Y, Kagimura T, Kawaguchi H, Matsuzawa H, Tachibana Y, Nishimura K, Kubota N, Kobayashi M, Saito T, Tamura K, Sato T, Takahashi M, Homma A. Analyses of natural courses of Japanese patients with Alzheimer's disease using placebo data from placebo-controlled, randomized clinical trials: Japanese Study on the Estimation of Clinical course of Alzheimer's disease. Alzheimers Dement (N Y) 2019; 5:398-408. [PMID: 31517028 PMCID: PMC6727219 DOI: 10.1016/j.trci.2019.07.004] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction Symptomatic anti-Alzheimer's disease (AD) drugs have been commonly used for the treatment of AD. Knowing the natural courses of patients with AD on placebo is highly relevant for clinicians to understand their efficacy and for investigators to design clinical studies. Methods The data on rating scales for dementia such as Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and Severe Impairment Battery were extracted from eight previous Japanese Phase II and III studies. Natural courses of Japanese AD patients in placebo groups were evaluated and statistically analyzed in a pooled and retrospective fashion. Results Decreases in ADAS-cog and Severe Impairment Battery was larger at week 22 or 24 than at week 12. Scores of ADAS-cog appeared to deteriorate faster in moderate AD than in mild AD. Discussion The present data will provide clinicians following up patients with AD with helpful information on how to manage AD patients and investigators with instruction for clinical study design.
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Affiliation(s)
- Mitsunori Watanabe
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan
| | - Yu Nakamura
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan.,Department of Neuropsychiatry, Kagawa University School of Medicine, Kagawa, Japan
| | - Yasumasa Yoshiyama
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan.,Inage Neurology and Memory Clinic, Chiba, Japan
| | - Tatsuo Kagimura
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan.,Translational Research Center for Medical Innovation (TRI), Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan
| | - Hiroyuki Kawaguchi
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan
| | - Hiroshi Matsuzawa
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan
| | - Yosuke Tachibana
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan
| | - Kazuma Nishimura
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan
| | - Naoki Kubota
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan
| | - Masato Kobayashi
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan
| | - Takayuki Saito
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan
| | - Kaoru Tamura
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan
| | - Takayuki Sato
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan
| | - Masayoshi Takahashi
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan
| | | | - Akira Homma
- Japanese Society of Scaling Keys of Evaluation Techniques for CNS Disorders Heterogeneity (SKETCH), Tokyo, Japan.,Otafuku Memory Clinic, Ibaraki, Japan
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31
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Wada S, Koga M, Minematsu K, Toyoda K, Suzuki R, Kagimura T, Nagai Y, Aoki S, Nezu T, Hosomi N, Origasa H, Ohtsuki T, Maruyama H, Yasaka M, Kitagawa K, Uchiyama S, Matsumoto M. Baseline Carotid Intima-Media Thickness and Stroke Recurrence During Secondary Prevention With Pravastatin. Stroke 2019; 50:1586-1589. [DOI: 10.1161/strokeaha.119.024968] [Citation(s) in RCA: 8] [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: 11/16/2022]
Affiliation(s)
- Shinichi Wada
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (S.W., M.K., K.M., K.T., R.S.)
| | - Masatoshi Koga
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (S.W., M.K., K.M., K.T., R.S.)
| | - Kazuo Minematsu
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (S.W., M.K., K.M., K.T., R.S.)
| | - Kazunori Toyoda
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (S.W., M.K., K.M., K.T., R.S.)
| | - Rieko Suzuki
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (S.W., M.K., K.M., K.T., R.S.)
| | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innovation at Kobe, Translational Research Center for Medical Innovation, Japan (T.K.)
| | - Yoji Nagai
- Center for Clinical Research, Kobe University Hospital, Japan (Y.N.)
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.)
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.)
| | - Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.)
| | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Science, Japan (H.O.)
| | - Toshiho Ohtsuki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.)
- Stroke Center, Kinki University Hospital, Osakasayama, Japan (T.O.)
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.)
| | - Masahiro Yasaka
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.)
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.)
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women’s Medical University, Japan (K.K.)
| | - Shinichiro Uchiyama
- Clinical Research Center for Medicine, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.)
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32
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Yasuno M, Uetake H, Ishiguro M, Mizunuma N, Komori T, Miyata G, Shiomi A, Kagimura T, Sugihara K. mFOLFOX6 plus bevacizumab to treat liver-only metastases of colorectal cancer that are unsuitable for upfront resection (TRICC0808): a multicenter phase II trial comprising the final analysis for survival. Int J Clin Oncol 2019; 24:516-525. [PMID: 30612267 PMCID: PMC6469677 DOI: 10.1007/s10147-018-01393-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 12/06/2018] [Accepted: 12/27/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND The TRICC0808 trial is a phase II multi-institutional trial that investigated the efficacy of preoperative mFOLFOX6 + bevacizumab (BV) therapy for liver-only metastasis that is unsuitable for upfront resection. The R0 resection rate in the efficacy analysis has been reported to be 44.4%, and the final analysis for survival was conducted (data fixation on February 16, 2015). METHODS Six cycles of mFOLFOX6 + BV therapy were applied to patients with liver-only metastases, which were > 5 cm in diameter or more than four tumors (H2 and H3), and hepatectomy was performed if possible. Primary and secondary endpoints were the R0 hepatectomy rate and overall survival (OS), respectively. RESULTS Of 46 patients registered, OS was analyzed for 45 patients in whom the 3-year OS rate from the starting date of chemotherapy was 44.0% with a 33.6-month median survival time (MST). The 3-year OS rate of 31 patients with hepatectomy, including resection after an additional chemotherapy, was 61.3% with a 43.1-month MST, which was significantly better than 0% of the 3-year OS rate with a 21.0-month MST of 14 patients without hepatectomy (p value < 0.0001). In 24 patients who underwent hepatectomy after six cycles of protocol chemotherapy, the 3-year relapse-free survival rate was 8.3%, with a 36.8-month MST. CONCLUSIONS This final analysis of the TRICC0808 trial revealed a better long-term survival in patients with hepatectomy after mFOLFOX6 + BV therapy, although most examined patients eventually developed recurrence. Thus, hepatectomy after chemotherapy might improve the survival in patients with advanced liver metastases, although cure remains difficult.
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Affiliation(s)
- Masamichi Yasuno
- Institute of Global Affairs, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Hiroyuki Uetake
- Department of Specialized Surgeries, Tokyo Medical and Dental University, Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Megumi Ishiguro
- Department of Specialized Surgeries, Tokyo Medical and Dental University, Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Nobuyuki Mizunuma
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto, Tokyo, 135-8550, Japan
| | - Takamichi Komori
- Department of Surgery, Osaka General Medical Center, 3-1-56 Bandai-Higashi, Sumiyoshi, Osaka, 558-8558, Japan
| | - Go Miyata
- Department of Surgery, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, Iwate, 020-0066, Japan
| | - Akio Shiomi
- Colon and Rectal Surgery, Shizuoka Cancer Center, 1007 Shimonogakubo, Nagaizumi, Shunto, Shuzuoka, 411-8777, Japan
| | - Tatsuo Kagimura
- Department of Statistical Analysis, Translational Research Informatics Center, 1-5-4 Minatojima-minamimachi, Chou, Kobe, Hyogo, 650-0047, Japan
| | - Kenichi Sugihara
- Tokyo Medical and Dental University, Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
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33
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Oki R, Izumi Y, Nodera H, Sato Y, Nokihara H, Kanai K, Sonoo M, Urushitani M, Nishinaka K, Atsuta N, Kohara N, Shimizu T, Kikuchi H, Oda M, Ikeda K, Nagai M, Komai K, Kojima Y, Kuzume D, Isose S, Shimohama S, Abe K, Ito H, Noda K, Ishihara T, Morita M, Shimohata T, Teramukai S, Kagimura T, Noma K, Yanagawa H, Kuwabara S, Kaji R. The Japanese Early-Stage Trial of High-Dose Methylcobalamin for Amyotrophic Lateral Sclerosis (JETALS): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e12046. [PMID: 30578206 PMCID: PMC6320396 DOI: 10.2196/12046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 11/17/2022] Open
Abstract
Background Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that affects the upper and lower motor neurons. Currently, only riluzole and edaravone are approved as drugs to treat ALS and new agents with larger effect sizes are warranted. Exploratory analyses in our previous study (study ID #E0302-J081-761) have suggested that high-dose methylcobalamin (E0302) prolonged the overall survival of ALS patients and suppressed ALS progression in patients with a disease duration of less than 12 months. Objective This clinical trial aims to evaluate the efficacy and safety of E0302 for treatment of ALS patients within one year of onset. Methods The Japanese early-stage trial of high-dose methylcobalamin for ALS (JETALS) is a prospective, multicenter, placebo-controlled, double-blind, randomized phase III study conducted at 24 tertiary neurology centers and is funded by the Japan Agency for Medical Research and Development. A total of 128 ALS patients within one year of onset were randomized at a 1:1 ratio to receive intramuscular injection with E0302 50 mg or placebo twice a week for 16 weeks. The primary endpoint is changes in the ALS Functional Rating Scale-Revised (ALSFRS-R) total score at 16 weeks. If patients wish to receive E0302 50 mg after the double-blind administration period, E0302 will be provided to them until March 2020 during the continuous administration period. Results This study began in October 2017 and is being conducted at 24 participating institutions in Japan. The study is in progress and the patient enrollment period is scheduled to end in August 2019, with follow-up scheduled to end in March 2020. Conclusions This study is being performed to revalidate the efficacy and safety of E0302 in patients with early-stage ALS in the first year of symptom onset. If positive results are obtained, the aim is to apply for E0302 approval as a new drug for the treatment of ALS. Trial Registration ClinicalTrials.gov NCT03548311; https://clinicaltrials.gov/ct2/show/NCT03548311 (Archived by WebCite at http://www.webcitation.org/74Fw3rDzb) International Registered Report Identifier (IRRID) PRR1-10.2196/12046
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Affiliation(s)
- Ryosuke Oki
- Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yuishin Izumi
- Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hiroyuki Nodera
- Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yasutaka Sato
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Hiroshi Nokihara
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Kazuaki Kanai
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Masahiro Sonoo
- Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan
| | - Makoto Urushitani
- Department of Neurology, Shiga University of Medical Science, Otsu, Japan
| | | | - Naoki Atsuta
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuo Kohara
- Department of Neurology, Kobe City Medical Centre General Hospital, Kobe, Japan
| | - Toshio Shimizu
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Hitoshi Kikuchi
- Department of Neurology, Murakami Karindo Hospital, Fukuoka, Japan
| | - Masaya Oda
- Department of Neurology, Vihara Hananosato Hospital, Miyoshi, Japan
| | - Ken Ikeda
- Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan
| | - Makiko Nagai
- Department of Neurology, Kitasato University East Hospital, Sagamihara, Japan
| | - Kiyonobu Komai
- Department of Neurology, National Hospital Organization Iou Hospital, Kanazawa, Japan
| | - Yasuhiro Kojima
- Department of Neurology, Takeda General Hospital, Kyoto, Japan
| | - Daisuke Kuzume
- Department of Neurology, Chikamori Hospital, Kochi, Japan
| | - Sagiri Isose
- Department of Neurology, National Hospital Organization Chiba-East Hospital, Chiba, Japan
| | - Shun Shimohama
- Department of Neurology, Sapporo Medical University, Sapporo, Japan
| | - Koji Abe
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Hidefumi Ito
- Department of Neurology, Wakayama Medical University, Wakayama, Japan
| | - Kazuyuki Noda
- Department of Neurology, Juntendo University Shizuoka Hospital, Izunokuni, Japan
| | - Tomohiko Ishihara
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Mitsuya Morita
- Division of Neurology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
| | - Takayoshi Shimohata
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Satoshi Teramukai
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tatsuo Kagimura
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Kensuke Noma
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.,Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Hiroaki Yanagawa
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ryuji Kaji
- Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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Umeda-Kameyama Y, Mori T, Wada-Isoe K, Kikuchi T, Kojima S, Kagimura T, Ueki A, Watabe T, Kudoh C, Akishita M, Nakamura Y. Development of a novel convenient Alzheimer's disease assessment scale, the ABC Dementia Scale, using item response theory. Geriatr Gerontol Int 2018; 19:18-23. [PMID: 30467944 PMCID: PMC7380014 DOI: 10.1111/ggi.13552] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 09/25/2018] [Indexed: 11/29/2022]
Abstract
Aim The present study aimed to assess the interrater reliability and construct the validity of a novel, convenient informant‐based Alzheimer's disease assessment scale to prepare its final version. Methods For the assessment, site investigators, co‐medicals and, if available, medical staff other than doctors or co‐medicals interviewed study informants to assess individuals using this scale. We then analyzed the interrater reliability and construct validity using factor analysis and item response characteristics. Results In this study, 427 eligible participants were enrolled. We first examined the interrater reliability, and found that the lower limit of the confidence interval of each item was never <0.4 (except for the item “delusion of theft”). After deleting this item, the 14 items of this scale were organized into three domains (activities of daily living, behavioral and psychological symptoms of dementia, and cognitive function) through factor analysis. After discussion of the similarity of two items and their integration into one item, we confirmed that the final version of the 13‐item scale showed almost the same degree of interrater reliability and construct validity as the former version of this scale. Conclusions The final version of this novel Alzheimer's disease assessment scale had high interrater reliability and construct validity. We named it the ABC (activities of daily living, behavioral and psychological symptoms of dementia, and cognitive function) Dementia Scale. Further studies on its validation are required. Geriatr Gerontol Int 2019; 19: 18–23.
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Affiliation(s)
- Yumi Umeda-Kameyama
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takahiro Mori
- Department of Neuropsychiatry, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Kenji Wada-Isoe
- Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Takashi Kikuchi
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Hyogo, Japan
| | - Shinsuke Kojima
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Hyogo, Japan
| | - Tatsuo Kagimura
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Hyogo, Japan
| | - Akinori Ueki
- Ueki Dementia and Geriatric Psychiatry Clinic, Hyogo, Japan
| | | | - Chiaki Kudoh
- KUDOH CHIAKI Clinic for Neurosurgery & Neurology, Tokyo, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yu Nakamura
- Department of Neuropsychiatry, Faculty of Medicine, Kagawa University, Kagawa, Japan
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Kitagawa K, Hosomi N, Nagai Y, Kagimura T, Ohtsuki T, Maruyama H, Origasa H, Minematsu K, Uchiyama S, Nakamura M, Matsumoto M. Cumulative Effects of LDL Cholesterol and CRP Levels on Recurrent Stroke and TIA. J Atheroscler Thromb 2018; 26:432-441. [PMID: 30318492 PMCID: PMC6514170 DOI: 10.5551/jat.45989] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
AIMS To investigate the relative contribution of on-treatment low-density lipoprotein (LDL) cholesterol and C-reactive protein (CRP) to the risk of recurrent stroke and transient ischemic attack (TIA) in patients with history of ischemic stroke. METHODS A total of 1095 patients with non-cardioembolic ischemic stroke were randomized into two groups: control and patients receiving 10 mg of pravastatin per day. After excluding 18 patients who did not have baseline CRP data, the effects of LDL cholesterol and CRP on recurrent stroke and TIA were prospectively assessed in 1077 patients. RESULTS During the follow-up of 4.9±1.4 years, there were 131 recurrent stroke or TIA cases. Patients with ontreatment LDL cholesterol <120 mg/dL showed 29% reduction in recurrent stroke and TIA than those with LDL cholesterol ≥ 120 mg/dL (event rate 2.20 vs. 3.11 per 100 person-years, hazard ratio [HR] 0.71, 95% confidence interval (CI) 0.50-0.99, p=0.048). Patients with CRP <1 mg/L had 32% reduction compared with that of patients with CRP ≥ 1 mg/L (event rate 2.26 vs. 3.40 per 100 person-years; HR 0.68, 95% CI 0.48-0.96, p=0.031). Although LDL cholesterol and CRP levels were not correlated in individual patients, those who achieved both LDL cholesterol <120 mg/dL and CRP <1 mg/L showed 51% reduction compared with that of patients with LDL cholesterol ≥ 120 mg/dL and CRP ≥ 1 mg/L (event rate 2.02 vs. 4.19 per 100 person-years; HR 0.49, 95% CI 0.31-0.79). CONCLUSIONS The control of both LDL cholesterol and CRP levels appears to be effective for preventing recurrent stroke and TIA in patients with non-cardiogenic ischemic stroke.
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Affiliation(s)
- Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University
| | - Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yoji Nagai
- Clinical and Translational Research Center, Kobe University Hospital
| | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innovation at Kobe, Translational Research Center for Medical Innovation
| | | | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences
| | | | - Shinichiro Uchiyama
- Clinical Research Center, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Medical Center
| | | | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.,Sakai City Medical Center, Sakai City Hospital Organization
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Paoletti X, Lewsley LA, Daniele G, Cook AD, Yanaihara N, Tinker A, Kristensen G, Ottevanger PB, Aravantinos G, Boere IA, Fruscio R, Reyners AK, Pujade-Lauraine E, Harkin A, Pignata S, Kagimura T, Welch S, Eleni K, Glasspool RM. Progression free survival (PFS) as a surrogate endpoint for overall survival (OS) in first-line advanced ovarian cancer (AOC) therapy: A Gynecologic Cancer InterGroup individual (GCIG) patient-level (IPD) analysis of multiple randomized trials. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.5576] [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: 11/20/2022] Open
Affiliation(s)
| | | | - Gennaro Daniele
- Istituto Nazionale per lo Studio e la Cura dei Tumori “Fondazione G. Pascale”- IRCCS, Naples, Italy
| | | | | | - Anna Tinker
- British Columbia Cancer Agency, Vancouver, BC, Canada
| | | | | | | | - Ingrid A. Boere
- Department of Medical Oncology, Daniel den Hoed Cancer Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Robert Fruscio
- University of Milan & Bicocca San Gerardo Hospital, Monza, Italy
| | - Anna K.L. Reyners
- University Medical Center, University of Groningen, Groningen, Netherlands
| | | | - Andrea Harkin
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Research, University of Glasgow, Glasgow, United Kingdom
| | | | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan
| | | | - Karamouza Eleni
- Ligue Nationale Contre le Cancer Meta-Analysis Platform, Department of Biostatistics and Epidemiology, Gustave-Roussy Cancer Campus, Villejuif, France
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Hosomi N, Kitagawa K, Nagai Y, Nakagawa Y, Aoki S, Nezu T, Kagimura T, Maruyama H, Origasa H, Minematsu K, Uchiyama S, Matsumoto M. Desirable Low-Density Lipoprotein Cholesterol Levels for Preventing Stroke Recurrence. Stroke 2018; 49:865-871. [DOI: 10.1161/strokeaha.117.018870] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 01/27/2018] [Accepted: 02/01/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Naohisa Hosomi
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Kazuo Kitagawa
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Yoji Nagai
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Yoko Nakagawa
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Shiro Aoki
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Tomohisa Nezu
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Tatsuo Kagimura
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Hirofumi Maruyama
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Hideki Origasa
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Kazuo Minematsu
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Shinichiro Uchiyama
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Masayasu Matsumoto
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
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Mori T, Kikuchi T, Umeda-Kameyama Y, Wada-Isoe K, Kojima S, Kagimura T, Kudoh C, Uchikado H, Ueki A, Yamashita M, Watabe T, Nishimura C, Tsuno N, Ueda T, Akishita M, Nakamura Y. ABC Dementia Scale: A Quick Assessment Tool for Determining Alzheimer's Disease Severity. Dement Geriatr Cogn Dis Extra 2018; 8:85-97. [PMID: 29706985 PMCID: PMC5921188 DOI: 10.1159/000486956] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/11/2018] [Indexed: 11/19/2022] Open
Abstract
Background In this study, we examined the construct validity, concurrent validity concerning other standard scales, intrarater reliability, and changes in scores at 12 weeks of the previously developed ABC Dementia Scale (ABC-DS), a novel assessment tool for Alzheimer's disease (AD). Methods Data were obtained from 312 patients diagnosed with either AD or mild cognitive impairment. The scores on the ABC-DS and standard scales were compared. Results The 13 items of the ABC-DS are grouped into three domains, and the domain-level scores were highly correlated with the corresponding conventional scales. Statistically significant changes in assessment scores after 12 weeks were observed for the total ABC-DS scores. Conclusion Our results demonstrate the ABC-DS to have good validity and reliability, and its usefulness in busy clinical settings.
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Affiliation(s)
- Takahiro Mori
- Department of Neuropsychiatry, Kagawa University School of Medicine, Kagawa, Japan
| | - Takashi Kikuchi
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Yumi Umeda-Kameyama
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Wada-Isoe
- Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Shinsuke Kojima
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Tatsuo Kagimura
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Chiaki Kudoh
- KUDOH CHIAKI Clinic for Neurosurgery and Neurology, Tokyo, Japan
| | | | - Akinori Ueki
- Ueki Dementia and Geriatric Psychiatry Clinic, Nishinomiya, Japan
| | | | | | | | - Norifumi Tsuno
- Department of Neuropsychiatry, Kagawa University School of Medicine, Kagawa, Japan
| | - Takashi Ueda
- Medical Corporation Koujinkai, Ueda Neurosurgical Clinic, Miyazaki, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yu Nakamura
- Department of Neuropsychiatry, Kagawa University School of Medicine, Kagawa, Japan
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Nakayama T, Sagara Y, Takashima T, Matsunami N, Masuda N, Miyoshi Y, Taguchi T, Aono T, Ito T, Kagimura T, Noguchi S. Randomized phase II study of anastrozole plus tegafur-uracil as neoadjuvant therapy for ER-positive breast cancer in postmenopausal Japanese women (Neo-ACET BC). Cancer Chemother Pharmacol 2018; 81:755-762. [PMID: 29468454 PMCID: PMC5854715 DOI: 10.1007/s00280-018-3544-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 02/12/2018] [Indexed: 12/22/2022]
Abstract
Purpose This phase II study evaluated the efficacy and safety of anastrozole concurrent with tegafur/uracil (UFT) as neoadjuvant therapy for ER-positive postmenopausal breast cancer. Methods Postmenopausal Japanese women with ER-positive, HER2-negative, T2,N0-1,M0 breast cancer seen at tertiary hospitals were eligible for this open-label, randomized, multicenter study. Patients were randomized 1:1 by minimization to orally receive either anastrozole (1 mg once daily) plus UFT (tegafur/uracil combination in 1:4 molar ratio; 270 mg/m2/day in two divided doses) or anastrozole (as above) alone for 24 weeks. Tumor response was assessed by investigator and central review as per RECIST v1.1. The primary endpoint was the proportion of patients with best overall response of CR or PR [clinical response rate (RR)] determined by central radiologic review. Results The study was prematurely terminated due to Grade ≥ 3 liver dysfunction reported in 3 patients receiving anastrozole/UFT. Of 57 patients randomized before termination (29 anastrozole/UFT, 28 anastrozole), all were analyzed for safety and 56 (28 each group) for tumor response. Compared with anastrozole alone, anastrozole/UFT did not achieve significantly higher RR [39.3% (90% CI 23.8–56.5%) vs 14.3% (90% CI 5.0–29.8%); p = 0.0683, Fisher’s exact test], but produced significantly greater tumor shrinkage (mean tumor reduction rate 31.0 vs. 14.2%; p = 0.0181, unpaired t-test). Grade ≥ 3 adverse events were more common with anastrozole/UFT than with anastrozole (17.2 vs. 0%). Conclusion Although the study was terminated owing to the altered liver function, it showed that there was a trend to greater shrinkage of tumor in the combination group for ER-positive, HER2-negative postmenopausal breast cancer.
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Affiliation(s)
- Takahiro Nakayama
- Department of Breast and Endocrine Surgery, Osaka International Cancer Institute, 3-1-69, Otemae, Chuou, Osaka, 541-8567, Japan.
| | - Yasuaki Sagara
- Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan
| | - Tsutomu Takashima
- Department of Surgical Oncology, Osaka City University Hospital, Osaka, Japan
| | | | - Norikazu Masuda
- Department of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Yasuo Miyoshi
- Department of Surgery, Division of Breast and Endocrine Surgery, Hyogo College of Medicine, Nishinomiya, Japan
| | - Tetsuya Taguchi
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toyokazu Aono
- Department of Breast Surgery, Osaka Breast Clinic, Osaka, Japan
| | - Toshikazu Ito
- Department of Surgery, Rinku General Medical Center, Izumisano, Japan
| | - Tatsuo Kagimura
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Shinzaburo Noguchi
- Department of Breast and Endocrine Surgery, Graduate School of Medicine Osaka University, Suita, Japan
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Kato H, Nangaku M, Hirakata H, Wada T, Hayashi T, Sato H, Yamazaki Y, Masaki T, Kagimura T, Yamamoto H, Hase H, Kamouchi M, Imai E, Mizuno K, Iwasaki M, Akizawa T, Tsubakihara Y, Maruyama S, Narita I. Rationale and design of oBservational clinical Research In chronic kidney disease patients with renal anemia: renal proGnosis in patients with Hyporesponsive anemia To Erythropoiesis-stimulating agents, darbepoetiN alfa (BRIGHTEN Trial). Clin Exp Nephrol 2018; 22:78-84. [PMID: 28660446 PMCID: PMC5805810 DOI: 10.1007/s10157-017-1427-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 06/01/2017] [Indexed: 10/29/2022]
Abstract
BACKGROUND Renal anemia is an important complication in non-dialysis chronic kidney disease (CKD) patients as well as in dialysis patients. Although recombinant human erythropoietin has dramatically improved prognosis and quality of life in these patients, there have been issues among non-dialysis CKD patients who exhibit hyporesponsiveness to erythropoiesis-stimulating agent (ESA). The causes and definition of ESA hyporesponsiveness, as well as the incidence of renal and cardiovascular disease (CVD) events in such patients, are yet to be clarified. METHODS This ongoing trial is a multicenter, prospective, observational study of non-dialysis CKD patients with renal anemia. The primary objective is to survey the current realities of the therapy with ESA in Japan and evaluate the correlation between hyporesponsiveness to darbepoetin alfa and CKD progression. The secondary objective is to investigate relationship between ESA hyporesponsiveness and CVD events based on the clinical situation in Japan, and to explore an ESA response index. RESULTS The subjects consist of CKD patients with estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2 who present renal anemia. The target number of registered cases is 2000 patients, based on estimates of incidences of renal and CVD events from past studies. Renal function and CVD events will be observed for 96 weeks after the initiation of darbepoetin alfa administration. Definitions of ESA hyporesponsiveness will also be investigated. CONCLUSION By clarifying markers and factors involved in ESA hyporesponsiveness and their relationships with renal and CVD events, this ongoing study aims to improve evidence-based therapies for renal anemia in non-dialysis CKD patients.
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Affiliation(s)
- Hideki Kato
- Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan.
| | | | - Takashi Wada
- Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Terumasa Hayashi
- Department of Kidney Disease and Hypertension, Osaka General Medical Centre, Sumiyoshi, Osaka, Japan
| | - Hiroshi Sato
- Division of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Faculty of Pharmaceutical Sciences, Sendai, Miyagi, Japan
| | - Yasushi Yamazaki
- Department of Nephrology and Rheumatology, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan
| | - Takao Masaki
- Department of Nephrology, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Tatsuo Kagimura
- Translational Research Informatics Center, Foundation Biomedical Research and Innovation, Kobe, Hyogo, Japan
| | - Hiroyasu Yamamoto
- Department of Internal Medicine, Atsugi City Hospital, Atsugi, Kanagawa, Japan
| | - Hiroki Hase
- Division of Nephrology, Toho University Ohashi Medical Center, Meguro, Tokyo, Japan
| | - Masahiro Kamouchi
- Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Enyu Imai
- Nakayamadera Imai Clinic, Takarazuka, Hyogo, Department of Nephrology, Fujita Health University Toyoake, Toyoake, Aichi, Japan
| | - Kyoichi Mizuno
- Mitsukoshi Health and Welfare Foundation, Shinjuku, Tokyo, Japan
| | - Manabu Iwasaki
- Department of Computer and Information Science, Seikei University, Musashino, Tokyo, Japan
| | - Tadao Akizawa
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Shinagawa, Tokyo, Japan
| | - Yoshiharu Tsubakihara
- Course of Safety Management in Health Care Sciences, Graduate School of Health Care Sciences, Jikei Institute, Yodogawa, Osaka, Japan
| | - Shoichi Maruyama
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata, Japan
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Hirano S, Kawamoto A, Tateya I, Mizuta M, Kishimoto Y, Hiwatashi N, Kawai Y, Tsuji T, Suzuki R, Kaneko M, Naito Y, Kagimura T, Nakamura T, Kanemaru SI. A phase I/II exploratory clinical trial for intracordal injection of recombinant hepatocyte growth factor for vocal fold scar and sulcus. J Tissue Eng Regen Med 2017; 12:1031-1038. [PMID: 29084372 DOI: 10.1002/term.2603] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/08/2017] [Accepted: 10/19/2017] [Indexed: 12/31/2022]
Abstract
Vocal fold scar and sulcus are intractable diseases with no effective established treatments. Hepatocyte growth factor (HGF) has preclinically proven to have potent antifibrotic and regenerative effects on vocal fold scar. The current Phase I/II clinical trial aims to examine the safety and effectiveness of intracordal injection of a recombinant human HGF drug for patients with vocal fold scar or sulcus. This is an open-label, dose-escalating, first-in-human clinical trial. Eighteen patients with bilateral vocal fold scar or sulcus were enrolled and divided into three groups: Step I received 1 μg of HGF per vocal fold; Step II received 3 μg of HGF; and Step III received 10 μg of HGF. Injections were administered once weekly for 4 weeks. The protocol treatment was performed starting with Step I and escalating to Step III. Patients were followed for 6 months post-treatment. Local and systemic safety aspects were examined as primary endpoints, and therapeutic effects were assessed as secondary endpoints using voice handicap index-10; maximum phonation time; vocal fold vibratory amplitude; grade, rough, breathy, asthenic, strained scale; and jitter. The results indicated no serious drug-related adverse events in either the systemic or local examinations. In whole-subject analysis, voice handicap index-10, vocal fold vibratory amplitude, and grade, rough, breathy, asthenic, strained scale were significantly improved at 6 months, whereas maximum phonation time and jitter varied. There were no significant differences in phonatory data between the step groups. In conclusion, intracordal injection of a recombinant human HGF drug was safe, feasible, and potentially effective for human patients with vocal fold scar or sulcus.
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Affiliation(s)
- Shigeru Hirano
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsuhiko Kawamoto
- Unit of Regenerative Medicine, Institute of Biomedical Research and Innovation/Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Ichiro Tateya
- Department of Otolaryngology-Head and Neck Surgery, Kyoto University, Kyoto, Japan
| | - Masanobu Mizuta
- Department of Otolaryngology-Head and Neck Surgery, Kyoto University, Kyoto, Japan
| | - Yo Kishimoto
- Department of Otolaryngology-Head and Neck Surgery, Kyoto University, Kyoto, Japan
| | - Nao Hiwatashi
- Department of Otolaryngology-Head and Neck Surgery, Kyoto University, Kyoto, Japan
| | - Yoshitaka Kawai
- Department of Otolaryngology-Head and Neck Surgery, Kyoto University, Kyoto, Japan
| | - Takuya Tsuji
- Department of Otolaryngology-Head and Neck Surgery, Kyoto University, Kyoto, Japan
| | - Ryo Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Kyoto University, Kyoto, Japan
| | - Mami Kaneko
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yasushi Naito
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tatsuo Kagimura
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Tatsuo Nakamura
- Department of Biomaterials, Field of Tissue Engineering, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Shin-Ichi Kanemaru
- Department of Otolaryngology, Kitano Hospital, Osaka, Japan.,Institute of Biomedical Research and Innovation, Kobe, Japan
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Koga M, Toyoda K, Minematsu K, Yasaka M, Nagai Y, Aoki S, Nezu T, Hosomi N, Kagimura T, Origasa H, Kamiyama K, Suzuki R, Ohtsuki T, Maruyama H, Kitagawa K, Uchiyama S, Matsumoto M. Long-Term Effect of Pravastatin on Carotid Intima-Media Complex Thickness: The J-STARS Echo Study (Japan Statin Treatment Against Recurrent Stroke). Stroke 2017; 49:107-113. [PMID: 29191850 PMCID: PMC5753816 DOI: 10.1161/strokeaha.117.018387] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 06/14/2017] [Revised: 10/19/2017] [Accepted: 10/23/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE The effect of statins on progression of carotid intima-media complex thickness (IMT) has been shown exclusively in nonstroke Western patients. This study aimed to determine the effect of low-dose pravastatin on carotid IMT in Japanese patients with noncardioembolic ischemic stroke. METHODS This is a substudy of the J-STARS trial (Japan Statin Treatment Against Recurrent Stroke), a multicenter, randomized, open-label, parallel-group trial to examine whether pravastatin reduces stroke recurrence. Patients were randomized to receive pravastatin (10 mg daily, usual dose in Japan; pravastatin group) or not to receive any statins (control group). The primary outcome was IMT change of the common carotid artery for a 5-year observation period. IMT change was compared using mixed-effects models for repeated measures. RESULTS Of 864 patients registered in this substudy, 71 without baseline ultrasonography were excluded, and 388 were randomly assigned to the pravastatin group and 405 to the control group. Baseline characteristics were not significantly different, except National Institutes of Health Stroke Scale scores (median, 0 [interquartile range, 0-2] versus 1 [interquartile range, 0-2]; P=0.019) between the 2 groups. Baseline IMT (mean±SD) was 0.887±0.155 mm in the pravastatin group and 0.887±0.152 mm in the control group (P=0.99). The annual change in the IMT at 5-year visit was significantly reduced in the pravastatin group as compared with that in the control group (0.021±0.116 versus 0.040±0.118 mm; P=0.010). CONCLUSIONS The usual Japanese dose of pravastatin significantly reduced the progression of carotid IMT at 5 years in patients with noncardioembolic stroke. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00361530.
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Affiliation(s)
- Masatoshi Koga
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.).
| | - Kazunori Toyoda
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Kazuo Minematsu
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Masahiro Yasaka
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Yoji Nagai
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Shiro Aoki
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Tomohisa Nezu
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Naohisa Hosomi
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Tatsuo Kagimura
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Hideki Origasa
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Kenji Kamiyama
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Rieko Suzuki
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Toshiho Ohtsuki
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Hirofumi Maruyama
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Kazuo Kitagawa
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Shinichiro Uchiyama
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Masayasu Matsumoto
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
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43
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Wada S, Koga M, Toyoda K, Minematsu K, Yasaka M, Nagai Y, Aoki S, Nezu T, Hosomi N, Kagimura T, Origasa H, Kamiyama K, Suzuki R, Ohtsuki T, Maruyama H, Kitagawa K, Uchiyama S, Matsumoto M. Factors Associated with Intima-Media Complex Thickness of the Common Carotid Artery in Japanese Noncardioembolic Stroke Patients with Hyperlipidemia: The J-STARS Echo Study. J Atheroscler Thromb 2017; 25:359-373. [PMID: 29118311 PMCID: PMC5906189 DOI: 10.5551/jat.41533] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Aims: There may be ethnic differences in carotid atherosclerosis and its contributing factors between Asian and other populations. The purpose of this study was to examine intima-media complex thickness (IMT) of the carotid artery and associated clinical factors in Japanese stroke patients with hyperlipidemia from a cohort of the Japan Statin Treatment Against Recurrent Stroke Echo Study. Methods: Patients with hyperlipidemia, not on statins, who developed noncardioembolic ischemic stroke were included in this study. Mean IMT and maximum IMT of the distal wall of the common carotid artery were centrally measured using carotid ultrasonography. Significant factors related to mean IMT and maximum IMT were examined using multivariable analysis. Results: In 793 studied patients, mean IMT was 0.89 ± 0.15 mm and maximum IMT was 1.19 ± 0.32 mm. Age (per 10 years, parameter estimate = 0.044, p < 0.001), smoking (0.022, p = 0.004), category of blood pressure (0.022, p = 0.006), HDL cholesterol (per 10 mg/dl, −0.009, p = 0.008), and diabetes mellitus (0.033, p = 0.010) were independently associated with mean IMT. Age (per 10 years, 0.076, p < 0.001), smoking (0.053, p = 0.001), HDL cholesterol (−0.016, p = 0.036), and diabetes mellitus (0.084, p = 0.002) were independently associated with maximum IMT. Conclusion: Baseline mean and maximum values of carotid IMT in Japanese noncardioembolic stroke patients with hyperlipidemia were 0.89 ± 0.15 mm and 1.19 ± 0.32 mm, respectively, which were similar to those previously reported from Western countries. Age, smoking, hypertension, HDL cholesterol, and diabetes mellitus were associated with mean IMT, and those, except for hypertension, were associated with maximum IMT.
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Affiliation(s)
- Shinichi Wada
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center
| | - Masatoshi Koga
- Division of Stroke Care Unit, National Cerebral and Cardiovascular Center
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kazuo Minematsu
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center
| | - Masahiro Yasaka
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center
| | - Yoji Nagai
- Center for Clinical Research, Kobe University Hospital
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innovation, Translational Research Informatics Center
| | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Science
| | - Kenji Kamiyama
- Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital
| | - Rieko Suzuki
- Department of Neurology, Kyorin University Hospital
| | - Toshiho Ohtsuki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.,Stroke Center, Kinki University
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University
| | - Shinichiro Uchiyama
- Clinical Research Center, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.,Japan Community Healthcare Organization (JCHO) Hoshigaoka Medical Center
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Hosomi N, Nagai Y, Kitagawa K, Nakagawa Y, Aoki S, Nezu T, Kagimura T, Maruyama H, Origasa H, Minematsu K, Uchiyama S, Matsumoto M. Pravastatin Reduces the Risk of Atherothrombotic Stroke when Administered within Six Months of an Initial Stroke Event. J Atheroscler Thromb 2017; 25:262-268. [PMID: 28924103 PMCID: PMC5868512 DOI: 10.5551/jat.40196] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 11/23/2022] Open
Abstract
Aims: The J-STARS study examined whether pravastatin (10 mg/day) reduces recurrence of stroke in non-cardioembolic ischemic stroke patients who were enrolled within 1 month to 3 years after initial stroke events (ClinicalTrials.gov, NCT00221104). The main results showed that the frequency of atherothrombotic stroke was low in pravastatin-treated patients, although no effect of pravastatin was found for the other stroke subtypes. We evaluated differences of early (within 6 months) or late (after 6 months) pravastatin treatment benefits on the incidence of stroke or transient ischemic attack (TIA), as well as atherothrombotic stroke and the other subtypes. Methods: Subjects in the J-STARS study were classified into two cohorts, depending on whether they enrolled early (1 to 6 months) or late (6 months to 3 years) following initial stroke events. Results: A total of 1578 patients (491 female, 66.2 ± 8.5 years) were randomly assigned to either the pravastatin group (n = 793; n = 426 in the early cohort, n = 367 in the late cohort) or the control group (n = 785; n = 417 in the early cohort, n = 368 in the late cohort). During the follow-up of 4.9 ± 1.4 years, the rate of atherothrombotic stroke was lower in the pravastatin group compared to controls in the early cohort (0.24 vs. 0.88%/year, p = 0.01) but not in the late cohort (0.17 vs. 0.39%/year, p = 0.29). However, this difference of pravastatin effect on atherothrombotic stroke was not significantly interacted by the early or late cohort (p = 0.59). The incidence rates of other stroke subtype were not different in between pravastatin and control groups despite the timing of entry. Conclusions: Pravastatin is likely to reduce atherothrombotic stroke in patients enrolled within 6 months after stroke onset. However, the clinical efficacy for prevention of recurrent stroke was not conclusive with earlier statin treatment.
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Affiliation(s)
- Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yoji Nagai
- Center for Clinical Research, Kobe University Hospital
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University School of Medicine
| | - Yoko Nakagawa
- Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tatsuo Kagimura
- Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences
| | | | - Shinichiro Uchiyama
- International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.,Hoshigaoka Medical Center, Japan Community Healthcare Organization (JCHO)
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Kato H, Nangaku M, Hirakata H, Wada T, Hayashi T, Sato H, Yamazaki Y, Masaki T, Kagimura T, Yamamoto H, Hase H, Kamouchi M, Imai E, Mizuno K, Iwasaki M, Akizawa T, Tsubakihara Y, Maruyama S, Narita I. Erratum to: Rationale and design of oBservational clinical Research In chronic kidney disease patients with renal anemia: renal proGnosis in patients with Hyporesponsive anemia To Erythropoiesis-stimulating agents, darbepoetiN alfa (BRIGHTEN Trial). Clin Exp Nephrol 2017; 22:85-86. [PMID: 28875480 DOI: 10.1007/s10157-017-1461-2] [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: 11/29/2022]
Affiliation(s)
- Hideki Kato
- Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan.
| | | | - Takashi Wada
- Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Terumasa Hayashi
- Department of Kidney Disease and Hypertension, Osaka General Medical Centre, Sumiyoshi, Osaka, Japan
| | - Hiroshi Sato
- Division of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Faculty of Pharmaceutical Sciences, Sendai, Miyagi, Japan
| | - Yasushi Yamazaki
- Department of Nephrology and Rheumatology, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan
| | - Takao Masaki
- Department of Nephrology, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Tatsuo Kagimura
- Translational Research Informatics Center, Foundation Biomedical Research and Innovation, Kobe, Hyogo, Japan
| | - Hiroyasu Yamamoto
- Department of Internal Medicine, Atsugi City Hospital, Atsugi, Kanagawa, Japan
| | - Hiroki Hase
- Division of Nephrology, Toho University Ohashi Medical Center, Meguro, Tokyo, Japan
| | - Masahiro Kamouchi
- Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Enyu Imai
- Nakayamadera Imai Clinic, Takarazuka, Hyogo, Department of Nephrology, Fujita Health University Toyoake, Toyoake, Aichi, Japan
| | - Kyoichi Mizuno
- Mitsukoshi Health and Welfare Foundation, Shinjuku, Tokyo, Japan
| | - Manabu Iwasaki
- Department of Computer and Information Science, Seikei University, Musashino, Tokyo, Japan
| | - Tadao Akizawa
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Shinagawa, Tokyo, Japan
| | - Yoshiharu Tsubakihara
- Course of Safety Management in Health Care Sciences, Graduate School of Health Care Sciences, Jikei Institute, Yodogawa, Osaka, Japan
| | - Shoichi Maruyama
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata, Japan
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Kanda T, Masuzawa T, Hirai T, Ikawa O, Takagane A, Hata Y, Ojima H, Sodeyama H, Mochizuki I, Ishikawa T, Kagimura T, Nishida T. Surgery and imatinib therapy for liver oligometastasis of GIST: a study of Japanese Study Group on GIST. Jpn J Clin Oncol 2017; 47:369-372. [PMID: 28073945 DOI: 10.1093/jjco/hyw203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 12/15/2016] [Indexed: 11/14/2022] Open
Abstract
We conducted a multicenter prospective study to clarify the efficacy and safety of surgery and imatinib for liver oligometastasis of gastrointestinal stromal tumors. Eligible gastrointestinal stromal tumor patients were enrolled in the surgery trial or the imatinib trial. Primary endpoints were recurrence-free survival and progression-free survival, respectively. The trials were prematurely terminated due to amendment of guidelines for adjuvant imatinib therapy and low patient accrual. In the surgery trial, all the six patients showed hepatic recurrence: median recurrence-free survival was 145 days (range: 62-1366 days). Of the five patients receiving salvage imatinib therapy, two showed progressive disease although no death was observed. Of the five patients enrolled in the imatinib trial, one died of pneumonia after progressive disease, and four had not shown progressive disease as of last visit. The results suggest that liver oligometastasis of gastrointestinal stromal tumor may not be controllable by surgery alone and require concomitant imatinib therapy.
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Affiliation(s)
- Tatsuo Kanda
- Department of Surgery, Sanjo General Hospital, Sanjo, Japan
| | - Toru Masuzawa
- Department of Surgery, Osaka Police Hospital, Osaka, Japan
| | - Toshihiro Hirai
- Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan
| | - Osamu Ikawa
- Department of Surgery, Kyoto Second Red Cross Hospital, Kyoto, Japan
| | - Akinori Takagane
- Department of Gastrointestinal Surgery, Hakodate Goryoukaku Hospital, Hakodate, Japan
| | - Yasuhiro Hata
- Department of Radiology, Kochi Health Sciences Center, Kochi, Japan
| | - Hitoshi Ojima
- Department of Surgery, Gunma Prefectural Cancer Center, Ota, Japan
| | | | - Izumi Mochizuki
- Department of Surgery, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Takashi Ishikawa
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Tatsuo Kagimura
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
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47
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Kitagawa K, Hosomi N, Nagai Y, Kagimura T, Ohtsuki T, Origasa H, Minematsu K, Uchiyama S, Nakamura M, Matsumoto M. Reduction in High-Sensitivity C-Reactive Protein Levels in Patients with Ischemic Stroke by Statin Treatment: Hs-CRP Sub-Study in J-STARS. J Atheroscler Thromb 2017; 24:1039-1047. [PMID: 28302952 PMCID: PMC5656766 DOI: 10.5551/jat.39354] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
AIMS The pleiotropic effects of statins on recurrent stroke remain unclear. We investigated the effects of pravastatin on high-sensitivity C-reactive proteins (Hs-CRP) in ischemic stroke, and explored the impact of Hs-CRP on recurrent stroke and vascular events. METHODS This randomized open-label trial was ancillary to the J-STARS trial. One thousand and ninety-five patients with non-cardiogenic ischemic stroke were assigned to the pravastatin (n=545) or control groups (n=550). The primary and secondary endpoints were serum Hs-CRP reduction and stroke recurrence, including both ischemic and hemorrhagic ones, respectively. Onset of vascular events and each stroke subtype in relation to Hs-CRP levels were also determined. RESULTS In the pravastatin treatment group, Hs-CRP levels (median 711 µg/L, IQR 344-1500) significantly decreased 2 months later (median 592 µg/L, IQR 301-1390), and they remained significantly lower until the end of the study. However, in the control group, baseline Hs-CRP levels were similar to those 2 months later. The reduction of Hs-CRP levels from the baseline to 2 months in the pravastatin group was statistically significant compared with the control (p=0.007). One SD increase in log-transformed Hs-CRP increased the risk of stroke recurrence (HR 1.17, 95% CI 0.97-1.40) and vascular events (HR 1.30, 95% CI 1.12-1.51). With an Hs-CRP cut-off of 1000 µg/L, higher Hs-CRP significantly increased the risk of recurrent stroke (HR 1.50, 95% CI 1.03-2.17)and vascular events (HR 1.68, 95% CI 1.23-2.29). CONCLUSION In non-cardiogenic ischemic stroke, pravastatin treatment may reduce vascular inflammation as assessed by Hs-CRP, and higher Hs-CRP levels appeared to increase the risk of recurrent stroke and vascular events.
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Affiliation(s)
- Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University
| | - Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yoji Nagai
- Center for Clinical Research, Kobe University Hospital
| | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innovation, Translational Research Informatics Center
| | | | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences
| | | | - Shinichiro Uchiyama
- Clinical Research Center, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center
| | | | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
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48
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Hosomi N, Nagai Y, Kitagawa K, Aoki S, Nezu T, Kagimura T, Origasa H, Minematsu K, Uchiyama S, Matsumoto M. Abstract WP415: Desirable LDL-cholesterol Levels For Preventing Stroke Recurrence -Subanalysis of J-STARS. Stroke 2017. [DOI: 10.1161/str.48.suppl_1.wp415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background & Aims:
The risk reduction of major vascular events per 1.0 mmol/L further reduction in LDL-cholesterol did not depend on the baseline LDL-cholesterol concentration. However, the desirable LDL-cholesterol level for preventing stroke recurrence has still not been defined. To define desirable LDL-cholesterol levels for preventing stroke recurrence, subanalysis was made on J-STARS.
Methods:
In J-STARS, patients with non-cardioembolic ischemic stroke (atherothrombotic infarction, lacunar infarction, infarction of undetermined etiology) were randomized into the pravastatin group (10 mg/day, n=793) or the control group (n=785) received no statin treatment. The primary endpoint was the recurrence of stroke and transient ischemic attack (TIA). The subjects were divided based on tertile of LDL-cholesterol at enrollment, mean during observation period, just before the event, and their differences. Adjusted hazard ratio (HR) (95% confidence interval [CI]) were analyzed for each tertile adjusting the factors that showed inter-group differences, including age, body mass index, hypertension, diabetes mellitus, duration until an enrollment following stroke events, and the usage of statin. Reference was set at the highest tertile.
Results:
Adjusted HR of stroke and TIA lowered in accordance with the reduction of LDL-cholesterol from enrollment both to mean during observation period and to just before the event (p<0.001 and <0.001 for trend). The occurrence of intracranial hemorrhage showed a significantly low relative risk in the middle tertile of LDL-cholesterol reduction (2.0 to 28.0 mg/dl) from enrollment to just before the event (adjusted HR 0.15 [95%CI 0.03, 0.68]). But, this risk reduction of intracranial hemorrhage was diminished in the lowest tertile. And, a relatively high risk of intracranial hemorrhage was observed in the lowest tertile of LDL-cholesterol (less than 101.0 mg/dl) just before the event (2.68 [0.82, 8.77]).
Conclusions:
The composite risk of stroke and TIA reduced according to the reduction of LDL-cholesterol adjusting the statin usage. The risk of intracranial hemorrhage reduced with mild reduction of LDL-cholesterol, but not when LDL-cholesterol reduced more than 28.0 mg/dl. (NCT00221104)
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Affiliation(s)
- Naohisa Hosomi
- Dept of Clinical Neuroscience and Therapeutics, Hiroshima Univ Graduate Sch of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yoji Nagai
- Cntr for Clinical Rsch, Kobe Univ Hosp, Kobe, Japan
| | - Kazuo Kitagawa
- Dept of Neurology, Tokyo Women’s Med Univ Sch of Medicine, Tokyo, Japan
| | - Shiro Aoki
- Dept of Clinical Neuroscience and Therapeutics, Hiroshima Univ Graduate Sch of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tomohisa Nezu
- Dept of Clinical Neuroscience and Therapeutics, Hiroshima Univ Graduate Sch of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tatsuo Kagimura
- Div of Med Statistics, Foundation for Biomedical Rsch and Innovation Translational Rsch Informatics Cntr, Kobe, Japan
| | - Hideki Origasa
- Div of Biostatistics and Clinical Epidemiology, Univ of Toyama Graduate Sch of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | | | - Shinichiro Uchiyama
- Clinical Rsch Cntr, International Univ of Health and Welfare, Cntr for Brain and Cerebral Vessels, Sanno Hosp and Sanno Med Cntr, Tokyo, Japan
| | - Masayasu Matsumoto
- Dept of Clinical Neuroscience and Therapeutics, Hiroshima Univ Graduate Sch of Biomedical and Health Sciences, Hiroshima, Japan
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Ogata H, Fukagawa M, Hirakata H, Kaneda H, Kagimura T, Akizawa T. Design and baseline characteristics of the LANDMARK study. Clin Exp Nephrol 2016; 21:531-537. [PMID: 27405619 PMCID: PMC5556131 DOI: 10.1007/s10157-016-1310-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 07/06/2016] [Indexed: 01/31/2023]
Abstract
Background Calcium (Ca)-based phosphate (P) binders, compared to non-Ca-based P binders, contribute to vascular calcification, which is associated with cardiovascular events. Methods The LANDMARK study is a multicenter, randomized, open-label, parallel comparative study of lanthanum carbonate (LC) and calcium carbonate (CC) in hemodialysis patients. Stable hemodialysis patients with intact parathyroid hormone ≤240 pg/mL meeting ≥1 of the following criteria (age >65 years, postmenopause, diabetes mellitus) were randomized into the LC and CC groups. LC group patients initially received LC 750 mg/day or the previously used dose and were titrated up to a maximum 2250 mg/day to achieve serum P levels of 3.5–6.0 mg/dL. CC group patients received CC 3 g/day or the previously used dose and were titrated to achieve the same P range. If the target serum P level was not achieved, non-Ca-based P binders (other than LC) could also be added. The primary endpoint is survival time free of cardiovascular events, including cardiovascular death, non-fatal myocardial infarction or stroke, and unstable angina. Results Overall, 2309 patients were allocated to the LC (N = 1154) or CC group (N = 1155). At baseline, the mean age was 68.4 years, 40.4 % were women, 55.9 % had diabetes, 18.3 % had a history of ischemic heart disease, and 13.9 % had cerebrovascular disease. A total of 184 patients (8.4 %) had undergone coronary intervention procedures. Baseline characteristics were well balanced between groups. Conclusions The LANDMARK study will determine whether LC, a non-Ca-based P binder, reduces cardiovascular mortality and morbidity in chronic hemodialysis patients.
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Affiliation(s)
- Hiroaki Ogata
- Department of Internal Medicine, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, Kanagawa, 224-8503, Japan.
| | - Masafumi Fukagawa
- Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Hideki Hirakata
- Division of Nephrology and Dialysis Center, Japanese Red Cross Fukuoka Hospital, Fukuoka, Fukuoka, Japan
| | - Hideaki Kaneda
- Translational Research Informatics Center, Kobe, Hyogo, Japan
| | - Tatsuo Kagimura
- Translational Research Informatics Center, Kobe, Hyogo, Japan
| | - Tadao Akizawa
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Sinagawa-ku, Tokyo, Japan
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50
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Yamashita S, Masuda D, Ohama T, Arai H, Bujo H, Kagimura T, Kita T, Matsuzaki M, Saito Y, Fukushima M, Matsuzawa Y. Rationale and Design of the PROSPECTIVE Trial: Probucol Trial for Secondary Prevention of Atherosclerotic Events in Patients with Prior Coronary Heart Disease. J Atheroscler Thromb 2016; 23:746-56. [PMID: 26803913 PMCID: PMC7399286 DOI: 10.5551/jat.32813] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 08/31/2015] [Accepted: 10/05/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Reduction of serum LDL-cholesterol by statins was shown to improve clinical outcomes in patients with coronary heart disease (CHD). Although intensive statin therapy significantly reduced cardiovascular risks, atherosclerotic cardiovascular events have not been completely prevented. Therefore, effective pharmacologic therapy is necessary to improve "residual risks" in combination with statins. Probucol has a potent antioxidative effect, inhibits the oxidation of LDL, and reduces xanthomas. Probucol Trial for Secondary Prevention of Atherosclerotic Events in Patients with Prior Coronary Heart Disease (PROSPECTIVE) is a multicenter, randomized, prospective study designed to test the hypothesis that the addition of probucol to other lipid-lowering drugs will prevent cerebro- and cardiovascular events in patients with prior coronary events and high LDL cholesterol levels. STUDY DESIGN The study will recruit approximately 860 patients with a prior CHD and dyslipidemia with LDL-C level ≥140 mg/dl without any medication and those treated with any lipid-lowering drugs with LDL-C level ≥100 mg/dl. Lipid-lowering agents are continuously administered during the study period in control group, and probucol (500 mg/day, 250 mg twice daily) is added to lipid-lowering therapy in the test group. The efficacy and safety of probucol with regard to the prevention of cerebro- and cardiovascular events and the intima-media thickness of carotid arteries as a surrogate marker will be evaluated. SUMMARY PROSPECTIVE will determine whether the addition of probucol to other lipid-lowering drugs improves cerebro- and cardiovascular outcomes in patients with prior coronary heart disease. Furthermore, the safety of a long-term treatment with probucol will be clarified.
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Affiliation(s)
- Shizuya Yamashita
- Department of Community Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Rinku General Medical Center, Izumisano, Osaka, Japan
| | - Daisaku Masuda
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Tohru Ohama
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Hidenori Arai
- The National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hideaki Bujo
- Department of Clinical Laboratory and Experimental Research Medicine, Toho University, Sakura Medical Center, Sakura, Chiba, Japan
| | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innovation, Kobe, Hyogo, Japan
| | - Toru Kita
- Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | | | - Yasushi Saito
- Chiba University Graduate School of Medicine, Chiba, Japan
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