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Okada S, Morimoto T, Ogawa H, Sakuma M, Matsumoto C, Soejima H, Nakayama M, Doi N, Jinnouchi H, Waki M, Masuda I, Saito Y, Miwa K, Akahoshi K, Misumi K, Araki H, Mitsudo Y, Kondo N, Ashihara K, Yumoto S, Horimoto M, Doi O, Doijiri K, Fukami R, Shimabukuro M, Egusa G, Goto K, Hanaoka Y, Kimura Y, Haraguchi Y, Haraguchi O, Hasegawa A, Shioya Y, Shioya Y, Tanaka E, Yamada K, Atsumi T, Tanazawa S, Horio Y, Ichihara S, Yasuda I, Ikeda T, Ikemura M, Imamoto C, Iseri Y, Iwai K, Okamoto S, Sugiyama S, Kamura M, Kan H, Kiyota M, Kawamura K, Ono T, Koga T, Kinuwaki E, Naito H, Kozuma K, Kudou K, Morikami Y, Yasue H, Mizuno Y, Fujimoto H, Matsuyama K, Fujii H, Kamijikkoku S, Kuwahara T, Takaoka K, Machii K, Maeda K, Mahara K, Maki A, Manda N, Marutsuka K, Sameshima N, Gi T, Matsunaga T, Matsuo S, Okubo H, Minagawa F, Minoda K, Miyata J, Matsuo T, Momosaki S, Munakata T, Nakamura T, Nagano H, Goshi K, Sugimoto K, Naomi S, Nasu T, Tanaka H, Sonoda R, Kajiwara K, Odo T, Ogata H, Ogihara M, Ogura T, Oka K, Kawashima E, Oshima E, Ozaki K, Ozawa S, Shono H, Sakamoto Y, Sakurai N, Wakabayashi C, Sawada T, Shibata J, Shimono H, Iemura A, Matsutani A, Suefuji H, Sugiyama H, Hokamaki J, Komori K, Kinoshita Y, Murakami H, Hashiguchi J, Hashiguchi Y, Sawai K, Hifumi A, Seo K, Toihata M, Tokube K, Ogawa H, Tomita F, Taguchi M, Tsubokura T, Tsuchiya T, Tsuda K, Tsurusaki R, Obata K, Watanabe K, Hayasida R, Ishibashi Y, Osamura Y, Yamanaka Y, Sonoda K, Iwaoka T, Yokota H, Yoshinari M, Abe N, Ando N, Bando H, Takami T, Doi M, Fujii Y, Fukuda M, Fukuoka Y, Hamano M, Takaoka M, Hasegawa H, Yabuta I, Higami K, Higami S, Yasuno A, Fujinaga Y, Onishi Y, Yoshimura K, Minami S, Nakashima T, Horie H, Horii K, Matsumura N, Ikuno T, Katsuyama Y, Uemura S, Kikukawa M, Kanauchi M, Kuzuya H, Iwasaki A, Koutani T, Makino H, Miki H, Misugi S, Naito M, Naito M, Nakano Y, Nakatani A, Nakatani F, Horii M, Yabuta M, Seno A, Kawata H, Samejima K, Onoue K, Kawakami R, Nakano T, Ueda T, Soeda T, Kita Y, Inoue F, Yamano S, Iwama H, Sakan H, Suzuki M, Kagoshima T, Nakai T, Hashimoto T, Nishitani Y, Kobayashi Y, Hoda K, Fujiki K, Uejima J, Morikawa Y, Kawano T, Yamada H, Nishimoto K, Ohsumi K, Ote N, Oya A, Nishiura K, Masuda J, Ban K, Kyoda Y, Sawada I, Sawada Y, Okada K, Yazaki A, Hanatani M, Sutani T, Hiramori Y, Tanaka Y, Igaki T, Tomioka Y, Shiiki H, Sugihara K, Hayashi M, Sasaki Y, Matsukura Y, Ueda M, Ueyama M, Uyama H, Yamada H, Yamaga K, Nakajima T, Yoshimoto K, Yoshimura M. Effect of Aspirin on Cancer Chemoprevention in Japanese Patients With Type 2 Diabetes: 10-Year Observational Follow-up of a Randomized Controlled Trial. Diabetes Care 2018; 41:1757-1764. [PMID: 29909377 DOI: 10.2337/dc18-0368] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/07/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study analyzed the efficacy of low-dose aspirin in cancer chemoprevention in patients with diabetes. RESEARCH DESIGN AND METHODS This study was a posttrial follow-up of the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) trial. Participants in the JPAD trial (2,536 Japanese patients with type 2 diabetes and without preexisting cardiovascular disease) were randomly allocated to receive aspirin (81 or 100 mg daily) or no aspirin. After that trial ended in 2008, we followed up with the participants until 2015, with no attempt to change the previously assigned therapy. The primary end point was total cancer incidence. We investigated the effect of low-dose aspirin on cancer incidence. RESULTS During the median follow-up period of 10.7 years, a total of 318 cancers occurred. The cancer incidence was not significantly different between the aspirin and no-aspirin groups (log-rank, P = 0.4; hazard ratio [HR], 0.92; 95% CI, 0.73-1.14; P = 0.4). In subgroup analyses, aspirin did not affect cancer incidence in men, women, or participants aged ≥65 years. However, it decreased cancer incidence in participants aged <65 years (log-rank, P = 0.05; HR, 0.67; 95% CI, 0.44-0.99; P = 0.048). After adjusting for sex, hemoglobin A1c, smoking status, and administration of metformin and statins, aspirin significantly reduced cancer incidence in participants aged <65 years (adjusted HR, 0.66; 95% CI, 0.43-0.99; P = 0.04). CONCLUSIONS Low-dose aspirin did not reduce cancer incidence in Japanese patients with type 2 diabetes.
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Affiliation(s)
- Sadanori Okada
- Department of Diabetology, Nara Medical University, Kashihara, Nara, Japan
- Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Nara, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Hisao Ogawa
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Mio Sakuma
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Chisa Matsumoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Hirofumi Soejima
- Department of Cardiology, Graduate School of Medical Science, Kumamoto University, Chuo, Kumamoto, Japan
| | | | - Naofumi Doi
- Department of Cardiovascular Medicine, Nara Prefectural Seiwa Medical Center, Sango, Ikoma, Nara, Japan
| | - Hideaki Jinnouchi
- Department of Internal Medicine, Jinnouchi Hospital Diabetes Care Center, Chuo, Kumamoto, Japan
| | - Masako Waki
- Department of Internal Medicine, Shizuoka City Shizuoka Hospital, Aoi, Shizuoka, Japan
| | - Izuru Masuda
- Medical Examination Center, Takeda Hospital, Shimogyo, Kyoto, Japan
| | - Yoshihiko Saito
- Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Nara, Japan
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Takahashi F, Miura E, Shibukawa K, Chinda J, Miyokawa N, Imamoto C, Kikuchi K, Hasebe N. Monitoring with serum SP-A, SP-D, and KL-6 in a patient with interstitial pneumonia complicated with ANCA-associated glomerulonephritis. CEN Case Rep 2014; 3:5-9. [PMID: 28509235 DOI: 10.1007/s13730-013-0074-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 03/01/2013] [Indexed: 11/26/2022] Open
Abstract
A 69-year-old woman was admitted to hospital, complaining of fatigue and dry cough. Her renal function deteriorated rapidly, and the laboratory findings showed elevated myeloperoxidase-specific anti-neutrophil cytoplasmic antibody (ANCA). Renal biopsy examination revealed crescentic glomerulonephritis (pauci-immune type), and linear opacities and a honeycomb appearance in both lower lobes was evident on the chest computed tomography scan. The patient was diagnosed as having ANCA-associated glomerulonephritis complicated with mild interstitial pneumonia (IP). Treatment with methylprednisolone pulse therapy improved both her renal function and IP, but her lung lesions worsened during the course of tapering the prednisolone doses. After careful observation, her IP improved gradually without specific treatment. Worsening or improvement of her lung lesions was accompanied by changes in the serological markers of IP, namely, surfactant protein-A, surfactant protein-D, and KL-6. We found that monitoring these markers was helpful in diagnosing and managing IP in our patient with ANCA-associated vasculitis.
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Affiliation(s)
- Fumihiko Takahashi
- Cardiovascular, Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan.
- Department of Cardiovascular Medicine, Rumoi City Hospital, 2-16, Shinonome-cho, Rumoi, 077-8511, Japan.
| | - Eriko Miura
- Cardiovascular, Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Kiyoko Shibukawa
- Cardiovascular, Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Junko Chinda
- Cardiovascular, Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Naoyuki Miyokawa
- Department of Surgical Pathology, Asahikawa Medical University, Asahikawa, Japan
| | | | - Kenjiro Kikuchi
- Cardiovascular, Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Naoyuki Hasebe
- Cardiovascular, Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan
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