Publications by authors named "Hideo Onizawa"
Article Synopsis
- - The study investigates how different biological and targeted synthetic anti-rheumatic drugs (b/tsDMARDs) affect kidney function in patients with rheumatoid arthritis (RA), particularly focusing on the incidence of chronic kidney disease (CKD).
- - Researchers followed 2,187 patients and evaluated the effects of tumor necrosis factor inhibitors (TNFi), cytotoxic T lymphocyte-associated antigen-4-Ig (CTLA4-Ig), interleukin-6 receptor inhibitors (IL-6Ri), and Janus kinase inhibitors (JAKi) on kidney health. They found that TNFi was linked to a lower CKD risk, while JAKi was associated with a higher risk.
- - The findings suggest that
Objectives: There are often discrepancies in the evaluation of disease activity between patients and physicians in systemic lupus erythematosus (SLE). In this study, we examined the factors that affect those evaluations.
Methods: Physician visual analogue scale (Ph-VAS), patient VAS (Pt-VAS), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2k), glucocorticoid (GC) usage and dose, age, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, and three patient-reported outcomes (SLE symptom checklist [SSC], short-form 36 questionnaire [SF-36], and LupusPRO) were obtained from a study performed in 2019 using 225 SLE outpatients of the Kyoto Lupus Cohort at Kyoto University Hospital.
Article Synopsis
- - This study compared juvenile idiopathic inflammatory myopathy (IIM) and adult-IIM by analyzing autoantibodies, clinical characteristics, and drug-free conditions in 320 patients over 20 years.
- - Juvenile-IIM showed a higher rate of achieving drug-free conditions (34%) compared to adult-IIM (18%), with specific autoantibodies like anti-TIF1-γ linked to fewer muscle symptoms and lower malignancy rates in juveniles.
- - Both groups had overlapping features with certain autoantibodies (like anti-MDA-5 and anti-ARS) associated with severe symptoms and a low likelihood of drug-free conditions, while treatment patterns differed notably between the two age groups.
Vesiculobullous dermatomyositis (VD) is a rare manifestation of dermatomyositis (DM) and has been suggested to be associated with malignancy. Although the myositis-specific autoantibodies are associated with distinct clinical presentations of DM, those associated with VD remain unclear. Here, we present the case of a 54-year-old man with VD who tested positive for anti-nuclear matrix protein 2 (NXP-2) antibody, one of the DM-specific autoantibodies.
View Article and Find Full Text PDFThis study aims to identify factors influencing the alleviation of knee joint symptoms in patients with rheumatoid arthritis treated with biologic or target synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). Among 2321 patients who started b/tsDMARDs between 2010 and 2023, we focused on 295 patients who had knee swelling or tenderness at the initiation of b/tsDMARDs and continued b/tsDMARDs at least 3 months, with recorded knee symptoms 6 months later. Symptom relief after 6 months was 78.
View Article and Find Full Text PDFStudy Design: Retrospective cohort study.
Objective: To elucidate the factors related to progression of scoliosis in patients with rheumatoid arthritis (RA) using longitudinal cohort data.
Summary Of Background Data: Thirty percent of patients with RA have lumbar scoliosis.
Data on the safety of Janus kinase inhibitors (JAKis) in patients with renal impairment are lacking. This study aimed to investigate the safety of JAKis compared to biological (b) DMARDs in patients with rheumatoid arthritis (RA) and renal impairment. We used a multi-centre observational registry of patients with RA in Japan (the ANSWER cohort).
View Article and Find Full Text PDFArticle Synopsis
- Rheumatoid arthritis leads to joint inflammation, causing pain and swelling due to immune system issues, but only about 60% of patients reach remission despite advancements in treatment.
- Many patients experience varying states of health, from stable to unstable, making it important to analyze these transitions over time for better treatment outcomes.
- The study uses energy landscape analysis and time-series clustering to track patient progress, identifying patterns of stability that can inform treatment strategies, emphasizing the need for early detection and tailored care for those in unstable states.
Objective: Hounsfield units (HU) measured using computed tomography (CT) have gained considerable attention for the detection of osteoporosis. This study aimed to investigate whether opportunistic CT could predict vertebral fractures in patients with rheumatoid arthritis (RA).
Methods: A total of 233 patients with RA who underwent chest CT were included in this study.
Article Synopsis
- Avacopan is an oral medication that acts as a C5a receptor antagonist and is effective in treating microscopic polyangiitis by inhibiting the activation of neutrophils.
- A patient case showed that despite high-dose steroids and azathioprine not reducing myeloperoxidase antineutrophil cytoplasmic antibodies (MPO-ANCA), adding avacopan lowered these antibody levels.
- The findings suggest avacopan might help in decreasing MPO-ANCA and improving ANCA-associated vasculitis, but more research with larger studies is needed to confirm these effects.
Objective: Atlantoaxial subluxation is a well-known serious complication encountered in patients with rheumatoid arthritis (RA). However, it is unknown whether RA affects global spinal alignment. The aim of this study was to investigate whether high disease activity in patients with RA exacerbates spinal sagittal malalignment.
View Article and Find Full Text PDFObjectives: Biosimilars are anticipated to be widely used in the treatment of rheumatoid arthritis (RA), owing to their cost efficiency; LBEC0101 was the first etanercept (ETN) biosimilar approved in Japan. However, there are limited real-world data comparing its safety and effectiveness with those of a reference product.
Methods: This study used data from the Kyoto University Rheumatoid Arthritis Management Alliance cohort, including patients with RA who received ETN therapy-ETN reference product (ETN-RP) or LBEC0101-between 2015 and 2021.
Article Synopsis
- The study aimed to explore how large joint involvement (LJI) impacts disease activity and medication retention in rheumatoid arthritis (RA) patients starting biological therapies or Janus kinase inhibitors.
- Researchers analyzed data from 1721 patients, finding that LJI led to significant improvements in disease activity at 24 weeks, but patients with LJI had higher overall disease activity levels.
- Although drug retention rates were similar between patients with and without LJI, the findings suggest that early treatment strategies, particularly using interleukin-6 receptor inhibitors, could benefit those with LJI.
Article Synopsis
- A multicentre, retrospective study analyzed the retention rates and reasons for stopping treatment in elderly patients with rheumatoid arthritis (EORA), comparing Janus kinase inhibitors (JAKi) to biologic disease-modifying drugs.
- The study found that IL-6 inhibitors had better retention rates than TNF inhibitors, while JAKi showed lower discontinuation due to ineffectiveness but higher rates of discontinuation due to adverse events compared to TNF inhibitors.
- The conclusions suggest that while IL-6i and JAKi are effective for EORA patients, the increased risk associated with JAKi requires careful consideration and a tailored treatment approach.
Background: Advances in rheumatoid arthritis (RA) treatment, highlighted by biological disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs), have altered the paradigm of RA treatment in the last decade. Therefore, real-world clinical evidence is needed to understand how treatment strategies and outcomes have changed.
Methods: Using an observational cohort of RA from 2012 to 2021, we collected cross-sectional data of RA patients annually to analyze a trend in RA management.
Article Synopsis
- The study aimed to assess changes in disease activity among elderly RA patients over 75 years old in Japan from 2014 to 2021.
- Data showed an increase in the percentage of elderly patients achieving remission and low disease activity (LDA), with rates rising from 62.2% to 78.2% during that time.
- Factors that positively influenced remission and LDA included the use of methotrexate, while glucocorticoid use and previous b/tsDMARDs treatments negatively impacted these outcomes.
Abatacept (ABT) is a biological disease-modifying antirheumatic drug (bDMARDs) for rheumatoid arthritis (RA) when conventional synthetic DMARDs are ineffective. We aimed to evaluate the long-term effects of ABT on joint destruction in patients treated for over 2 years. Radiographic progression was evaluated using the van der Heijde-modified Total Sharp Score (mTSS) by two rheumatologists at ABT initiation and after 2 years.
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- IgG4-related disease (Ig4-RD) is a condition that can impact various organs, such as the salivary and lacrimal glands, pancreas, and liver.
- A 72-year-old woman exhibited multiple symptoms including high eosinophil counts, elevated IgG4 levels, and dysfunction in liver and nerves, which led to a diagnosis of Ig4-RD confirmed through biopsies.
- The patient showed improvement with glucocorticoid treatment, emphasizing the importance of biopsies to correctly differentiate Ig4-RD from similar disorders.
Article Synopsis
- * A study of 4,016 RA patients analyzed the impact of joint tenderness and swelling on these assessment tools, revealing that specific joints contribute differently to various scores.
- * Findings indicate that while the wrist and knee have broad influence across multiple assessment tools, other joints like the shoulder and ankle play unique roles, suggesting that joint symptom changes affect assessments in distinct ways.
Secondary non-response to infliximab (IFX) occurs in some patients with rheumatoid arthritis (RA). Although therapeutic drug monitoring (TDM) is a useful tool to optimize IFX therapy, it is unclear whether it can help to identify the risk of secondary non-response. This study aimed to explore the utility of serum levels of IFX or other biomarkers to predict IFX discontinuation owing to secondary non-response.
View Article and Find Full Text PDFObjectives: Decreased sialylation of IgG-Fc glycans has been reported in autoimmune diseases, but its role in systemic lupus erythematosus (SLE) is not fully understood. In this study, we examined the pathogenicity of IgG desialylation and its association with Th17 in SLE using an animal model.
Methods: B6SKG mice, which develop lupus-like systemic autoimmunity due to the ZAP70 mutation, were used to investigate the pathogenicity of IgG desialylation.
Background: Patients with rheumatoid arthritis (RA) are prone to muscle atrophy due to inflammatory cytokines and corticosteroid use and immobility due to joint pain and deformity. Although resistance training is effective and safe in reversing muscle atrophy in RA, some patients are unable to perform a conventional high-load exercise program due to disease-related limitations. This study aims to examine the efficacy of individualized exercise therapy on physical function in elderly patients with RA who are at a high risk for sarcopenia.
View Article and Find Full Text PDFElderly-onset rheumatoid arthritis (EORA) is associated with higher disease activity and accelerated joint destruction compared with young-onset RA (YORA). However, the underlying immunological mechanism remains unclear. Regulatory T cells (Tregs) are an immunosuppressive T cell subset, and CD4 Tregs are deficient and/or dysfunctional in RA; however, CD8 Tregs have not been fully examined in RA.
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