Publications by authors named "Masayoshi Harigai"
Objectives: To compare treatment outcomes in patients with late-onset rheumatoid arthritis (LORA) and younger-onset rheumatoid arthritis (YORA).
Methods: We analyzed patients diagnosed with early rheumatoid arthritis (disease duration < 2 years) between 2000 and 2016 in the IORRA cohort. Patients were categorized into LORA (onset at ≥ 65 years) and YORA (onset at < 65 years).
Objective: High disease activity status (HDAS) in patients with systemic lupus erythematosus (SLE) is associated with adverse long-term outcomes. We examined the frequency of lupus low disease activity state (LLDAS) and remission (REM) attainment in HDAS patients and whether their attainment was associated with improved patient outcomes.
Methods: Demographic, clinical and outcomes data, collected prospectively from a multinational cohort between 2013 and 2020, were analysed.
The patient was diagnosed with amyopathic dermatomyositis complicated with interstitial pneumonia (IP) at age 35. She had been treated with prednisolone and maintained on tacrolimus (TAC) + azathioprine (AZA). Eight years later, she experienced epigastric pain, and esophagogastroduodenoscopy (EGD) led to a diagnosis of duodenal ulcer.
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- The study evaluated various ANCA detection methods in a group of 147 patients with untreated ANCA-associated vasculitis, focusing primarily on myeloperoxidase (MPO)-ANCA.
- Different testing methods were compared, including immunofluorescence (IIF) and several antigen-specific immunoassays (ELISA, CLEIA, FEIA, LTIA), revealing varying sensitivities and specificities for diagnosing AAV.
- Results indicated that while antigen-specific immunoassays performed well overall, using dual IIF and these immunoassays had limited benefits, and standardizing ANCA measurements across different methods remained challenging.
Article Synopsis
- The lupus low disease activity state (LLDAS) allows some activity in systemic lupus erythematosus (SLE) as long as it stays within certain limits; this study examined the outcomes of patients achieving LLDAS with different levels of activity.
- A total of 2,099 SLE patients were analyzed over a median follow-up of 3.5 years, revealing that 20.8% had clinical activity, 50.4% had serological activity only, and 28.8% had neither while in LLDAS.
- Results indicated that all LLDAS subsets reduced the risk of disease flares and damage, with LLDAS showing no activity being the most protective against severe flares.
Clinical Characteristics and Treatment Outcomes of Patients With Newly Diagnosed Takayasu Arteritis in Japan During the First 2 Years of Treatment - A Nationwide Retrospective Cohort Study.
Circ J
September 2024
Article Synopsis
- This study focused on understanding the clinical features and treatment outcomes of Japanese patients newly diagnosed with Takayasu arteritis (TAK) during the initial two years of their treatment.
- A total of 129 patients were analyzed, with a majority being women, and common clinical symptoms related to large-vessel lesions, particularly in areas like the carotid and subclavian arteries.
- The results highlighted that 82.9% of patients achieved clinical remission at 24 weeks, but only 39.5% maintained it at 52 weeks, with large-vessel symptoms linked to poorer outcomes for sustained remission.*
Objectives: This study aimed to understand the status quo of medical treatments of the primary disease and pregnancy outcomes in patients with Takayasu arteritis (TAK) and children's birth outcomes.
Methods: This study retrospectively enrolled patients with TAK who conceived after the disease onset and were managed at medical facilities participating in the Japan Research Committee of the Ministry of Health, Labor, and Welfare for Intractable Vasculitis.
Results: This study enrolled 51 cases and 68 pregnancies 2019-2021.
Article Synopsis
- The study investigates the safety and effectiveness of various DMARDs, including methotrexate (MTX), tofacitinib, tumor necrosis factor inhibitors (TNFi), and non-TNFi biologic DMARDs, in patients with rheumatoid arthritis (RA) using data from the CorEvitas RA Japan registry.
- Safety outcomes measured include major cardiovascular events, serious infections, herpes zoster, and malignancies, while effectiveness was measured using the Clinical Disease Activity Index (CDAI).
- Findings show that MTX and TNFi had lower rates of adverse cardiovascular events compared to tofacitinib and non-TNFi, but tofacitinib demonstrated superior effectiveness in improving CDAI scores at 6 months
Introduction: Patients with rheumatoid arthritis (RA) may have an increased malignancy risk versus the general population, potentially elevated by biological disease-modifying antirheumatic drug (bDMARD) use. Using patient registry data, we determined malignancy risk, stratified by bDMARD use, among Japanese patients with RA versus the Japanese general population and investigated whether bDMARD use is a time-dependent risk factor for the development of malignancy.
Methods: Patients aged ≥ 18 years with ≥ 2 data entries of RA in the IORRA (Institute of Rheumatology, Rheumatoid Arthritis) patient registry, enrolled from January 2013-December 2018, were identified ('All RA' cohort).
Aim: To evaluate whether seasonal changes influence fluctuations in serum Krebs von den Lungen-6 (KL-6) levels in systemic sclerosis-related interstitial lung disease (SSc-ILD).
Methods: Summer was defined as the period between July and September, and winter as between December and February. The study was conducted between 2015 and 2016, with a focus on these two seasons.
Objectives: To compare the risk of cardiovascular events among Janus kinase inhibitors (JAKIs), biological disease-modifying antirheumatic drugs (bDMARDs) (tumour necrosis factor inhibitors (TNFIs) and non-TNFIs) and methotrexate (MTX) in Japanese patients with rheumatoid arthritis (RA).
Methods: Using Japanese claims data, patients with RA were enrolled in this study if they had at least one ICD-10 code (M05 or M06), were new users of JAKIs, bDMARDs or MTX between July 2013 and July 2020 and being 18 years old or older. The incidence rate (IR), IR ratio and adjusted hazard ratio (aHR (95% CI)) of cardiovascular events including venous thromboembolism, arterial thrombosis, acute myocardial infarction and stroke were calculated.
Background: Validation of protective associations of the lupus low disease activity state (LLDAS) against flare, irreversible damage, health-related quality of life, and mortality has enabled the adoption of treat-to-target strategies in patients with systemic lupus erythematosus (SLE). Previous validation studies were of short duration, limiting the ability to detect longer term signals in flare rate and irreversible damage. In addition, previous studies have focused on percent time at target, rather than actual periods of time that are more useful in clinical practice and trials.
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- The article aims to update evidence on the effectiveness and safety of DMARDs for rheumatoid arthritis (RA) to inform the 2024 guidelines by the Japan College of Rheumatology.
- A thorough search included randomized controlled trials published until June 2022, with independent reviews and meta-analyses conducted on 15 clinical questions related to RA treatment.
- Key findings indicate that subcutaneous methotrexate is as effective as oral, ozoralizumab with methotrexate is more effective than a placebo, and biosimilars are equally effective as their original counterparts in treating RA.
Objectives: We investigated the long-term effectiveness, safety, and factors affecting Japanese Health Assessment Questionnaire (J-HAQ) improvement during abatacept treatment in Japanese rheumatoid arthritis (RA) patients.
Methods: The Orencia® Registry in Geographically Assembled Multicenter Investigation (ORIGAMI) study is an ongoing observational study of biologic-naïve RA patients with moderate disease activity treated with subcutaneous abatacept (125 mg, once weekly). Patients treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) were extracted from the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) registry as a historical, weighted control group.
Article Synopsis
- This study looked at how standard medications for systemic lupus erythematosus (SLE) affect important health outcomes like disease activity, flare-ups, and damage over time, using a substantial patient data set from the Asia Pacific Lupus Collaboration (APLC).
- Findings showed that a significant percentage of patients reached low disease activity levels, but many also had flares, with variations in medication use across different countries; specifically, some medications appeared to have a steroid-sparing effect.
- Key results revealed that patients on specific medications like tacrolimus had better odds of achieving low disease activity, while those taking azathioprine and methotrexate were less likely to reach that outcome; however
Article Synopsis
- * A majority of respondents indicated that over half of newly diagnosed patients were 65 or older, with a focus on achieving remission or low disease activity, while also prioritizing patient safety.
- * Rheumatologists expressed concern about comorbidities and other factors that could interfere with optimal treatment, indicating a more complex management landscape for older patients with LORA.
Objective: This study aimed to investigate the role of the programmed cell death protein 1 (PD-1) pathway and T peripheral helper (Tph) cells in the pathogenesis of lupus nephritis using lupus-prone BXSB- mice.
Methods: Male BXSB- mice and age-matched male C57BL/6 mice were used. The expression of PD-1 and its ligands (programmed cell death 1 ligand-1, PD-L1 and programmed cell death 1 ligand-2, PD-L2) and the phenotypes of kidney-derived cells and splenocytes expressing these molecules were analyzed by immunofluorescence and flow cytometry.
Objectives: The aim is to access the real-world clinical management of physicians who treat Takayasu arteritis (TAK) and giant cell arteritis (GCA) after the publication of the Japanese Circulation Society (JCS) 2017 Guidelines for the Management of Vasculitis Syndrome.
Methods: This descriptive, cross-sectional study utilized self-administered electronic questionnaires, which were answered in February 2022 by physicians treating TAK or GCA and registered with Macromill Inc.
Results: The 329 survey respondents were enrolled.
Article Synopsis
- Late-onset rheumatoid arthritis (LORA) is a type of arthritis that affects older people, and experts realized there wasn’t enough information on how to treat it.
- A group of Japanese doctors discussed treatments, reviewed past studies, and worked together to make a set of recommendations for how to manage LORA effectively.
- They found that one of the best treatments is methotrexate and that it's important to consider the health and daily lives of older patients when choosing the right treatment.
Article Synopsis
- The study aimed to determine if achieving Lupus Low Disease Activity State (LLDAS) leads to better outcomes for patients with newly diagnosed systemic lupus erythematosus (SLE).
- Data was collected from a longitudinal SLE cohort in 13 countries, focusing on patients diagnosed within the last year, revealing that these patients had higher disease activity and use of glucocorticoids, but less organ damage initially compared to older patients in the study.
- Results showed that while fewer patients in the recent onset group were in LLDAS at the start, they were more likely to achieve it during follow-up and LLDAS attainment was linked to a lower risk of disease flare-ups.
Objectives: To update an evidence base informing the 2024 Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis (RA) in older adults.
Methods: Four clinical questions (CQs) regarding efficacy and safety of drug treatment were evaluated, with CQ1 addressing methotrexate (MTX), CQ2 biological disease-modifying antirheumatic drugs, CQ3 Janus kinase (JAK) inhibitors, and CQ4 glucocorticoids (GCs). Quality of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system.
Objectives: To identify differences in effectiveness and safety of a treat-to-target (T2T) strategy comparing late-onset MTX-naïve RA patients (LORA) ≥75 or <75 years of age.
Methods: Treatment was adjusted to target low disease activity with conventional synthetic DMARDs followed by biologic DMARDs (bDMARDs) in LORA ≥75 years ( = 98, mean age 80.0 years) and LORA <75 years ( = 99) with moderate-high disease activity.
Article Synopsis
- * Data from a large international cohort of 1,850 mSACQ patients revealed that reducing GCs by 1 mg/day did not increase the risk of overall or severe flares; in fact, the use of antimalarials was linked to a lower risk of flares.
- * Tapering GCs was found to reduce the risk of damage accrual for patients starting with higher prednisolone doses (over 5 mg/day