111 results match your criteria: "Niigata Rheumatic Center[Affiliation]"

Background: Fanconi syndrome is a disorder of the proximal tubule that leads to malabsorption of various electrolytes and substances and is a common consequence of drug-induced nephrotoxicity. However, cases of dietary supplement-induced Fanconi syndrome are rare, and detailed reports on the evaluation of renal histology in patients with this syndrome are lacking.

Case Presentation: We present two cases of dietary supplement-induced Fanconi syndrome that was confirmed by kidney biopsy.

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Objective: To elucidate the therapeutic effect of orthopedic surgical intervention (OSI) in difficult-to-treat rheumatoid arthritis (D2T RA) compared with non-D2T RA.

Methods: A total of 534 recent surgeries were analyzed only in patients who had undergone OSI since 2016 and for whom a 12-month post-operative follow-up was available. D2T RA was determined according to the EULAR definition, and patients with D2T RA were matched to patients with non-D2T RA using propensity scores calculated by a logistic regression analysis.

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  • The study compared the initial treatment responses of late-onset rheumatoid arthritis (LORA) patients aged 65 and older with those of young-onset rheumatoid arthritis (YORA) patients under 65, focusing on the influence of osteoarthritis (OA).
  • A retrospective analysis of RA patients referred to a clinic showed that LORA patients with significant OA experienced worse control over their disease and greater difficulties in daily activities after one year of treatment compared to those without OA.
  • In contrast, YORA patients did not show significant differences in daily activity limitations between those with and without OA, indicating that OA had a more pronounced effect on older RA patients.
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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.

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Objectives: Rheumatoid arthritis (RA) is sometimes complicated by interstitial lung disease (ILD) with a poor prognosis. A single nucleotide variant (SNV) in MUC5B was associated with ILD in European RA patients. However, associations of this SNV were not found in Japanese RA patients, because its frequency in Japanese populations is very low.

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  • * 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.
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  • 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.
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  • The study aimed to compare the effectiveness of methotrexate (MTX) as the initial treatment in patients with late-onset rheumatoid arthritis (LORA) versus younger-onset rheumatoid arthritis (YORA).
  • It included 71 YORA patients and 66 LORA patients who were followed for 6 months after starting MTX, showing high treatment adherence (96% for YORA and 92% for LORA).
  • No significant differences in disease activity or remission rates were found between the two groups, indicating comparable effectiveness of MTX regardless of the onset age of rheumatoid arthritis.
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  • - Adult-onset Still's disease (AOSD) is characterized by symptoms like fever, rash, and joint pain due to autoinflammation, and the patient's complement titer was notably low during her condition's onset.
  • - The female patient, in her 60s, presented with elevated white blood cell counts and ferritin levels, but tested negative for common autoimmune markers and infections, leading to a diagnosis of hypocomplementemia.
  • - Despite receiving several standard treatments including corticosteroids, her condition did not improve until she was treated with intravenous cyclophosphamide, which resulted in remission and normalized her complement levels, highlighting the potential of low complement levels as an indicator of severe disease activity and treatment resistance.
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  • The study investigates how new antirheumatic drugs affect the characteristics of lymphoproliferative disorder (LPD) in rheumatoid arthritis (RA) patients, using data from 53 hospitals in Japan between 1999 and 2021.
  • A total of 752 patients with RA-associated LPD were compared to 770 with sporadic LPD, revealing notable differences in their clinical features and the impact of various drug combinations.
  • The findings suggest that medications taken before LPD onset may alter its characteristics, and recommend tocilizumab (TCZ) as a better treatment option after LPD has developed.
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  • Interstitial lung disease and airway disease are serious complications of rheumatoid arthritis, leading to a poor prognosis among affected individuals.
  • This study examined the genetic factors linked to these lung diseases in Japanese RA patients, specifically focusing on two single nucleotide variants (rs2736100 and rs1278769).
  • Findings indicated that rs2736100 is associated with increased susceptibility to airway disease, while rs1278769 is linked to nonspecific interstitial pneumonia in older patients, marking a significant step in understanding genetic risks in RA-related lung issues.
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Objectives: The aim is to evaluate the treatment and prognosis of coronavirus disease 2019 (COVID-19) according to the time of onset and dominant strain in patients with rheumatic diseases.

Methods: This study analysed a nationwide COVID-19 registry of Japanese patients with rheumatic diseases compiled between June 2020 and December 2022. The primary endpoints of the study were hypoxaemia incidence and mortality.

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Background: Infliximab is a human-murine chimeric monoclonal IgG antibody against tumor necrosis factor that is used in combination with methotrexate for the treatment of moderate to severe rheumatoid arthritis (RA). The trough concentration of serum infliximab required to control disease activity in RA is ≥1 μg/mL, and we investigated whether this trough concentration can predict the effectiveness of RA treatment.

Methods: We retrospectively analyzed the cases of 76 patients with RA.

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Objective: Various guidelines recommend that patients with early rheumatoid arthritis (RA) try to achieve clinical remission within 6 months, and early therapeutic intervention is important to this end. This study aimed to investigate short-term treatment outcomes of patients with early-diagnosed RA in clinical practice and to examine predictive factors for achieving remission.

Methods: Of the 210 patients enrolled in the multicenter RA inception cohort, 172 patients who were followed up to 6 months after treatment initiation (baseline) were included.

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Background: In recent years, advances in pharmacotherapy for rheumatoid arthritis have dramatically improved the control of disease activity. However, a significant number of patients still develop hand deformity and require surgical reconstruction. The objective of this study was to evaluate the long-term efficacy and drawbacks of the Swanson metacarpophalangeal joint arthroplasty for patients with rheumatoid arthritis over 10 years.

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Objective Sarcopenia is characterized by a loss of muscle mass and strength, which leads to frailty and mortality. Rheumatoid arthritis (RA) is considered to be a cause of sarcopenia. The present study assessed the effectiveness of biological disease-modifying antirheumatic drugs (bDMARDs) on sarcopenia.

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Background: Interstitial lung disease (ILD) occasionally occurs in rheumatoid arthritis (RA) and confers a dismal prognosis. We previously reported that a single-nucleotide variant (SNV) of was associated with ILD in RA. However, the pathogenesis of ILD in Japanese patients with RA could not be explained solely by this SNV because its frequency is extremely low in the Japanese population.

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Background: Although drug treatment strategies for rheumatoid arthritis (RA) are relatively well established, there is a paucity of evidence on the treatment in older patients. The purpose of this study is to build a registry for late-onset RA (LORA), which is expected to increase rapidly worldwide. In addition, we aim to propose optimal treatment strategies according to the patient background including frailty, thereby contributing to improving the quality of treatment and daily living in patients with RA.

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Multi-ancestry genome-wide association analyses identify novel genetic mechanisms in rheumatoid arthritis.

Nat Genet

November 2022

Center for Data Sciences, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.

Rheumatoid arthritis (RA) is a highly heritable complex disease with unknown etiology. Multi-ancestry genetic research of RA promises to improve power to detect genetic signals, fine-mapping resolution and performances of polygenic risk scores (PRS). Here, we present a large-scale genome-wide association study (GWAS) of RA, which includes 276,020 samples from five ancestral groups.

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Objectives: The aim is to evaluate the relevance of serum immunoglobulin G (IgG) titres against periodontopathic bacteria to predict the clinical response to 1-year treatment with biological disease-modifying antirheumatic drugs (bDMARDs) in rheumatoid arthritis (RA) patients.

Methods: Data were collected from 50 RA patients who had received conventional synthetic DMARDs, corticosteroids, or non-steroidal anti-inflammatory drugs before (baseline) and after 1-year treatment with bDMARDs in a retrospective cohort study. Changes in rheumatologic conditions were compared between the two groups for low and high baseline IgG titres against Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans according to their median measurements.

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Article Synopsis
  • Elderly patients with rheumatoid arthritis (RA) often face challenges using methotrexate (MTX) due to serious health issues, so the study investigated the safety and effectiveness of golimumab (GLM) as an alternative.
  • The findings showed that GLM had comparable survival rates (80.8% for elderly vs. 82.3% for younger patients) and improved disease activity scores in elderly patients over 52 weeks, regardless of their MTX treatment status.
  • Although GLM improved disease activity, it did not significantly impact the Health Assessment Questionnaire Disability Index (HAQ-DI), suggesting that while it’s effective, it may not enhance overall disability levels in elderly patients with RA.
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Objectives: The incidence of femoral localized periosteal thickening (LPT), which can precede atypical femoral fracture (AFF), is not low (1-10%) in Japanese patients with autoimmune inflammatory rheumatic diseases (AIRDs). We explored the associations between underlying AIRDs and the prevalence of LPT.

Methods: We conducted post hoc analyses of two cohorts that included a total of 280 Japanese women, 105 of whom had AIRDs and had been taking bisphosphonate (BP) and prednisolone (PSL) and 175 of whom had rheumatoid arthritis (RA).

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Multiple subcutaneous extensor tendon ruptures in more than the ulnar three fingers sometimes occur in patients with rheumatoid arthritis accompanied by wrist deformity. In these situations, the flexor digitorum superficialis tendon of the middle finger (the FDS3 tendon) and that of the ring finger (the FDS4 tendon) are used for the transferred tendon (modified Boyes' procedure). Here, we treated two patients with rheumatoid arthritis, whose extensor tendons of more than three fingers were ruptured, using the modified Boyes' procedure.

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Background: In recent years, advances in pharmacotherapy for rheumatoid arthritis (RA) have dramatically improved the control of disease activity. However, a significant number of patients still develop forefoot deformity. The purpose of this study was to investigate the results of more than 20 years' follow-up of metatarsal neck shortening oblique osteotomy (SOO) for forefoot deformity in patients with RA.

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Herein, we present two cases of older adult patients with highly destructive changes in ankle joints (Larsen grade IV) who underwent retrograde intramedullary ankle nail fixation with fins. In both patients, bony union was achieved, and full weight-bearing was attained at 3 months after surgery.

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