Modern Rheumatology最新文献

Awareness of Social Insurance, Welfare Systems, and Home Medical Care Among Rheumatologists in Japan: A Cross-Sectional Study. 日本风湿病学家对社会保险、福利制度和家庭医疗护理的认识：一项横断面研究。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-10-02 DOI: 10.1093/mr/roaf085

Toshihiro Matsui, Mie Fusama, Kimito Kawahata, Ryoko Sakai, Takahiko Sugihara, Miho Tsujimura, Isao Matsushita, Nobuyuki Yajima, Takeo Isozaki, Noriyoshi Shimahara, Shotaro Suzuki, Rei Ono, Shinya Taguchi, Shigeto Tohma, Ryo Yanai, Hideshi Yamazaki, Toshie Kadonaga, Hiroaki Nakabayashi, Chiaki Ando, Masayo Kojima, Yutaka Kawahito

{"title":"Awareness of Social Insurance, Welfare Systems, and Home Medical Care Among Rheumatologists in Japan: A Cross-Sectional Study.","authors":"Toshihiro Matsui, Mie Fusama, Kimito Kawahata, Ryoko Sakai, Takahiko Sugihara, Miho Tsujimura, Isao Matsushita, Nobuyuki Yajima, Takeo Isozaki, Noriyoshi Shimahara, Shotaro Suzuki, Rei Ono, Shinya Taguchi, Shigeto Tohma, Ryo Yanai, Hideshi Yamazaki, Toshie Kadonaga, Hiroaki Nakabayashi, Chiaki Ando, Masayo Kojima, Yutaka Kawahito","doi":"10.1093/mr/roaf085","DOIUrl":"https://doi.org/10.1093/mr/roaf085","url":null,"abstract":"Objectives: To assess rheumatologists' awareness of social insurance, welfare systems, and home medical care for rheumatoid arthritis (RA) patients in Japan.Methods: An anonymous, web-based questionnaire was distributed to 5 128 members of the Japan College of Rheumatology between April 11-30, 2024. The survey covered demographics, knowledge of support systems, and attitudes toward home medical care.Results: A total of 478 rheumatologists responded (response rate 9.3%). While over 80% had some understanding of the High-Cost Medical Expense Benefit and Long-Term Care Insurance systems, knowledge of the Disability Pension and long-term care facility characteristics was limited. About 73% reported facing difficulties in patient support due to insufficient knowledge. Medical Social Workers played a central role in providing patient support; however, their availability was limited in smaller clinics. Although 95.3% of respondents recognized the growing need for home medical care, only 24.5% had practical experience. Major concerns included the lack of RA expertise among physicians caring for patients living at home and challenges in medication management after care transition.Conclusions: Despite recognizing the importance of integrating social support and medical care, significant gaps remain in rheumatologists' knowledge and engagement, especially in home care settings. Educational and systemic improvements are needed.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessment of Muscle Quality and Quantity in Individuals with Diffuse Idiopathic Skeletal Hyperostosis. 弥漫性特发性骨骼肥厚症患者肌肉质量和数量的评估。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-10-02 DOI: 10.1093/mr/roaf084

Kosei Ono, Takayoshi Shimizu, Masaki Sakamoto, Masaya Kubota, Masahiro Yakami, Takashi Sono, Ryusuke Nakamoto, Koichi Murata, Shuichi Matsuda, Bungo Otsuki

{"title":"Assessment of Muscle Quality and Quantity in Individuals with Diffuse Idiopathic Skeletal Hyperostosis.","authors":"Kosei Ono, Takayoshi Shimizu, Masaki Sakamoto, Masaya Kubota, Masahiro Yakami, Takashi Sono, Ryusuke Nakamoto, Koichi Murata, Shuichi Matsuda, Bungo Otsuki","doi":"10.1093/mr/roaf084","DOIUrl":"https://doi.org/10.1093/mr/roaf084","url":null,"abstract":"Objectives: Diffuse idiopathic skeletal hyperostosis (DISH) may reduce spinal mobility and affect muscle quantity and quality, increasing sarcopenia risk. However, longitudinal data are limited. We investigated muscle quantity, quality, and their changes in DISH using computed tomography (CT) and bioelectrical impedance analysis (BIA).Methods: We analysed health screening data including participants who underwent CT and BIA twice over five years. We identified 143 DISH patients (58.0 ± 8.4 years, 19 females) and 143 age- and sex-matched controls (58.4 ± 8.8 years, 19 females). At L3, psoas and posterior paraspinal muscle (PSM) areas were measured on CT and normalized to height squared as muscle index (MI, cm2/m2). Muscle density was assessed in Hounsfield units (HU). Skeletal muscle mass index (SMI, kg/m2) was obtained from BIA.Results: At baseline, DISH had higher MI (psoas: 347.5 ± 86.0 versus 294.8 ± 81.7, p < 0.001; PSM: 809.3 ± 146.2 versus 758.8 ± 130.7, p = 0.002) but lower HU (psoas: 36.0 ± 9.1 versus 40.9 ± 5.2, p < 0.001; PSM: 39.0 ± 8.8 versus 42.0 ± 7.4, p = 0.002). SMI was similar (7.9 ± 0.9 versus 7.7 ± 0.9, p = 0.212). Over five years, DISH MI declined (psoas: 334.3 ± 94.9, p = 0.006; PSM: 782.6 ± 166.4, p = 0.007), while controls showed no change (psoas: 294.7 ± 94.1, p = 0.695; PSM: 757.2 ± 170.3, p = 0.776).Conclusion: DISH patients have greater muscle mass but lower quality and trend toward decline, suggesting sarcopenia risk.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Real-world use of biologics for systemic juvenile idiopathic arthritis: information from a Japanese hospital claims database. 真实世界中使用生物制剂治疗系统性青少年特发性关节炎：来自日本医院索赔数据库的信息。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-09-13 DOI: 10.1093/mr/roaf083

Takashi Funatogawa, Kazuma Mii, Saki Katayama, Yuka Aoki, Yasuaki Matsubara, Kazuki Kojima, Mariko Hoshiba

{"title":"Real-world use of biologics for systemic juvenile idiopathic arthritis: information from a Japanese hospital claims database.","authors":"Takashi Funatogawa, Kazuma Mii, Saki Katayama, Yuka Aoki, Yasuaki Matsubara, Kazuki Kojima, Mariko Hoshiba","doi":"10.1093/mr/roaf083","DOIUrl":"https://doi.org/10.1093/mr/roaf083","url":null,"abstract":"Objectives: Limited information is available on patients with systemic juvenile idiopathic arthritis (sJIA) receiving biologics in Japan. The types of biologics, treatment duration, prior and concomitant treatments, administration route (intravenous [IV] or subcutaneous [SC] injection), treatment sequence, and characteristics of patients receiving biologics were investigated.Methods: We used data from a Japanese hospital claims database (2008-2024).Results: Of the 2000 sJIA patients in the database, 315 (15.8%) received one or more biologics. For the first biologic, the most common were anti-interleukin-6 (anti-IL-6) drugs (82.5%; tocilizumab, 82.2% [IV, 65.1%; SC, 17.1%]; others, <0.4%), followed by anti-tumour necrosis factor (anti-TNF) drugs (11.7%; adalimumab SC, 4.4%; infliximab IV, 4.1%; others, <1.6% each), canakinumab SC (3.8%), and abatacept IV or SC (1.9%). Over 53% of patients received anti-IL-6 drugs for ≥1 year. The most common csDMARDs administered prior to anti-IL-6 drugs were cyclosporine (11.9%), methotrexate (11.5%), and tacrolimus (6.2%), and those most commonly administered concomitantly with anti-IL-6 drugs were methotrexate (22.7%), cyclosporine (16.9%), and tacrolimus (11.5%). Fifty patients switched from tocilizumab IV to a second biologic (tocilizumab SC, 50.0%; canakinumab SC, 36.0%; others ≤4.0% each).Conclusions: Our study described the real-world usage of biologics for sJIA in Japan.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Real-world treatment for systemic sclerosis and systemic sclerosis-associated interstitial lung disease: information from a Japanese hospital claims database. 系统性硬化症和系统性硬化症相关间质性肺病的现实治疗：来自日本医院索赔数据库的信息

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-09-10 DOI: 10.1093/mr/roaf082

Takashi Funatogawa, Kazuma Mii, Kazuki Kojima, Yuka Aoki, Yasuaki Matsubara, Mariko Hoshiba

{"title":"Real-world treatment for systemic sclerosis and systemic sclerosis-associated interstitial lung disease: information from a Japanese hospital claims database.","authors":"Takashi Funatogawa, Kazuma Mii, Kazuki Kojima, Yuka Aoki, Yasuaki Matsubara, Mariko Hoshiba","doi":"10.1093/mr/roaf082","DOIUrl":"https://doi.org/10.1093/mr/roaf082","url":null,"abstract":"ObjectivesThe 2023 EULAR guidelines for systemic sclerosis (SSc) newly recommend biologics (rituximab, tocilizumab), mycophenolate mofetil (MMF), and nintedanib in addition to cyclophosphamide for interstitial lung disease (ILD). This study investigated recent actual use of these drugs in Japan. MethodsWe analysed data from a Japanese hospital claims database (2020-2023), identifying patients with SSc disease codes (ICD-10 M34.x) and/or ILD codes. Patients with coexisting autoimmune disease codes were also included. ResultsOf 14 522 SSc patients, 2080 (14.3%) received small-molecule drugs and 618 (4.3%) received biologics. For SSc, common first small-molecule drugs were methotrexate (24.2%), nintedanib (19.5%), tacrolimus (17.9%), and MMF (16.8%); common first biologics were rituximab (44.2%) and tocilizumab (29.1%). Of 4 890 SSc-ILD patients, 1 081 (22.1%) received small-molecule drugs and 282 (5.8%) received biologics. For SSc-ILD, common first small-molecule drugs were nintedanib (30.8%), tacrolimus (20.9%), and MMF (18.3%); common first biologics were rituximab (51.8%) and tocilizumab (25.2%). Rituximab showed the greatest increase in use for both SSc and SSc-ILD between 2020 and 2023. Common subsequent treatments following rituximab or intravenous cyclophosphamide (which are typically administered for a limited duration) were nintedanib, MMF, and rituximab. ConclusionsRecent actual drug use in Japan has been aligning increasingly closely with the EULAR recommendations.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correction to: Rituximab in the real-world treatment of lupus nephritis: A retrospective cohort study in Japan. 更正：利妥昔单抗在狼疮肾炎实际治疗中的应用：日本的一项回顾性队列研究。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-09-02 DOI: 10.1093/mr/roae013

引用次数: 0

Distinct impact of RF and ACPA titre on the effectiveness and persistency of biologics and JAK inhibitors: The ANSWER cohort study. RF和ACPA滴度对生物制剂和JAK抑制剂的有效性和持久性的显著影响：ANSWER队列研究。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-09-02 DOI: 10.1093/mr/roaf029

Yuki Etani, Yasutaka Okita, Yuichi Maeda, Kohei Tsujimoto, Makoto Hirao, Akira Onishi, Hideo Onizawa, Takaichi Okano, Keisuke Nishimura, Ayaka Yoshikawa, Hideyuki Shiba, Hideki Amuro, Yonsu Son, Motomu Hashimoto, Tadashi Okano, Ryota Hara, Wataru Yamamoto, Shotaro Tachibana, Shinya Hayashi, Takaaki Noguchi, Atsushi Kumanogoh, Seiji Okada, Ken Nakata, Kosuke Ebina

{"title":"Distinct impact of RF and ACPA titre on the effectiveness and persistency of biologics and JAK inhibitors: The ANSWER cohort study.","authors":"Yuki Etani, Yasutaka Okita, Yuichi Maeda, Kohei Tsujimoto, Makoto Hirao, Akira Onishi, Hideo Onizawa, Takaichi Okano, Keisuke Nishimura, Ayaka Yoshikawa, Hideyuki Shiba, Hideki Amuro, Yonsu Son, Motomu Hashimoto, Tadashi Okano, Ryota Hara, Wataru Yamamoto, Shotaro Tachibana, Shinya Hayashi, Takaaki Noguchi, Atsushi Kumanogoh, Seiji Okada, Ken Nakata, Kosuke Ebina","doi":"10.1093/mr/roaf029","DOIUrl":"10.1093/mr/roaf029","url":null,"abstract":"Objectives: We aimed to identify the impact of rheumatoid factor (RF) or anticyclic citrullinated peptide antibody (ACPA) titres on the retention of biological disease-modifying antirheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKis) in patients with rheumatoid arthritis.Methods: We retrospectively analysed 5312 courses of bDMARDs or JAKis from the ANSWER cohort. To calculate hazard ratios (HRs) for treatment discontinuation, we used multivariate Cox proportional hazards modelling, adjusted for potential confounders.Results: HRs for discontinuation due to ineffectiveness were calculated based on RF classification, revealing that anti-interleukin-6 receptor (aIL-6R) antibodies exhibited the highest retention rates regardless of RF titre. In the RF-positive group, tumour necrosis factor inhibitors (TNFis) showed lower retention rates, whereas cytotoxic T lymphocyte-associated antigen-4-Ig (CTLA4-Ig) and JAKis followed aIL-6R in the retention rates. When classified based on ACPA, aIL-6R also exhibited the highest retention rates across all ACPA groups. TNFis showed lower retention rates compared with other agents in the ACPA-positive group, whereas CTLA4-Ig showed lower retention rates in the ACPA-negative group compared with other agents.Conclusions: Considering effectiveness, aIL-6R showed the highest retention rates regardless of seropositivity. Although CTLA4-Ig and JAKis followed aIL-6R in RF or ACPA-positive cases, CTLA4-Ig showed the lowest retention rates in ACPA-negative cases.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"820-829"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

1 mg/day or 10 mg/week? Folic acid supplementation with methotrexate in rheumatoid arthritis. 每天1毫克还是每周10毫克？叶酸补充甲氨蝶呤治疗类风湿性关节炎。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-09-02 DOI: 10.1093/mr/roaf028

Hiroya Tamai, Tsutomu Takeuchi, Yuko Kaneko

引用次数: 0

Verification of unmet medical needs in patients with juvenile idiopathic arthritis in Japan. 日本青少年特发性关节炎患者未满足医疗需求的验证。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-09-02 DOI: 10.1093/mr/roaf032

Masaki Shimizu, Eisuke Inoue, Ryoko Sakai, Yuzaburo Inoue, Kanako Mitsunaga, Takahiko Sugihara, Toru Hirano, Kazushi Izawa, Dai Kishida, Masakazu Matsushita, Masaaki Mori, Hidehiko Narazaki, Ryuta Nishikomori, Shuji Sumitomo, Takayuki Tanaka, Susumu Yamazaki, Ken Yamaji, Naoto Yokogawa, Hajime Yoshifuji, Takako Miyamae

{"title":"Verification of unmet medical needs in patients with juvenile idiopathic arthritis in Japan.","authors":"Masaki Shimizu, Eisuke Inoue, Ryoko Sakai, Yuzaburo Inoue, Kanako Mitsunaga, Takahiko Sugihara, Toru Hirano, Kazushi Izawa, Dai Kishida, Masakazu Matsushita, Masaaki Mori, Hidehiko Narazaki, Ryuta Nishikomori, Shuji Sumitomo, Takayuki Tanaka, Susumu Yamazaki, Ken Yamaji, Naoto Yokogawa, Hajime Yoshifuji, Takako Miyamae","doi":"10.1093/mr/roaf032","DOIUrl":"10.1093/mr/roaf032","url":null,"abstract":"Objectives: To identify unmet medical needs (UMNs) of medical practices and investigate the real-world prescribing practices of therapeutic medical treatments and test implementation for patients with juvenile idiopathic arthritis (JIA).Methods: The possible UMNs were collected from eight paediatric and eight adult rheumatologists. To verify UMNs, the real-world prescribing practices of therapeutic medical treatments and test implementation for patients with JIA were described using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB).Results: Fifty-eight possible UMNs collected from 16 experts and 35 UMNs were investigated using NDB. The highest priority UMNs was the expansion of indications for subcutaneous tocilizumab (TCZ sc) and subcutaneous abatacept- subcutaneous tocilizumab was administered to 12.8% systemic JIA and 5.5% JIA with polyarthritis or oligoarthritis. Comorbidities for systemic JIA and JIA with polyarthritis or oligoarthritis included hypertension (7.1%, 1.3%), osteoporosis (17%, 5.4%), depression (2.3%, 1.3%), diabetes (1.9% systemic JIA), and iritis and/or uveitis (6.5% JIA with polyarthritis or oligoarthritis).Conclusions: The highest priority UMNs for JIA was the expansion of indications for abatacept sc and especially subcutaneous tocilizumab. This study reveals the real-world prescribing practices of therapeutic medical treatments and test implementation for patients with JIA in Japan.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"909-915"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nationwide epidemiological survey of primary Sjogren's disease in Japan using the National Database of Designated Intractable Diseases. 利用国家指定疑难病数据库对日本原发性 Sjogren's 病进行全国流行病学调查。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-09-02 DOI: 10.1093/mr/roaf027

Yuzaburo Inoue, Ryoko Sakai, Eisuke Inoue, Kanako Mitsunaga, Ken Yamaji, Masaaki Mori, Minako Tomiita, Naoki Shimojo, Takako Miyamae

{"title":"Nationwide epidemiological survey of primary Sjogren's disease in Japan using the National Database of Designated Intractable Diseases.","authors":"Yuzaburo Inoue, Ryoko Sakai, Eisuke Inoue, Kanako Mitsunaga, Ken Yamaji, Masaaki Mori, Minako Tomiita, Naoki Shimojo, Takako Miyamae","doi":"10.1093/mr/roaf027","DOIUrl":"10.1093/mr/roaf027","url":null,"abstract":"Objectives: This study aimed to evaluate clinical and serological factors influencing systemic disease activity in primary Sjögren's disease (SjD) using the European League Against Rheumatism Sjögren's Syndrome Disease Activity Index (ESSDAI) and to identify distinct patient subgroups in a Japanese cohort.Methods: Data from 7444 patients with ESSDAI ≥5 registered in Japan's National Database of Designated Intractable Diseases were analysed. Univariate and multivariate regression analyses evaluated the impact of demographic and serological factors on ESSDAI scores. K-means clustering identified subgroups based on significant variables.Results: Male patients exhibited higher ESSDAI scores (coefficient: 0.76, P = .0007), whereas Hashimoto's disease was associated with lower scores (coefficient: -0.53, P = .009). Anti-SS-B/La (coefficient: 1.08, P = .0002) and high titre of antinuclear antibody (ANA) (coefficient: 0.64, P = .02) were associated with increased ESSDAI. Clustering identified three subgroups: a 'classic' SjD group with balanced systemic involvement, a male-specific group with severe manifestations, and a Hashimoto's disease group with milder activity.Conclusions: Primary SjD in Japan exhibits significant heterogeneity influenced by demographic and serological factors. Male sex and specific autoantibodies correlate with higher systemic activity, whereas Hashimoto's disease is associated with reduced severity. These findings elucidate the need for personalised management and longitudinal studies.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"859-865"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analysis of the appropriate dose of hydroxychloroquine in systemic lupus erythematosus in Japan. 日本系统性红斑狼疮患者羟氯喹适宜剂量分析。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-09-02 DOI: 10.1093/mr/roaf025

Eitaro Yoshida, Kentaro Minowa, Yusuke Yanagimoto, Emi Nakanishi, Takuya Nishi, Ayako Makiyama, Hirofumi Amano, Ken Yamaji, Naoto Tamura

{"title":"Analysis of the appropriate dose of hydroxychloroquine in systemic lupus erythematosus in Japan.","authors":"Eitaro Yoshida, Kentaro Minowa, Yusuke Yanagimoto, Emi Nakanishi, Takuya Nishi, Ayako Makiyama, Hirofumi Amano, Ken Yamaji, Naoto Tamura","doi":"10.1093/mr/roaf025","DOIUrl":"10.1093/mr/roaf025","url":null,"abstract":"Objective: : Recent systemic lupus erythematosus (SLE) guidelines recommend using hydroxychloroquine (HCQ) at <5.0 mg/kg/day to reduce retinopathy risk but note that doses below this may increase flare risk, suggesting 5.0 mg/kg/day as ideal. Evidence is insufficient, especially among the Japanese.Method: : We retrospectively analysed 321 SLE patients treated with HCQ at Juntendo University Hospital between December 2015 and March 2019. They were divided into a low-dose group (<5 mg/kg/day, n = 205) and a high-dose group (≥5 mg/kg/day, n = 116). This study compared side effect discontinuation rates, flare rates, and treatment efficacy in Japanese SLE patients according to HCQ dosage, evaluating changes in Systemic Lupus Erythematosus Disease Activity Index, glucocorticoid dosage, complement activity, and anti-ds DNA antibody titer.Results: : Three hundred and twenty-one patients were followed for a median of 66 months. The side effect discontinuation rate was not significantly different. SLE flare rates were 5.4% in the low-dose group and 8.6% in the high-dose group, with no significant difference (P = .170). While the high-dose group showed a trend towards better treatment efficacy for secondary outcomes, the differences were not statistically significant.Conclusion: : There was no significant difference in flare incidence based on HCQ dosage. In the maintenance phase of remission, a lower dosage may be sufficient.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"843-849"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0