Modern Rheumatology最新文献_第2页

TAFRO Syndrome: Early Combination Therapy Outcomes and Prolonged Thrombocytopenia - A Seven-Case Series. TAFRO综合征：早期联合治疗的结果和延长的血小板减少-一个七例系列。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-10-09 DOI: 10.1093/mr/roaf092

Shiro Ono, Tomohiro Nakamura, Nobushiro Nishimura, Hidetoshi Matsuoka, Ryo Yoneima, Hiromasa Kawashima, Makiko Miyamoto, Masaki Matsubara, Noritaka Yada, Kiyomi Yoshimoto

{"title":"TAFRO Syndrome: Early Combination Therapy Outcomes and Prolonged Thrombocytopenia - A Seven-Case Series.","authors":"Shiro Ono, Tomohiro Nakamura, Nobushiro Nishimura, Hidetoshi Matsuoka, Ryo Yoneima, Hiromasa Kawashima, Makiko Miyamoto, Masaki Matsubara, Noritaka Yada, Kiyomi Yoshimoto","doi":"10.1093/mr/roaf092","DOIUrl":"https://doi.org/10.1093/mr/roaf092","url":null,"abstract":"Objective: This study aimed to evaluate treatment outcomes, complications, and clinical course of thrombocytopenia in patients with TAFRO syndrome.Methods: We conducted a retrospective analysis of patients treated at Nara Medical University Hospital from 2015 to 2023. Diagnosis of TAFRO syndrome was made according to the 2015 or 2019 criteria, and disease severity was assessed based on the updated disease severity classification. Clinical characteristics and laboratory and histological data were analyzed.Results: Seven patients, median age 51 years, were included, with four classified as very severe, two as severe, and one as slightly severe. All patients received early combination therapy (various combinations of glucocorticoids, tocilizumab, cyclosporine, and rituximab), with the second therapy added a median of 5 days after the first. Six patients received eltrombopag. Despite intensive treatment, thrombocytopenia persisted for a prolonged period, with a median time to platelet count normalization of 54 days. Cytomegalovirus reactivation occurred in six patients during treatment but resolved with appropriate antiviral therapy. All patients achieved remission and survived.Conclusions: Thrombocytopenia in TAFRO syndrome persists long-term despite intensive combination therapy. Early combination therapy was associated with excellent survival outcomes, suggesting that intensifying treatment solely for thrombocytopenia may not be necessary given its prolonged course (200 words).","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251805","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

The effectiveness and safety of subcutaneous methotrexate injection in Japanese patients with rheumatoid arthritis in a real-world setting. 甲氨蝶呤皮下注射在日本类风湿性关节炎患者中的有效性和安全性。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-10-09 DOI: 10.1093/mr/roaf093

Yuta Shimomura, Shigeru Iwata, Ryo Matsumiya, Takashi Kato, Kodai Ueno, Taro Nishikawa, Takeru Sonoda, Takao Fujii

{"title":"The effectiveness and safety of subcutaneous methotrexate injection in Japanese patients with rheumatoid arthritis in a real-world setting.","authors":"Yuta Shimomura, Shigeru Iwata, Ryo Matsumiya, Takashi Kato, Kodai Ueno, Taro Nishikawa, Takeru Sonoda, Takao Fujii","doi":"10.1093/mr/roaf093","DOIUrl":"https://doi.org/10.1093/mr/roaf093","url":null,"abstract":"Objectives: To clarify the effectiveness and safety of subcutaneous injections (SC) of methotrexate (MTX) in Japanese patients with rheumatoid arthritis (RA) using real-world data.Methods: In this retrospective observational study, 82 patients with RA were administered SC MTX at our department and affiliated facilities for 24 weeks (wks) after approval in September 2022. Drug continuation rate, disease activity, clinical symptoms including adverse events (AEs) and glucocorticoid (GC) dose after SC MTX administration were retrospectively examined.Results: The patients' background: age 59.8 years, male/female 16/66, disease duration 8.6 years, stage I/II/III/IV 36/32/2/11, DAS28-ESR 3.5, CDAI 10.4, and SDAI 11.2. SC MTX continuation rate after 24 wks (primary endpoint) was 86.6%. In 72 of 82 patients (87.8%), oral MTX was switched to SC MTX. Mean oral MTX dose before the switch was 10.6 mg/wk. Mean maximum dose after switching to SC was 12.0 mg/wk. AEs were observed in 30 patients (36.6%), with a total CTCAE grade of 2 or lower. Clinical symptoms such as nausea, liver dysfunction, and stomatitis improved in 15 (20.8%) patients. In 53 patients who switched from oral to SC MTX, the disease activity scores were improved and the GC dose can be reduced.Conclusion: In real-world setting, switching from oral to SC MTX is useful in Japanese patients with RA.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251802","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

Validation of the 2019 EULAR/ACR classification criteria and clinical characteristics of childhood-onset Japanese patients with systemic lupus erythematosus. 日本儿童期系统性红斑狼疮患者的2019年EULAR/ACR分类标准和临床特征验证

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-10-08 DOI: 10.1093/mr/roaf088

Hitoshi Irabu, Asami Ohara, Aki Nakamura, Hidehiko Narazaki, Yuko Hayashi, Yuichi Yamasaki, Naomi Iwata, Shiro Ohshima, Susumu Nishiyama, Yasuo Nakagishi, Daisuke Fukuhara, Hiroyuki Ishida, Miwa Goto, Kunio Hashimoto, Ryuhei Yasuoka, Tomo Nozawa, Takako Miyamae, Hiroaki Umebayashi, Masaaki Mori, Masaki Shimizu

{"title":"Validation of the 2019 EULAR/ACR classification criteria and clinical characteristics of childhood-onset Japanese patients with systemic lupus erythematosus.","authors":"Hitoshi Irabu, Asami Ohara, Aki Nakamura, Hidehiko Narazaki, Yuko Hayashi, Yuichi Yamasaki, Naomi Iwata, Shiro Ohshima, Susumu Nishiyama, Yasuo Nakagishi, Daisuke Fukuhara, Hiroyuki Ishida, Miwa Goto, Kunio Hashimoto, Ryuhei Yasuoka, Tomo Nozawa, Takako Miyamae, Hiroaki Umebayashi, Masaaki Mori, Masaki Shimizu","doi":"10.1093/mr/roaf088","DOIUrl":"https://doi.org/10.1093/mr/roaf088","url":null,"abstract":"Objectives: This study was aimed to evaluate the diagnostic performance of the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR-2019) classification criteria of systemic lupus erythematosus (SLE) and to clarify the clinical characteristics of Japanese childhood-onset SLE (cSLE).Methods: We retrospectively analyzed clinical data registered in the Pediatric Rheumatology International Collaboration Unit Registry (PRICURE) version 2 up to March 31, 2023. Frequencies of individual items within the EULAR/ACR-2019 criteria were compared with those observed in a Japanese adult SLE cohort.Results: A total of 105 patients with cSLE, 19 with Juvenile dermatomyositis (JDM), 27 with primary Sjögren's disease (pSjD), and 9 with mixed connective-tissue disease (MCTD) were included. The sensitivity of the EULAR/ACR-2019 criteria was 97.1%. The specificity was 94.7% for JDM, 92.6% for pSjD, 55.6% for MCTD, and 87.3% for all disease controls. cSLE patients in this cohort more frequently exhibited renal involvement, low serum C3 or C4 levels, and positivity for antiphospholipid and anti-double-stranded DNA antibodies, whereas joint symptoms were less common than in adult SLE patients.Conclusions: Although the EULAR/ACR-2019 criteria are generally applicable, the limited specificity for MCTD necessitates careful differential diagnosis. Japanese cSLE is commonly characterized by renal involvement, hypocomplementemia, and SLE-related autoantibody positivity.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251837","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

Comparison of the risk of hospitalized infections between self-injecting and non-self-injecting biologics in patients with rheumatoid arthritis. 类风湿性关节炎患者自注射与非自注射生物制剂住院感染风险的比较

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-10-08 DOI: 10.1093/mr/roaf086

Shingo Akutsu, Kazuhiko Takahata, Ryoko Sakai, Manabu Akazawa

引用次数: 0

Systematic review of the treatment of rheumatoid arthritis patients of reproductive age: Informing the 2024 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis - secondary publication. 育龄期类风湿关节炎患者治疗的系统综述：告知2024年日本风湿病学会类风湿关节炎管理临床实践指南的更新-二次出版。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-10-08 DOI: 10.1093/mr/roaf087

Mikako Goto, Chie Kohno, Chinatsu Takai, Eiko Miyagawa, Ryo Yanai, Nobuyuki Yajima, Yuko Kaneko, Eiichi Tanaka, Yutaka Kawahito, Masayoshi Harigai, Kayoko Kaneko

{"title":"Systematic review of the treatment of rheumatoid arthritis patients of reproductive age: Informing the 2024 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis - secondary publication.","authors":"Mikako Goto, Chie Kohno, Chinatsu Takai, Eiko Miyagawa, Ryo Yanai, Nobuyuki Yajima, Yuko Kaneko, Eiichi Tanaka, Yutaka Kawahito, Masayoshi Harigai, Kayoko Kaneko","doi":"10.1093/mr/roaf087","DOIUrl":"https://doi.org/10.1093/mr/roaf087","url":null,"abstract":"Objectives: To inform the 2024 updates of the Japanese College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis (RA) of the safety of maternal and paternal exposure to disease-modifying antirheumatic drugs (DMARDs).Methods: We searched the databases of PubMed, the Cochrane Library, and the Japana Centra Revuo Medicina for articles published between 2019 and 2022 and combined them with our previous systematic review. Two independent reviewers screened articles, evaluated core outcomes, and performed meta-analyses for each clinical question.Results: The relative effects (odds ratio (OR) [95% confidence interval (95% CI)]) of tumour necrosis factor inhibitor (TNFi) exposure on the infants of pregnant women with RA were as follows: major birth defects, 1.51 [0.89, 2.58]); and serious neonatal infections, 1.20 [0.84, 1.71]. For the relative effect (OR [95% CI]) of paternal antirheumatic drugs exposure on major birth defect of their infants were1.3 [0.28, 6.14] for TNFi and 0.94 [0.38, 2.33] for methotrexate.Conclusions: This systematic review provided the latest evidence on effects of maternal and paternal exposure to DMARDs on their infants for the 2024 update of the CPG.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251885","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

Cold Fingers Under the Lens: Unveiling Microvascular Differences Between Children with Primary Raynaud's Phenomenon and Healthy Individuals. 镜头下的冷手指：揭示原发性雷诺现象儿童与健康个体的微血管差异。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2025-10-08 DOI: 10.1093/mr/roaf089

Gülşah Kavrul Kayaalp, Selen Duygu Arık, Özlem Akgün, Bengisu Menentoğlu, Ayşenur Doğru, Figen Çakmak, Nuray Aktay Ayaz

{"title":"Cold Fingers Under the Lens: Unveiling Microvascular Differences Between Children with Primary Raynaud's Phenomenon and Healthy Individuals.","authors":"Gülşah Kavrul Kayaalp, Selen Duygu Arık, Özlem Akgün, Bengisu Menentoğlu, Ayşenur Doğru, Figen Çakmak, Nuray Aktay Ayaz","doi":"10.1093/mr/roaf089","DOIUrl":"https://doi.org/10.1093/mr/roaf089","url":null,"abstract":"Objectives: This study aimed to evaluate capillaroscopic findings in children with Raynaud's phenomenon (RP) referred to a pediatric rheumatology clinic and compare them to healthy controls to identify RP-related patterns.Methods: Sixty-six patients aged 0-18 years with RP and 65 age- and sex-matched healthy controls were included. Standardized capillaroscopic assessments followed the 2020 recommendations of EULAR study group on microcirculation in rheumatic diseases. Capillaroscopic patterns of 62 primary RP patients were compared with controls.Results: Two patients were diagnosed with systemic sclerosis and two with systemic lupus erythematosus. Among 62 primary RP patients (median age 14.92 years, 62.9% female), ANA positivity was 11.29%. Capillaroscopy revealed increased apical loop diameter (18.74±4.40 vs 15.20±2.98, p<0.001), dilated capillaries (82.3% vs 15.40%, p<0.001), abnormal capillaries (53.2% vs 18.5%, p<0.001), microhemorrhages (17.7% vs 1.5%, p=0.002) in primary RP patients compared to controls. The predominant pattern was non-specific (56.5%) in RP patients, and normal pattern in controls (87.7%, p<0.001). No correlation was found between capillaroscopy patterns and ANA positivity, or medication use.Conclusion: Patients with primary RP showed a unique capillaroscopy pattern. Follow-up studies are needed to assess the proportion who may develop secondary RP and how capillaroscopic findings evolve.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251687","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

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