Modern Rheumatology最新文献_第4页

Systematic review for the treatment of older rheumatoid arthritis patients informing the 2024 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis. 治疗老年类风湿关节炎患者的系统回顾，为 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提供参考。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-08-20 DOI: 10.1093/mr/roae026

Takahiko Sugihara, Yutaka Kawahito, Yuko Kaneko, Eiichi Tanaka, Ryo Yanai, Nobuyuki Yajima, Masayo Kojima, Masayoshi Harigai

{"title":"Systematic review for the treatment of older rheumatoid arthritis patients informing the 2024 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis.","authors":"Takahiko Sugihara, Yutaka Kawahito, Yuko Kaneko, Eiichi Tanaka, Ryo Yanai, Nobuyuki Yajima, Masayo Kojima, Masayoshi Harigai","doi":"10.1093/mr/roae026","DOIUrl":"10.1093/mr/roae026","url":null,"abstract":"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.Results: Observational studies confirmed a pivotal role of methotrexate in the treatment of older RA patients. The meta-analysis showed that tumour necrosis factor inhibitors and JAK inhibitors were unequivocally effective in older RA patients. No data indicated that biological disease-modifying antirheumatic drugs were unsafe for older patients. No safety data for JAK inhibitor use in older patients were available. One randomized controlled trial demonstrated that long-term treatment with low-dose GCs increased risks of GC-associated adverse events. The certainty of overall evidence was very low for all CQs.Conclusions: This systematic review provides the necessary evidence for developing 2024 Japan College of Rheumatology clinical practice guidelines for managing older patients with RA. Continued updates on the evidence of JAK inhibitors and GC are desired.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140039859","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 effectiveness of methotrexate in patients with late-onset versus younger-onset rheumatoid arthritis: Real-world data from an inception cohort in Japan (NICER-J). 比较甲氨蝶呤对晚发与年轻类风湿关节炎患者的疗效：来自日本初始队列的真实世界数据（NICER-J）。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-08-20 DOI: 10.1093/mr/roae027

Shuji Asai, Mochihito Suzuki, Ryota Hara, Yuji Hirano, Satomi Nagamine, Tetsuya Kaneko, Takahito Suto, Tadashi Okano, Yutaka Yoshioka, Makoto Hirao, Hiroki Wakabayashi, Takayoshi Fujibayashi, Tatsuo Watanabe, Yuya Takakubo, Hajime Ishikawa, Yoshihisa Nasu, Toki Takemoto, Takefumi Kato, Eiji Torikai, Kensuke Koyama, Hideki Takagi, Toshifumi Fujiwara, Yasumori Sobue, Yoshifumi Ohashi, Tsuyoshi Nishiume, Kenya Terabe, Masayo Kojima, Toshihisa Kojima, Shiro Imagama

{"title":"Comparison of effectiveness of methotrexate in patients with late-onset versus younger-onset rheumatoid arthritis: Real-world data from an inception cohort in Japan (NICER-J).","authors":"Shuji Asai, Mochihito Suzuki, Ryota Hara, Yuji Hirano, Satomi Nagamine, Tetsuya Kaneko, Takahito Suto, Tadashi Okano, Yutaka Yoshioka, Makoto Hirao, Hiroki Wakabayashi, Takayoshi Fujibayashi, Tatsuo Watanabe, Yuya Takakubo, Hajime Ishikawa, Yoshihisa Nasu, Toki Takemoto, Takefumi Kato, Eiji Torikai, Kensuke Koyama, Hideki Takagi, Toshifumi Fujiwara, Yasumori Sobue, Yoshifumi Ohashi, Tsuyoshi Nishiume, Kenya Terabe, Masayo Kojima, Toshihisa Kojima, Shiro Imagama","doi":"10.1093/mr/roae027","DOIUrl":"10.1093/mr/roae027","url":null,"abstract":"Objective: To compare the effectiveness of methotrexate (MTX) as initial therapy in patients with late-onset and younger-onset rheumatoid arthritis (LORA and YORA).Methods: Of 114 patients with YORA and 96 patients with LORA, defined as RA occurring at ≥65 years of age, enrolled in a multicentre RA inception cohort study, 71 and 66 patients who had been followed up to 6 months after starting MTX treatment were included in this study.Results: Proportions of patients on MTX treatment at 6 months were 96% and 92% in the YORA and LORA groups, respectively. Despite lower doses of MTX in the LORA group compared with the YORA group, no significant difference was observed in clinical disease activity index scores between the two groups throughout the follow-up period. The proportion of patients in clinical disease activity index remission at 6 months was 35% in both groups. Logistic regression analysis revealed that knee joint involvement and high Health Assessment Questionnaire-Disability Index were significant negative predictors of achieving clinical disease activity index remission at 6 months in the LORA group.Conclusion: Observations up to 6 months revealed that the effectiveness of MTX administered based on rheumatologist discretion in patients with LORA is comparable to that in patients with YORA in clinical settings.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140400","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

Increased risk of malignancy in HLA-B27-positive patients with ankylosing spondylitis requiring biologics for sustained inflammation: A long-term, single-center retrospective study. HLA-B27阳性的强直性脊柱炎患者因炎症持续存在而需要使用生物制剂时，其恶性肿瘤风险增加：一项长期的单中心回顾性研究。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-08-20 DOI: 10.1093/mr/roae004

Kai-Chun Wang, Yi-Syuan Sun, Hung-Cheng Tsai, Hsien-Tzung Liao, Chien-Chih Lai, Wei-Sheng Chen, Ling-Ying Lu, Ming-Han Chen

{"title":"Increased risk of malignancy in HLA-B27-positive patients with ankylosing spondylitis requiring biologics for sustained inflammation: A long-term, single-center retrospective study.","authors":"Kai-Chun Wang, Yi-Syuan Sun, Hung-Cheng Tsai, Hsien-Tzung Liao, Chien-Chih Lai, Wei-Sheng Chen, Ling-Ying Lu, Ming-Han Chen","doi":"10.1093/mr/roae004","DOIUrl":"10.1093/mr/roae004","url":null,"abstract":"Objectives: To assess the link between the administration of biologic disease-modifying antirheumatic drugs (bDMARDs) and the risk of malignancy in human leukocyte antigen B27 (HLA-B27)-positive patients with ankylosing spondylitis (AS) experiencing sustained inflammation.Methods: Between 2006 and 2021, 1445 HLA-B27-positive patients with AS were retrospectively evaluated. Among them, 112 patients required bDMARD therapy. The study compared conventional therapy with bDMARDs and investigated the risk factors for developing malignancies.Results: During 8253 patient-years of follow-up, 38 (2.6%) patients developed various malignancies, including lung, liver, breast, and colon cancer. The risk of malignancy was significantly higher in the bDMARD-treated group compared to PS-matched groups receiving conventional synthetic DMARDs (csDMARD) and non-steroidal anti-inflammatory drugs. The cumulative risk of malignancies increased significantly after 6 years of follow-up. All patients who developed malignancy after bDMARD therapy received tumor necrosis factor-α inhibitors. Requiring bDMARD therapy, requiring bDMARDs in combination with csDMARD therapy, and being diagnosed with AS after 30 years of age were independent risk factors for developing malignancy.Conclusions: HLA-B27-positive AS patients with sustained inflammation requiring biologic therapy, particularly if diagnosed after age 30, may have an increased risk of malignancy. Regular cancer screenings are advisable for these patients while undergoing biologic treatment.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672221","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

Healthcare resource utilisation and economic burden of patients with adequate and inadequate responses to biological and targeted synthetic disease-modifying antirheumatic drugs for rheumatoid arthritis in Japan. 日本对治疗类风湿性关节炎的生物和靶向合成疾病改良抗风湿药物反应充分和不足的患者的医疗资源利用和经济负担。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-08-20 DOI: 10.1093/mr/road106

Kei Ikeda, Yuko Kaneko, Yuki Tsujita, Isao Kawaguchi, Jayeshkumar Patel, Toru Yamazaki, Siran Fang, Yutaka Kawahito

{"title":"Healthcare resource utilisation and economic burden of patients with adequate and inadequate responses to biological and targeted synthetic disease-modifying antirheumatic drugs for rheumatoid arthritis in Japan.","authors":"Kei Ikeda, Yuko Kaneko, Yuki Tsujita, Isao Kawaguchi, Jayeshkumar Patel, Toru Yamazaki, Siran Fang, Yutaka Kawahito","doi":"10.1093/mr/road106","DOIUrl":"10.1093/mr/road106","url":null,"abstract":"Objective: To compare healthcare resource utilisation (HCRU) and direct costs between responders versus non-responders to advanced therapies for rheumatoid arthritis (RA).Methods: Patients initiating ≥1 advanced therapy (October 2018 - September 2019) with ≥1 RA claim (6-month pre-index period), ≥2 RA claims (any period), and ≥12 months follow-up were identified from the Medical Data Vision claims database. HCRU and all-cause and RA-related costs [direct medical, emergency department (ED), laboratory, and pharmacy] were compared between responders and non-responders. Adjusted incidence rate ratios (IRRs) for HCRU or cost were calculated via multivariable analyses.Results: Among 2446 patients [non-responders (n = 1817); responders (n = 629)], non-responders had significantly longer hospitalisation days [IRR: 1.8 (95% CI: 1.2 - 2.6)], and significantly more ED visits [2.5 (1.5 - 4.2)] and prescriptions [1.1 (1.1 - 1.2)]. Mean all-cause hospital/outpatient medical costs were significantly higher for non-responders [1.4 (1.3 - 1.6), ¥530,895 versus ¥357,009 ($3992 versus $2684) for responders; ¥173,886 ($1307) difference]; RA-related medical costs showed a similar trend [¥351,306 vs ¥253,030 ($2641 vs $1902); ¥98,276 ($739) difference]. No differences between responders and non-responders were observed in mean all-cause and RA-related pharmacy costs.Conclusions: Non-responders to advanced therapies had greater HCRU and all-cause/RA-related direct costs as compared with responders, suggesting a need for more effective RA therapies to reduce the economic burden associated with non-response.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72210007","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

Safety and effectiveness of denosumab in Japanese patients with rheumatoid arthritis: A 2-year post-marketing surveillance study. denosumab在日本类风湿性关节炎患者中的安全性和有效性:一项为期2年的上市后监测研究

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-08-20 DOI: 10.1093/mr/road108

Yoshiya Tanaka, Hideki Mizutani, Kunimitsu Fujii, Naoki Okubo

{"title":"Safety and effectiveness of denosumab in Japanese patients with rheumatoid arthritis: A 2-year post-marketing surveillance study.","authors":"Yoshiya Tanaka, Hideki Mizutani, Kunimitsu Fujii, Naoki Okubo","doi":"10.1093/mr/road108","DOIUrl":"10.1093/mr/road108","url":null,"abstract":"Objectives: To investigate the 2 year safety and effectiveness of denosumab 60 mg in patients with rheumatoid arthritis (RA) in clinical practice in Japan.Methods: This 2 year, prospective, observational cohort study included patients who initiated treatment with denosumab 60 mg for the progression of bone erosion associated with RA. Key endpoints were adverse drug reactions (ADRs), progression of bone erosion, and 28-joint Disease Activity Score based on C-reactive protein or erythrocyte sedimentation rate. Univariate and multivariate analyses were conducted to determine the risk factors for ADRs and the progression of bone erosion.Results: In the safety analysis set (n = 1239), the incidence of ADRs was 3.0%; the most common ADRs were hypocalcaemia (1.2%) and osteonecrosis of jaw-related events (0.6%). A history of any drug allergy was a statistically significant risk factor associated with the occurrence of ADRs. In the effectiveness analysis set (n = 815), the incidence of progression of bone erosion was 8.7%. Steinbrocker stage and initial steroid dose were statistically significant risk factors associated with the progression of bone erosion.Conclusion: Denosumab demonstrated safety and effectiveness over a 2 year period in RA patients without any new safety concerns.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482632","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

Large language model may assist diagnosis of SAPHO syndrome by bone scintigraphy. 大语言模型可帮助通过骨闪烁扫描诊断 SAPHO 综合征。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-08-20 DOI: 10.1093/mr/road115

Yu Mori, Takuya Izumiyama, Ryuichi Kanabuchi, Naoko Mori, Toshimi Aizawa

{"title":"Large language model may assist diagnosis of SAPHO syndrome by bone scintigraphy.","authors":"Yu Mori, Takuya Izumiyama, Ryuichi Kanabuchi, Naoko Mori, Toshimi Aizawa","doi":"10.1093/mr/road115","DOIUrl":"10.1093/mr/road115","url":null,"abstract":"Objective: In this study, we employed a large language model to evaluate the diagnostic efficacy of radiology reports of bone scintigraphy in the context of identifying SAPHO syndrome, and further examined the potential of such a model to augment the diagnostic procedure.Methods: Imaging data and clinical information of 151 patients (105/46 women/men, mean age: 53.5 years) who underwent bone scintigraphy for suspected Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) syndrome between January 2007 and December 2022 were retrospectively reviewed. ChatGPT-4.0 was used as the large language model. The diagnostic performance of the large language model was verified by comparing the cases judged to have SAPHO syndrome that fulfilled Kahn's classification criteria based on a combination of concise radiology reports and skin lesions such as palmoplantar pustulosis, with cases diagnosed with SAPHO syndrome by rheumatologists based on all clinical information.Results: The diagnostic accuracy of a large language model for analysing bone scintigraphy radiology reports in conjunction with information about skin symptoms, such as palmoplantar pustulosis, achieved a sensitivity of 83.5%, specificity of 69.4%, and an overall accuracy of 76.8%.Conclusion: This research indicates the prospective value of extensive language models in scrutinizing radiology accounts from bone scintigraphy for the diagnosis of SAPHO syndrome.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048944","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

Thirty-year overview of Japanese autopsy cases of Takayasu arteritis - Results of analysis of Japanese autopsy reports. 日本高安动脉炎尸检病例三十年概述--日本尸检报告分析结果。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-08-20 DOI: 10.1093/mr/road117

Yuki Yokouchi, Nanae Asakawa, Toshiaki Oharaseki, Kei Takahashi

{"title":"Thirty-year overview of Japanese autopsy cases of Takayasu arteritis - Results of analysis of Japanese autopsy reports.","authors":"Yuki Yokouchi, Nanae Asakawa, Toshiaki Oharaseki, Kei Takahashi","doi":"10.1093/mr/road117","DOIUrl":"10.1093/mr/road117","url":null,"abstract":"Objective: The objective of the study was to analyse the trends in Takayasu arteritis (TAK) in Japan during three recent decades based on autopsy reports.Methods: We extracted TAK cases from the Japanese Pathological Autopsy Reports published during three decades (1991-2000, 2001-10, and 2011-20) and compared the data for the number of cases, age, gender, malignant tumour complication rate, and cause of death.Results: 322 TAK cases were reported during the 30 years. They represented 0.04-0.06% of the total autopsies, with little variation among the three decades. The peak age at autopsy increased: from the 60s for 1991-2010 to the 70s for 2011-20. The malignant tumour complication rate increased to 12.2%, 18.5%, and 22.7% during the three decades. However, about half of those cases had no metastases, and malignant tumours were rarely directly involved in a TAK patient's death. TAK-associated cardiovascular lesions accounted for most deaths.Conclusions: Although the age at TAK onset showed little change during the 30 years, the age at autopsy has increased, suggesting that the long-term prognosis has improved. Although the malignant tumour complication rate increased with age, the most common causes of death were cardiovascular lesions.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058492","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

Leucine-rich α2-glycoprotein as a useful biomarker for evaluating disease activity in rheumatoid arthritis. 富亮氨酸α2-糖蛋白是评估类风湿性关节炎疾病活动性的有效生物标记物。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-08-20 DOI: 10.1093/mr/road112

Minoru Fujimoto, Yuji Hosono, Satoshi Serada, Yuji Suzuki, Tomoharu Ohkawara, Okinori Murata, Ayumi Quick, Katuya Suzuki, Yuko Kaneko, Tsutomu Takeuchi, Tetsuji Naka

引用次数: 0

The importance of small joint involvement in oligoarticular juvenile idiopathic arthritis. 小关节参与在少关节青少年特发性关节炎中的重要性。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-08-20 DOI: 10.1093/mr/road101

Melike Mehveş Kaplan, Zahide Ekici Tekin, Vildan Güngörer, Elif Çelikel, Tuba Kurt, Merve Cansu Polat, Müge Sezer, Nilüfer Tekgöz, Cüneyt Karagöl, Serkan Coşkun, Nimet Öner, Banu Çelikel Acar

{"title":"The importance of small joint involvement in oligoarticular juvenile idiopathic arthritis.","authors":"Melike Mehveş Kaplan, Zahide Ekici Tekin, Vildan Güngörer, Elif Çelikel, Tuba Kurt, Merve Cansu Polat, Müge Sezer, Nilüfer Tekgöz, Cüneyt Karagöl, Serkan Coşkun, Nimet Öner, Banu Çelikel Acar","doi":"10.1093/mr/road101","DOIUrl":"10.1093/mr/road101","url":null,"abstract":"Objectives: Our study aimed to evaluate the relationship of small joint involvement with demographic, clinical, and laboratory findings and to determine its possible effects on prognosis.Methods: This retrospective observational study was conducted in patients diagnosed with oligoarticular juvenile idiopathic arthritis (oJIA) in the paediatric rheumatology department of Ankara City Hospital between April 2009 and September 2022. The relationship between small joint involvement and demographic, clinical, and laboratory findings and prognosis was investigated by statistical methods with the data recorded from the medical records of oJIA patients.Results: Of the 198 patients diagnosed with oJIA, small joint involvement was observed in a total of 20 (10%) patients, 11 (5.5%) at the time of diagnosis, and 9 (4.5%) during the follow-up period. The frequency of small joint involvement in extended oJIA was significantly higher than in persistent oJIA (P = .001). Patients with small joint involvement had significantly higher erythrocyte sedimentation rate and C-reactive protein values at admission (P = .047, P = .038) and Juvenile Arthritis Disease Activity Score at 3, 6, and 12 months (P = .001, P = .001, P = .018). The need for conventional disease-modifying antirheumatic drugs and biologic disease-modifying antirheumatic drugs was significantly higher in patients with small joint involvement (P = .001, P = .001).Conclusions: oJIA patients with small joint involvement may have higher acute phase reactants at diagnosis, a more extended course and active disease in follow-up, and the need for treatment escalation.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41205265","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

Disease-modifying antirheumatic drug selection in Japanese patients with rheumatoid arthritis treated with biologics or JAK inhibitors without methotrexate: A retrospective hospital-based administrative claims database study. 使用生物制剂或 JAK 抑制剂治疗而不使用甲氨蝶呤的日本类风湿关节炎患者的疾病修饰抗风湿药选择：一项基于医院行政报销数据库的回顾性研究。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-08-20 DOI: 10.1093/mr/roae021

Naohisa Miyakawa, Katsuki Tsuritani, Bruno Casaes Teixeira, Keishi Fujio

{"title":"Disease-modifying antirheumatic drug selection in Japanese patients with rheumatoid arthritis treated with biologics or JAK inhibitors without methotrexate: A retrospective hospital-based administrative claims database study.","authors":"Naohisa Miyakawa, Katsuki Tsuritani, Bruno Casaes Teixeira, Keishi Fujio","doi":"10.1093/mr/roae021","DOIUrl":"10.1093/mr/roae021","url":null,"abstract":"Objectives: We evaluated the medication selection and clinical characteristics of rheumatoid arthritis patients who started treatment with/without methotrexate (MTX) (using biologic disease-modifying antirheumatic drugs or Janus kinase inhibitors instead) in Japan.Methods: Using a Japanese hospital-based administrative claims database, rheumatoid arthritis patients who received treatment [abatacept (ABA), interleukin-6 receptor inhibitor, tumor necrosis factor inhibitor, or Janus kinase inhibitor] between 1 January 2015 and 31 December 2019 were enrolled.Results: Overall, 19,301 patients were included (10,530 receiving MTX; 8771 not receiving MTX within 60 days of the first treatment). Mean ages at diagnosis were 60.7 and 65.9 years in the MTX and non-MTX groups, respectively (P < .0001). The non-MTX group had higher proportions of patients with Charlson Comorbidity Index ≥1 (P < .0001) and higher comorbidity rates. ABA was the most frequently used drug among patients with infectious/parasitic, circulatory, and respiratory diseases at baseline. Interleukin-6 receptor inhibitor had the highest use rate among patients with neoplasms; blood, gastrointestinal, and genitourinary diseases; and abnormal clinical/laboratory findings. ABA had the highest persistence probability from 6 months onward.Conclusions: MTX is used less frequently among older Japanese rheumatoid arthritis patients or those with comorbidities. In such patients, ABA is the most frequently used drug, followed by interleukin-6 receptor inhibitor, when MTX is not used at treatment start.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140049860","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