5 results on '"Masahiro Hanabayashi"'
Search Results
2. Higher doses of methotrexate associated with discontinuation of oral glucocorticoids after initiation of biological DMARDs: A retrospective observational study based on data from a Japanese multicenter registry study
- Author
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Kenya Terabe, Hisato Ishikawa, Takeshi Oguchi, Yasuhide Kanayama, Naoki Ishiguro, Yutaka Yoshioka, Atsushi Kaneko, Yuji Hirano, Shuji Asai, Hideki Takagi, Masahiro Hanabayashi, Yutaka Yokota, Toshihisa Kojima, Koji Funahashi, Tsuyoshi Nishiume, Seiji Tsuboi, Takayoshi Fujibayashi, Nobunori Takahashi, Takayasu Ito, Mochihito Suzuki, Yasumori Sobue, and Yuichiro Yabe
- Subjects
Male ,medicine.medical_specialty ,Registry study ,Administration, Oral ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Rheumatology ,Internal medicine ,medicine ,Humans ,Registries ,030212 general & internal medicine ,Propensity Score ,Glucocorticoids ,Retrospective Studies ,030203 arthritis & rheumatology ,business.industry ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Discontinuation ,Methotrexate ,Treatment Outcome ,Withholding Treatment ,Antirheumatic Agents ,Rheumatoid arthritis ,Female ,business ,hormones, hormone substitutes, and hormone antagonists ,Glucocorticoid ,medicine.drug - Abstract
Glucocorticoids are important drugs used to treat rheumatoid arthritis. We recommend glucocorticoid discontinuation as soon as possible given the associated side-effects, but many patients continue to take oral glucocorticoids long-term. The present study aimed to explore factors associated with glucocorticoid discontinuation at 52 weeks after initiating biological disease-modifying antirheumatic drugs (bDMARDs). Subjects were 564 patients from a Japanese multicenter registry who were administered glucocorticoids and methotrexate (MTX) followed by initiation of the first bDMARD. We examined the status of oral glucocorticoid use at 52 weeks after initiating the first bDMARD. By 52 weeks after bDMARD initiation, 164 patients (29.1%) discontinued glucocorticoids. Multivariable analysis identified age, MTX dose, and glucocorticoid dose as factors independently associated with glucocorticoid discontinuation. After adjusting for baseline characteristics using propensity score matching, among patient groups administered MTX ≤ 8 mg/week and MTX > 8 mg/week, 105 pairs remained. A significantly higher rate of glucocorticoid discontinuation (41.0%) was noted for patients administered MTX > 8 mg/week. Our findings suggest that glucocorticoids may be discontinued after initiating bDMARDs. Moreover, higher MTX doses (>8 mg/week) at the time of bDMARD initiation were associated with glucocorticoid discontinuation among patients treated with bDMARDs.
- Published
- 2021
3. Use of a 12-week observational period for predicting low disease activity at 52 weeks in RA patients treated with abatacept: a retrospective observational study based on data from a Japanese multicentre registry study
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Naoki Ishiguro, Hideki Takagi, S. Hirabara, Masahiro Hanabayashi, Takefumi Kato, Takayoshi Fujibayashi, Seiji Tsuboi, Nobunori Takahashi, Koji Funahashi, Toshihisa Kojima, Takeshi Oguchi, Yuji Hirano, Shuji Asai, Naoki Fukaya, Yutaka Yoshioka, Atsushi Kaneko, Daihei Kida, Yuichiro Yabe, Yasuhide Kanayama, Hiroyuki Miyake, and Masatoshi Hayashi
- Subjects
Male ,musculoskeletal diseases ,medicine.medical_specialty ,Immunoconjugates ,Registry study ,Logistic regression ,Severity of Illness Index ,Observational period ,Abatacept ,Arthritis, Rheumatoid ,Disease activity ,Japan ,Rheumatology ,Predictive Value of Tests ,Internal medicine ,Humans ,Medicine ,Pharmacology (medical) ,Longitudinal Studies ,Registries ,Aged ,Retrospective Studies ,Receiver operating characteristic ,Tumor Necrosis Factor-alpha ,business.industry ,Retrospective cohort study ,Odds ratio ,Middle Aged ,Surgery ,C-Reactive Protein ,Logistic Models ,Treatment Outcome ,Antirheumatic Agents ,Female ,business ,Biomarkers ,Follow-Up Studies ,medicine.drug - Abstract
OBJECTIVE Only a few studies have assessed predictive factors for the long-term efficacy of abatacept. This study aimed to provide clinical evidence of an adequate observational period for predicting low disease activity (LDA) achievement at 52 weeks in RA patients treated with abatacept. METHODS Participants were all patients registered in a Japanese multicentre registry who were treated with abatacept and had at least 52 weeks of follow-up (n = 254). RESULTS Areas under the receiver operating characteristic curves for the 28-joint count with CRP (DAS28-CRP) at each time point for LDA achievement at 52 weeks were: 0.686 (cut-off score: 4.6) at baseline, 0.780 (3.8) at 4 weeks, 0.875 (3.3) at 12 weeks, and 0.900 (3.0) at 24 weeks. Although patients with a DAS28-CRP score < 3.0 at 24 weeks had the highest proportion of LDA achievement at 52 weeks (79.3%), the proportion for those with a score < 3.3 at 12 weeks was comparable (77.2%, P = 0.697). Proportions were significantly lower in patients with a score < 3.8 at 4 weeks or < 4.6 at baseline. Multivariate logistic regression demonstrated that a DAS28 score of < 3.3 at 12 weeks was an independent strong predictor for LDA at 52 weeks (adjusted odds ratio: 15.2, P < 0.001). CONCLUSION Twelve weeks is an adequate observational period to judge the long-term clinical efficacy of abatacept, and is about as early as the period for assessing TNF blockade therapy.
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- 2014
4. Drug retention rates of second biologic agents after switching from tumor necrosis factor inhibitors for rheumatoid arthritis in Japanese patients on low-dose methotrexate or without methotrexate
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Tomone Shioura, Naoki Ishiguro, Masahiro Hanabayashi, Koji Funahashi, Atsushi Kaneko, Yuji Hirano, Toshihisa Kojima, Shuji Asai, S. Hirabara, Yasuhide Kanayama, Tomonori Kobayakawa, Masatoshi Hayashi, Yuichiro Yabe, Nobuyuki Asai, Kiwamu Saito, Nobunori Takahashi, and Hiroyuki Miyake
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Adult ,Male ,musculoskeletal diseases ,medicine.medical_specialty ,medicine.medical_treatment ,Pharmacology ,Gastroenterology ,Etanercept ,Arthritis, Rheumatoid ,chemistry.chemical_compound ,Tocilizumab ,Japan ,Rheumatology ,Internal medicine ,Adalimumab ,Humans ,Medicine ,skin and connective tissue diseases ,Aged ,Biological Products ,Drug Substitution ,Tumor Necrosis Factor-alpha ,business.industry ,Middle Aged ,medicine.disease ,Infliximab ,TNF inhibitor ,Antirheumatic Agents ,Methotrexate ,Treatment Outcome ,chemistry ,Rheumatoid arthritis ,Drug Therapy, Combination ,Female ,business ,medicine.drug - Abstract
The purpose of this study was to explore drug retention rates of second biologic agents after switching from tumor necrosis factor inhibitors (TNFi) in clinical practice in patients with rheumatoid arthritis (RA) on low-dose methotrexate (MTX) or without MTX.A total of 169 RA patients who had been withdrawn from first-course TNFi therapy and received a different TNFi or tocilizumab (TCZ) as a second biologic agent were selected from the Tsurumai Biologics Communication Registry, an observational cohort database. Retention rates of second biologic treatment were compared by the type of first TNFi and second biologic agents.Eighty-six patients received first-course infliximab (IFX) or adalimumab (ADA) therapy, and 83 patients received first-course etanercept (ETN) therapy. The former group had a significantly higher retention rate (IFX, 81.1%; ADA, 83.3%) of the second biologic therapy compared to the latter (56.6%, p0.001, log-rank test). Drug retention rates of the second biologic agent after switching from IFX/ADA were significantly higher with ETN (90.0%) and TCZ (94.7%) than with ADA/IFX (59.3%). Drug retention rates of the second biologic agent after switching from ETN were significantly higher with TCZ (75.9%) than with ADA/IFX (46.3%). The differences were significant even after adjusting for baseline clinical variables using the Cox proportional hazards model.Drug retention rates of IFX and ADA after switching from the first TNFi were significantly lower compared to those of ETN and TCZ in patients on low-dose MTX or without MTX.
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- 2014
5. Importance of methotrexate therapy concomitant with tocilizumab treatment in achieving better clinical outcomes for rheumatoid arthritis patients with high disease activity: an observational cohort study
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Masayo Kojima, Hiroyuki Miyake, Shuji Asai, Yuichiro Yabe, S. Hirabara, Atsushi Kaneko, Koji Funahashi, Yuji Hirano, Nobunori Takahashi, Naoki Ishiguro, Daizo Kato, Masahiro Hanabayashi, Toshihisa Kojima, Nobuyuki Asai, and Masatoshi Hayashi
- Subjects
Adult ,Male ,musculoskeletal diseases ,medicine.medical_specialty ,Blood Sedimentation ,Antibodies, Monoclonal, Humanized ,Severity of Illness Index ,Arthritis, Rheumatoid ,Cohort Studies ,Disease activity ,chemistry.chemical_compound ,Tocilizumab ,Rheumatology ,immune system diseases ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,In patient ,skin and connective tissue diseases ,Aged ,business.industry ,Remission Induction ,Middle Aged ,medicine.disease ,Logistic Models ,Methotrexate ,Treatment Outcome ,chemistry ,Antirheumatic Agents ,Rheumatoid arthritis ,Concomitant ,Prednisolone ,Physical therapy ,Drug Therapy, Combination ,Female ,business ,medicine.drug ,Cohort study - Abstract
The purpose of this study was to identify the effects of concomitant use of MTX and baseline characteristics for remission in the treatment of RA with tocilizumab (TCZ) in daily clinical practice.A total of 240 RA patients who received TCZ were selected from the multicentre Tsurumai Biologics Communication Registry. Predictive baseline factors for remission [28-item DAS (DAS28)2.6] at 52 weeks were determined by logistic regression analysis. To confirm whether the associations varied by the level of baseline disease activity, we also assessed the model including the interaction term (each baseline variable × DAS28).In total, 49.3% of the study participants used MTX with TCZ. Even after controlling for the baseline DAS28, shorter disease duration (≤3 year) [odds ratio (OR) 3.58 (95% CI 1.81, 7.07)], less structural damage [Steinbroker stage ≤II, OR 2.33 (95% CI 1.32, 4.12)] and concomitant prednisolone use [OR 0.38 (95% CI 0.21, 0.68)] showed significant predictive values for remission. Concomitant MTX use failed to show a significant association with remission, whereas a significant interaction was observed among concomitant MTX use × DAS28 (P = 0.006). In patients with high baseline disease activity (DAS285.1), concomitant MTX use was associated with increased odds for remission [adjusted OR for all baseline variables 2.54 (95% CI 1.11, 5.83)], while no association was indicated between them in patients with low to moderate baseline disease activity (DAS28 ≤ 5.1).Concomitant MTX use is an important component of TCZ treatment for RA patients with high disease activity.
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- 2014
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