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Papers - Kikuchi, Jun

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大量ステロイドとトシリズマブ治療経過中に巨細胞性動脈炎による重症脳梗塞を発症した一例

鈴木浩司, 秋山光浩, 花岡洋成, 近藤泰, 齋藤俊太郎, 菊池潤, 金子祐子

関東リウマチ (関東リウマチ研究会) 55 7 - 11 2023.05

ISSN 0911-4807

症例は77歳女性で、発熱、両肩関節の疼痛・挙上困難、顎跛行を主訴とした。血液検査、画像所見(PET-CT、頭部造影MRI)、右側頭動脈生検より、巨細胞性動脈炎と診断した。大量ステロイドとトシリズマブを開始したが、重症脳梗塞を発症し、ステロイドパルスとシクロフォスファミドによる再寛解導入療法を行い、病勢をコントロールできた。脳梗塞に対してはアスピリンとクロピドグレルを開始した。本症例は高齢、高血圧、顎跛行、炎症マーカー低値で、PET-CTで内頸動脈への集積亢進を認めるなど脳梗塞のリスクが高かった。

Deep remission within 12 months prevents renal flare and damage accrual in lupus nephritis.

Kikuchi J, Hanaoka H, Saito S, Oshige T, Hiramoto K, Takeuchi T, Kaneko Y

Clinical and experimental rheumatology 2023.01

ISSN 0392-856X

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Differences in the strength of inhibition of interleukin-6 signalling by subcutaneous sarilumab and tocilizumab in rheumatoid arthritis patients.

Saito S, Suzuki K, Yoshimoto K, Kondo Y, Kikuchi J, Hanaoka H, Kaneko Y, Takeuchi T

Clinical and experimental rheumatology 2022.12

ISSN 0392-856X

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Clinical and immunological effects of hydroxychloroquine in patients with active rheumatoid arthritis despite antirheumatic treatment.

Hiroshi Takei, Satoshi Takanashi, Kotaro Otomo, Hironari Hanaoka, Jun Kikuchi, Kunihiro Yamaoka, Keiko Yoshimoto, Takayuki Abe, Tsutomu Takeuchi, Yuko Kaneko

Modern rheumatology 2022.12

ISSN 1439-7595

OBJECTIVE: To investigate the efficacy and safety of hydroxychloroquine (HCQ) in patients with rheumatoid arthritis (RA). METHODS: Patients with active RA, despite conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), were recruited. HCQ was administered for 24 weeks, in addition to prior treatment. The primary endpoint was the proportion of American College of Rheumatology (ACR) 20 achievement at week 24, compared to that of a propensity score matched historical control group. RESULTS: Sixty patients were enrolled and administered HCQ. We also identified 276 patients as candidates for the historical control group. Propensity score matching yielded 46 patients in each group. The proportion of ACR20 achievements at week 24 was significantly higher in the HCQ group than that in the control group (54.4% vs. 28.3%, P = 0.007). The proportion of ACR50 and ACR70 achievement at week 24 were also higher in the HCQ group than those in the control group (ACR50, 30.4% vs. 4.3%, P = 0.006; ACR70, 17.4% vs. 0%, P = 0.005). Neither hydroxychloroquine retinopathy nor any new safety signal was observed during the study. CONCLUSION: The addition of HCQ to csDMARDs was effective, with no new safety signal in patients with RA.

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Associations of improvement in laboratory tests with clinical outcomes in patients with active systemic lupus erythematosus: a multinational longitudinal cohort study

Connelly K., Kandane-Rathnayake R., Hoi A., Louthrenoo W., Hamijoyo L., Cho J., Lateef A., Fen Luo S., Wu Y.J.J., Li Z., Navarra S., Zamora L., Sockalingam S., Hao Y., Zhang Z., Katsumata Y., Harigai M., Oon S., Chan M., Chen Y.H., Bae S.C., O'Neill S., Goldblatt F., Kikuchi J., Takeuchi T., Ling Ng K.P., Tugnet N., Basnayake B.M.D.B., Ohkubo N., Tanaka Y., Sing Lau C., Nikpour M., Golder V., Morand E.F.

The Lancet Rheumatology (The Lancet Rheumatology) 4 ( 12 ) e831 - e841 2022.12

Background: The selection and categorisation of laboratory tests in disease activity measures used within systemic lupus erythematosus (SLE) trial endpoints lack strong evidence. We aimed to determine whether longitudinal improvements in routinely measured laboratory tests are associated with measures of clinical improvement in patients with baseline active SLE. Methods: We included patients from a multicentre longitudinal cohort (recruited between May 1, 2013, and Dec 31, 2019) with active SLE (SLEDAI-2K ≥6) coinciding with an abnormality in at least one of 13 routine laboratory tests, at a visit designated as baseline. At 12 months, we analysed associations between thresholds of improvement in individual laboratory test results, measured as continuous variables, and five clinical outcomes using logistic regression. Primary outcomes were damage accrual and lupus low disease activity state (LLDAS), and secondary outcomes were modified SLE responder index (mSRI), physician global assessment (PGA) improvement of at least 0·3, and flare. Findings: We included 1525 patients (1415 [93%] women and 110 [7%] men, 1328 [87%] Asian ethnicity) in separate subsets for each laboratory test. The strongest associations with LLDAS and damage protection were seen with improvements in proteinuria (complete response: adjusted odds ratio [OR] 62·48, 95% CI 18·79–208·31 for LLDAS, OR 0·22, 95% CI 0·10–0·49 for damage accrual), albumin (complete response: adjusted OR 6·46, 95% CI 2·20–18·98 for LLDAS, OR 0·42, 95% CI 0·20–1·22 for damage accrual), haemoglobin (complete response: adjusted OR 1·97, 95% CI 1·09–3·53 for LLDAS, OR 0·33, 95% CI 0·15–0·71 for damage accrual), erythrocyte sedimentation rate (complete response: adjusted OR 1·71, 95% CI 1·10–2·67 for LLDAS, OR 0·53, 95% CI 0·30–0·94 for damage accrual), and platelets (complete response: adjusted OR 4·82, 95% CI 1·54–15·07 for LLDAS, OR 0·49, 95% CI 0·20–1·19 for damage accrual). Improvement in serological tests were mainly associated with PGA and mSRI. White cell and lymphocyte count improvements were least predictive. Interpretation: Improvements in several routine laboratory tests correspond with clinical outcomes in SLE over 12 months. Tests with the strongest associations were discrepant with laboratory tests included in current trial endpoints, and associations were observed across a range of improvement thresholds including incomplete resolution. These findings suggest the need to revise the use of laboratory test results in SLE trial endpoints. Funding: Abbvie.

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Lupus low disease activity state and remission and risk of mortality in patients with systemic lupus erythematosus: a prospective, multinational, longitudinal cohort study

Kandane-Rathnayake R., Golder V., Louthrenoo W., Chen Y.H., Cho J., Lateef A., Hamijoyo L., Luo S.F., Wu Y.J.J., Navarra S.V., Zamora L., Li Z., Sockalingam S., Katsumata Y., Harigai M., Hao Y., Zhang Z., Basnayake B.M.D.B., Chan M., Kikuchi J., Takeuchi T., Bae S.C., Oon S., O'Neill S., Goldblatt F., Ng K.P.L., Law A., Tugnet N., Kumar S., Tee C., Tee M., Ohkubo N., Tanaka Y., Yu D.Y., Karyekar C.S., Sing Lau C., Monk J.A., Nikpour M., Hoi A., Morand E.F.

The Lancet Rheumatology (The Lancet Rheumatology) 4 ( 12 ) e822 - e830 2022.12

Background: Treat-to-target goals for patients with systemic lupus erythematosus (SLE) have been validated to protect against organ damage and to improve quality of life. We aimed to investigate the association between lupus low disease activity state (LLDAS) and remission and risk of mortality in patients with SLE. We hypothesised that LLDAS has a protective association with mortality risk. Methods: In this prospective, multinational, longitudinal cohort study, we used data from patients with SLE in the Asia Pacific Lupus Collaboration cohort collected between May 1, 2013, and Dec 31, 2020. Eligible patients were adults (aged ≥18 years) who met either the 1997 American College of Rheumatology modified classification criteria for SLE or the 2012 Systemic Lupus International Collaborating Clinics classification criteria. The primary outcome was all-cause mortality, and LLDAS, remission, and variations of remission with lower glucocorticoid thresholds were the primary exposure variables. Survival analyses were used to examine longitudinal associations between these endpoints and risk of mortality. This study is registered with ClinicalTrials.gov, NCT03138941. Findings: Among a total of 4106 patients in the cohort, 3811 (92·8%) patients were included in the final analysis (median follow-up 2·8 years [IQR 1·0–5·3]; 3509 [92·1%] women and 302 [7·9%] men), of whom 80 died during the observation period (crude mortality rate 6·4 deaths per 1000 person-years). LLDAS was attained at least once in 43 (53·8%) of 80 participants who died and in 3035 (81·3%) of 3731 participants who were alive at the end of the study (p<0·0001); 22 (27·5%) participants who died versus 1966 (52·7%) who were alive at the end of the study attained LLDAS for at least 50% of observed time (p<0·0001). Remission was attained by 32 (40·0%) of 80 who died and in 2403 (64·4%) of 3731 participants who were alive at the end of the study (p<0·0001); 14 (17·5%) participants who died versus 1389 (37·2%) who were alive at the end of the study attained remission for at least 50% of observed time (p<0·0001). LLDAS for at least 50% of observed time (adjusted hazard ratio 0·51 [95% CI 0·31–0·85]; p=0·010) and remission for at least 50% of observed time (0·52 [0·29–0·93]; p=0·027) were associated with reduced risk of mortality. Modifying the remission glucocorticoid threshold (<5·0 mg/day prednisolone) was more protective against mortality than current remission definitions (0·31 [0·12–0·77]; p=0·012), and glucocorticoid-free remission was the most protective (0·13 [0·02–0·96]; p=0·046). Interpretation: LLDAS significantly reduced the risk of mortality in patients with SLE. Remission did not further reduce the risk of mortality compared with LLDAS, unless lower glucocorticoid thresholds were used. Funding: The Asia-Pacific Lupus Collaboration received funding from Janssen, Bristol Myers Squibb, Eli Lilly, and UCB for this study.

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Patterns of Medication Use in Systemic Lupus Erythematosus - A Multi-Centre Cohort Study.

Rangi Kandane-Rathnayake, Worawit Louthrenoo, Shue-Fen Luo, Yeong-Jian J Wu, Yi-Hsing Chen, Vera Golder, Aisha Lateef, Jiacai Cho, Sandra V Navarra, Leonid Zamora, Laniyati Hamijoyo, Sargunan Sockalingam, Yuan An, Zhanguo Li, Ricardo Montes, Shereen Oon, Yasuhiro Katsumata, Masayoshi Harigai, Yanjie Hao, Zhuoli Zhang, Madelynn Chan, Jun Kikuchi, Tsutomu Takeuchi, Fiona Goldblatt, Sean O'Neill, Sang-Cheol Bae, Chak S Lau, Alberta Hoi, Chetan S Karyekar, Mandana Nikpour, Eric F Morand

Arthritis care & research (Arthritis Care and Research) 74 ( 12 ) 2033 - 2041 2022.12

ISSN 2151464X

OBJECTIVES: Evidence for the utility of medications in settings lacking randomised trial data can come from studies of treatment persistence. We examined patterns of medication use in systemic lupus erythematosus (SLE) using data from a large multicentre longitudinal cohort. METHODS: Prospectively collected data from the Asia Pacific Lupus Collaboration cohort including disease activity (SLEDAI-2K) and medication details, captured at every visit from 2013-18, were used. Medications were categorised as glucocorticoids (GC), anti-malarials (AM), and immunosuppressants (IS). Cox regression analyses were performed to determine the time-to-discontinuation of medications, stratified by SLE disease activity. RESULTS: Data from 19,804 visits of 2,860 patients were analysed. Eight medication categories were observed: no treatment; GC, AM or IS only; GC+AM; GC+IS; AM+IS and GC+AM+IS (triple therapy). Triple therapy was the most frequent pattern (31.4% of visits); single agents were used in 21% of visits and biologicals in only 3%. Time-to-discontinuation analysis indicated that medication persistence varied widely, with the highest treatment persistence for AM and lowest for IS. Patients with time-adjusted mean SLEDAI-2K≥10 had lower discontinuation of GC and higher discontinuation of IS. CONCLUSION: Most patients received combination treatment. GC persistence was high, while IS persistence was low. Patients with high disease activity received more medication combinations but had reduced IS persistence, consistent with limited utility. These data confirm unmet need for improved SLE treatments.

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'Not at target': prevalence and consequences of inadequate disease control in systemic lupus erythematosus-a multinational observational cohort study.

Rangi Kandane-Rathnayake, Worawit Louthrenoo, Alberta Hoi, Shue-Fen Luo, Yeong-Jian J Wu, Yi-Hsing Chen, Jiacai Cho, Aisha Lateef, Laniyati Hamijoyo, Sandra V Navarra, Leonid Zamora, Sargunan Sockalingam, Yuan An, Zhanguo Li, Yasuhiro Katsumata, Masayoshi Harigai, Yanjie Hao, Zhuoli Zhang, Jun Kikuchi, Tsutomu Takeuchi, B M D B Basnayake, Madelynn Chan, Kristine Pek Ling Ng, Nicola Tugnet, Sunil Kumar, Shereen Oon, Fiona Goldblatt, Sean O'Neill, Kathryn A Gibson, Naoaki Ohkubo, Yoshiya Tanaka, Sang-Cheol Bae, Chak Sing Lau, Mandana Nikpour, Vera Golder, Eric F Morand

Arthritis research & therapy (Arthritis Research and Therapy) 24 ( 1 ) 70 - 70 2022.12

ISSN 14786354

BACKGROUND: The unmet need in systemic lupus erythematosus (SLE) with the current standard of care is widely recognised, but few studies have quantified this. The recent definition of treat-to-target endpoints and other thresholds of uncontrolled disease activity provide an opportunity to formally define unmet need in SLE. In this study, we enumerated the prevalence of these states and examined their association with adverse outcomes. METHODS: Data were collected prospectively in a 13-country longitudinal SLE cohort between 2013 and 2019. Unmet need was defined as never attaining lupus low disease activity state (LLDAS), a time-adjusted mean SLEDAI-2K (AMS) > 4, or ever experiencing high disease activity status (HDAS; SLEDAI-2K ≥10). Health-related quality of life (HRQoL) was assessed using SF36 (v2) and damage accrual using the SLICC-ACR SLE Damage Index (SDI). RESULTS: A total of 3384 SLE patients were followed over 30,313 visits (median [IQR] follow-up 2.4 [0.4, 4.3] years). Eight hundred thirteen patients (24%) never achieved LLDAS. Median AMS was 3.0 [1.4, 4.9]; 34% of patients had AMS > 4. Twenty-five per cent of patients had episodes of HDAS. Each of LLDAS-never, AMS>4, and HDAS-ever was strongly associated with damage accrual, higher glucocorticoid use, and worse HRQoL. Mortality was significantly increased in LLDAS-never (adjusted HR [95% CI] = 4.98 [2.07, 12.0], p<0.001) and HDAS-ever (adjusted hazard ratio (HR) [95% CI] = 5.45 [2.75, 10.8], p<0.001) patients. CONCLUSION: Failure to achieve LLDAS, high average disease activity, and episodes of HDAS were prevalent in SLE and were significantly associated with poor outcomes including organ damage, glucocorticoid exposure, poor quality of life, and mortality.

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Role of interferons (IFNs) in the differentiation of T peripheral helper (Tph) cells

Tanemura S., Seki N., Tsujimoto H., Saito S., Kikuchi J., Sugahara K., Yoshimoto K., Suzuki K., Kaneko Y., Chiba K., Takeuchi T.

International immunology (International immunology) 34 ( 10 ) 533 - 544 2022.09

ISSN 0953-8178

Interleukin (IL)-21-producing T peripheral helper (Tph) cells are thought to contribute to extra-follicular B cell activation and play a pathogenic role in autoimmune diseases. In this study, we investigated the relationship between Tph cells and interferons (IFNs) in several autoimmune diseases because our previous study demonstrated that type I IFNs promote the differentiation of IL-21-producing Tph-like cells. The frequency of Tph cells in the blood as well as serum IFN-α2a and IFN-λ1 were markedly elevated in patients with active systemic lupus erythematosus (SLE) compared to other autoimmune diseases or healthy controls. Notably, the frequency of Tph cells was positively correlated with the SLE disease activity index, serum IFN-α and serum IFN-λ1 in SLE patients. Additionally, we found that type III IFNs (IFN-λ1, IFN-λ2 and IFN-λ3) promote the differentiation of programmed cell death-1 (PD-1)+ CXCR5 -CD4+ T cells and enhance the secretion of IL-21, IFN-γ and CXCL13. IFN-λ1, like IFN-α, up-regulated the mRNA expression of IL21, IFNG, CXCL13, CD244, SLAMF7, GZMB, PRF1, CCR5 and PRDM1, whereas it down-regulated that of CXCR5 and BCL6, reflecting a Tph-related gene expression pattern. IFN-α in combination with IFN-λ1, IFN-λ2 or IFN-λ3 significantly increased the differentiation of PD-1+CXCR5- Tph-like cells and the secretion of Tph-related cytokines as compared with each IFN alone, suggesting a cooperative interaction. From these findings, it is highly probable that type III IFNs in addition to type I IFNs play a key role in the differentiation of Tph cells and that high levels of IFN-α and IFN-λ1 trigger the differentiation and expansion of Tph cells in SLE.

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Tapering of Corticosteroids or Immunosuppressive Therapy in Stable SLE: A Comparison of Complete Remission, Clinical Remission and Lupus Low Disease Activity State in Protection Against Flares

Cho Jiacai, Shen Liang, Huq Molla, Kandane-Rathnayake Rangi, Golder Vera, Louthrenoo Worawit, Chen Yi-Hsin, Hamijoyo Laniyati, Fen Luo Shue, Wu Yeong-Jian, Zamora Leonid, Zhang Zhouli, Yuan An, Sockalingam Sargunan, Katsumata Yasuhiro, Harigai Masayoshi, Hao Yanjie, Li Zhanguo, Basnayake Duminda, Chan Madelynn, Kikuchi Jun, Takeuchi Tsutomu, Bae Sang-Cheol, Goldblatt Fiona, Oon Shereen, O'Neill Sean, Gibson Kathy, Ng Kristine, Law Hui Nee Annie, Tugnet Nicole, Kumar Sunil, Tee Cherica, Tee Michael, Ohkubo Naoaki, Tanaka Yoshiya, Navarra Sandra, Sing Chak, Hoi Alberta, Morand Eric, Nikpour Mandana, Lateef Aisha

ARTHRITIS & RHEUMATOLOGY 74 1969 - 1972 2022.09

ISSN 2326-5191

Association of Sustained Lupus Low Disease Activity State with Improved Outcomes in SLE: A Multinational Prospective Cohort Study

Golder Vera, Kandane-Rathnayake Rangi, Li Ning, Louthrenoo Worawit, Chen Yi-Hsing, Cho Jiacai, Lateef Aisha, Hamijoyo Laniyati, Fen Luo Shue, Wu Yeong-Jian, Navarra Sandra, Zamora Leonid, Li Zhanguo, Yuan An, Sockalingam Sargunan, Katsumata Yasuhiro, Harigai Masayoshi, Hao Yanjie, Zhang Zhouli, Basnayake Duminda, Chan Madelynn, Kikuchi Jun, Takeuchi Tsutomu, Bae Sang-Cheol, Goldblatt Fiona, Oon Shereen, O'Neill Sean, Gibson Kathryn, Ng Kristine, Law Hui Nee Annie, Tugnet Nicole, Kumar Sunil, Tee Cherica, Tee Michael, Tanaka Yoshiya, Sing Chak, Hoi Alberta, Nikpour Mandana, Morand Eric

ARTHRITIS & RHEUMATOLOGY 74 3160 - 3161 2022.09

ISSN 2326-5191

Predictors of Organ Damage Accrual by Domains

Kandane-Rathnayake Rangi, Li Ning, Golder Vera, Louthrenoo Worawit, Chen Yi-Hsin, Cho Jiacai, Lateef Aisha, Hamijoyo Laniyati, Fen Luo Shue, Wu Yeong-Jian, Navarra Sandra, Zamora Leonid, Li Zhanguo, Yuan An, Sockalingam Sargunan, Katsumata Yasuhiro, Harigai Masayoshi, Hao Yanjie, Zhang Zhouli, Chan Madelynn, Kikuchi Jun, Takeuchi Tsutomu, Oon Shereen, Bae Sang-Cheol, Goldblatt Fiona, O'Neill Sean, Gibson Kathy, Ng Kristine, Law Hui Nee Annie, Basnayake Duminda, Tugnet Nicole, Kumar Sunil, Tee Cherica, Tee Michael, Tanaka Yoshiya, Sing Chak, Nikpour Mandana, Hoi Alberta, Morand Eric

ARTHRITIS & RHEUMATOLOGY 74 4077 - 4080 2022.09

ISSN 2326-5191

SMART-SLE: Serology Monitoring and Repeat Testing in Systemic Lupus Erythematosus

Yeo Ai Li, Kandane-Rathnayake Rangi, Koelmeyer Rachel, Golder Vera, Louthrenoo Worawit, Chen Yi-Hsin, Cho Jiacai, Lateef Aisha, Hamijoyo Laniyati, Fen Luo Shue, Wu Yeong-Jian, Navarra Sandra, Zamora Leonid, Li Zhanguo, Yuan An, Sockalingam Sargunan, Katsumata Yasuhiro, Harigai Masayoshi, Hao Yanjie, Zhang Zhouli, Basnayake Duminda, Chan Madelynn, Kikuchi Jun, Takeuchi Tsutomu, Bae Sang-Cheol, Oon Shereen, O'Neill Sean, Goldblatt Fiona, Gibson Kathy, Ng Kristine, Law Hui Nee Annie, Tugnet Nicole, Kumar Sunil, Tee Cherica, Tee Michael, Tanaka Yoshiya, Ohkubo Naoaki, Sing Chak, Nikpour Mandana, Hoi Alberta, Leech Michelle, Morand Eric

ARTHRITIS & RHEUMATOLOGY 74 642 - 643 2022.09

ISSN 2326-5191

Lupus low disease activity state within 12 months is associated with favourable outcomes in severely active systemic lupus erythematosus.

Jun Kikuchi, Hironari Hanaoka, Shuntaro Saito, Tatsuhiro Oshige, Kazuoto Hiramoto, Yuko Kaneko, Tsutomu Takeuchi

Rheumatology (Oxford, England) (Rheumatology (Oxford, England)) 61 ( 9 ) 3777 - 3791 2022.08

ISSN 1462-0324

OBJECTIVES: To demonstrate the significance of the time to attain lupus low disease activity state (LLDAS) after remission induction therapy in patients with severely active systemic lupus erythematosus (SLE). METHODS: We enrolled 79 patients starting prednisolone ≥0.4 mg/kg/day for active lupus with a British Isles Lupus Assessment Group 2004 index of A ≥ 1 or B ≥ 2, or for severe flare based on the Safety of Estrogens in Lupus Erythematosus National Assessment-SLE Disease Activity Index (SELENA-SLEDAI). The time to LLDAS attainment was divided into ≤6, 6-12, and >12 months and non-LLDAS; associations between the timing of LLDAS and flares, damage accrual, and ≥50% LLDAS attainment were examined. RESULTS: The mean SLEDAI was 17; median starting dose of prednisolone, 0.95 mg/kg/day; and mean observational period, 39.7 months. Six (7.6%) and 41 (51.9%) patients achieved LLDAS within 6 and 12 months. Patients with a shorter time to LLDAS achievement were more likely to spend ≥50% of the time in LLDAS and had a lower cumulative prednisolone dose; no differences were observed in damage accrual. Patients requiring longer than 12 months to achieve LLDAS had a higher prevalence of thrombocytopenia and those with non-LLDAS had lower renal function and a higher starting dose of prednisolone and steroid pulse therapy than those who achieved LLDAS within 12 months. CONCLUSION: Achieving LLDAS within 12 months of induction therapy may be favourable in patients with severely active SLE. The low frequency of LLDAS attainment in high-risk populations highlights the need for a new strategy for SLE treatment.

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Decreased chronic kidney disease in rheumatoid arthritis in the era of biologic disease-modifying anti-rheumatic drugs

Hanaoka H., Kikuchi J., Hiramoto K., Saito S., Kondo Y., Kaneko Y.

Clinical Kidney Journal (Clinical Kidney Journal) 15 ( 7 ) 1373 - 1378 2022.07

ISSN 20488505

Background: We investigated the incidence of chronic kidney disease (CKD) progression and its factors relevant to patients with stable rheumatoid arthritis (RA). Methods: We enrolled consecutive patients with RA who had initiated treatment with a biologic disease-modifying anti-rheumatic drug (bDMARD) at our institution and continued the same drug for >5 years between 2001 and 2016. Patients with CKD at bDMARD initiation were excluded. C-reactive protein (CRP) level, Clinical Disease Activity Index (CDAI) score and estimated glomerular filtration rate were measured every 6 months. Results: We included 423 patients, with 196 on tumour necrosis factor inhibitors, 190 on tocilizumab and 37 on abatacept. Among these patients, 34 (8.0%) progressed to CKD within 5 years. The mean CRP level and CDAI score over 5 years were significantly lower in patients without CKD progression than in those with CKD progression (P <. 001 and P =. 008, respectively). Multivariable analysis revealed that age at bDMARD initiation [odds ratio (OR) 1.05, P =. 002], non-steroidal anti-inflammatory drug use (OR 3.47, P =. 004) and mean CRP >0.14 mg/dL (OR 5.89, P =. 015) were independently associated with CKD progression, while tocilizumab use was associated with a decreased risk of CKD progression (OR 0.31, P =. 027). Conclusions: Controlling inflammation contributes to the inhibition of CKD progression in RA patients.

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RISK FACTORS FOR CYTOMEGALOVIRUS INFECTION IN PATIENTS WITH RHEUMATIC DISEASE; SINGLE-CENTER PROSPECTIVE COHORT STUDY.

Ota Y., Kondo Y., Saito S., Kikuchi J., Hanaoka H., Kaneko Y.

ANNALS OF THE RHEUMATIC DISEASES 81 919 - 919 2022.06

ISSN 0003-4967

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COMPARISON OF ATTAINMENT AND PROTECTIVE EFFECTS OF THE LUPUS LOW DISEASE ACTIVITY STATE IN PATIENTS WITH NEWLY DIAGNOSED VERSUS ESTABLISHED SLE - A MULTICENTRE PROSPECTIVE STUDY

Golder V., Kandane-Rathnayake R., Louthrenoo W., Chen Y. H., Cho J., Lateef A., Hamijoyo L., Luo S. F., Wu Y. J. Jan, Navarra S., Zamora L., Li Z., An Y., Sockalingam S., Katsumata Y., Harigai M., Hao Y., Zhang Z., Basnayake B., Chan M., Kikuchi J., Takeuchi T., Bae S. C., O'neill S., Goldblatt F., Oon S., Gibson K., Ng K., Law A., Tugnet N., Kumar S., Tee C., Tee M., Tanaka Y., Lau C. S., Nikpour M., Hoi A., Morand E. F.

ANNALS OF THE RHEUMATIC DISEASES 81 91 - 92 2022.06

ISSN 0003-4967

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ASSOCIATION OF LUPUS LOW DISEASE ACTIVITY STATE ATTAINMENT WITH REDUCED ORGAN DAMAGE AND FLARE IN SLE PATIENTS WITH HIGH DISEASE ACTIVITY

Kandane-Rathnayake R., Golder V., Louthrenoo W., Chen Y. H., Cho J., Lateef A., Hamijoyo L., Luo S. F., Wu Y. J. Jan, Navarra S., Zamora L., Li Z., An Y., Sockalingam S., Katsumata Y., Harigai M., Hao Y., Zhang Z., Basnayake B., Chan M., Kikuchi J., Takeuchi T., Bae S. C., Oon S., O'neill S., Goldblatt F., Gibson K., Ng K., Law A., Tugnet N., Kumar S., Tee C., Tee M., Tanaka Y., Lau C. S., Nikpour M., Morand E. F., Hoi A.

ANNALS OF THE RHEUMATIC DISEASES 81 286 - 287 2022.06

ISSN 0003-4967

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APTAMER-BASED PROTEOMIC SCREENING IN IDENTIFICATION OF PATHOGENIC SIGNAL PATHWAY AND URINARY BIOMARKERS ASSOCIATED WITH HISTOLOGICAL FINDINGS IN LUPUS NEPHRITIS

Hiramoto K., Saito S., Hanaoka H., Suzuki K., Kikuchi J., Fukui H., Takano R., Miyoshi F., Seki N., Sugahara K., Kaneko Y., Takeuchi T.

ANNALS OF THE RHEUMATIC DISEASES 81 483 - 483 2022.06

ISSN 0003-4967

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COMPARISON OF SARS-COV-2 VACCINE RESPONSE IN PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASE; MRNA-1273 VACCINE INDUCES HIGHER HUMORAL IMMUNOGENICITY THAN BNT162B2

Kondo Y., Takeshita M., Uwamino Y., Namkoong H., Saito S., Kikuchi J., Hanaoka H., Suzuki K., Hasegawa N., Murata M., Kaneko Y.

ANNALS OF THE RHEUMATIC DISEASES 81 370 - 370 2022.06

ISSN 0003-4967

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