Infection rates in patients from five rheumatoid arthritis (RA) registries: contextualising an RA clinical trial programme

OBJECTIVE: Patients with rheumatoid arthritis (RA) have an increased risk of serious infections. Comparing infection rates across RA populations is complicated by differences in background infection risk, population composition and study methodology. We measured infection rates from five RA registries globally, with the aim to contextualise infection rates from an RA clinical trials population. METHODS: We used data from Consortium of Rheumatology Research of North America (CORRONA) (USA), Swedish Rheumatology Quality of Care Register (Sweden), Norfolk Arthritis Register (UK), CORRONA International (multiple countries) and Institute of Rheumatology Rheumatoid Arthritis (Japan) and an RA clinical trial programme (fostamatinib). Within each registry, we analysed a main cohort of all patients with RA from January 2000 to last available data. Infection definitions were harmonised across registries. Sensitivity analyses to address potential confounding explored subcohorts defined by disease activity, treatment change and/or prior comorbidities and restriction by calendar time or follow-up. Rates of infections were estimated and standardised to the trial population for age/sex and, in one sensitivity analysis also, for Health Assessment Questionnaire (HAQ) score. RESULTS: Overall, age/sex-standardised rates of hospitalised infection were quite consistent across registries (range 1.14-1.62 per 100 patient-years). Higher and more consistent rates across registries and with the trial programme overall were seen when adding standardisation for HAQ score (registry range 1.86-2.18, trials rate 2.92) or restricting to a treatment initiation subcohort followed for 18 months (registry range 0.99-2.84, trials rate 2.74). CONCLUSION: This prospective, coordinated analysis of RA registries provided incidence rate estimates for infection events to contextualise infection rates from an RA clinical trial programme and demonstrated relative comparability of hospitalised infection rates across registries

Cytokines and Chemokines in Neuropsychiatric Syndromes of Systemic Lupus Erythematosus

Neuropsychiatric syndromes of systemic lupus erythematosus (NPSLE) is a life-threatening disorder and early diagnosis and proper treatment are critical in the management of this neuropsychiatric manifestations in lupus. Brain magnetic resonance imaging (MRI), electroencephalogram (EEG), neuropsychological tests, and lumbar puncture are clinical used for the diagnosis of NPSLE. In addition to these tests, cytokine and chemokine levels in CSF have been reported as useful diagnostic marker of NPSLE. Based on the number of recently published studies, this review overviewed the roles of cytokines and chemokines in NPSLE

Mixing analysis of groundwater recharge sources for better watershed management

This paper describes application of three-end member mixing model with isotopic tracers to analyse groundwater recharge sources in the Nasu Fan, Japan. Relative contribution of river water accounts for 50-60% at areas adjacent to interrupted rivers, and precipitation fallen onto the fan is dominant recharge source at the other areas. Contribution ratio of paddyfield water is 30% at most. Implication of such results for better watershed management is given

Comprehensive evaluation of the public policy for making solidified fuel and compost out of waste : case study for Nogi Town, Tochigi Prefecture, Japan

Centering on the policy of the production of solidified fuel and compost in Nogi Town, TochigiPrefecture, Japan, an evaluation of this policy was carried out from the standpoint of garbagereduction and recycling. With respect to the reduction in amount, a theoretical model was set, upon which an empirical analysis of the effect of a reduction in the amount of waste through an analysis of the primary factor of the structure of the production of waste and its disposal was carried out. With regards to recycling, an analysis of a simulation of RDF production and the effect of the amount ofwater contained in the raw waste was carried out. Furthermore, an analysis was performed inrelation to the ‘Container and Packaging Recycling law’, to include the influence that things such as PET bottles and other plastics have on the production of RDF. It was indicated that the policy for the production of RDF and compost in Nogi Town, Tochigi Prefecture, had the effect of a reduction in the amount of waste due to the simultaneously implementedof a system for separate collection of combustible waste and kitchen waste. In addition, it was found that when the amount of water contained in the raw waste is high, there is a large effect on theproduction of RDF such as an increase in the cost of the drying process and a decrease in the amount of RDF produced.Includes bibliographical references (p. 20-21

Prevalence of polymorphisms of the genes responsible for auto-inflammatory diseases among 202 patients with recurrent fever in a rheumatology institute in Japan

Pediatric Rheumatology Congress 2014 2014年09月20日 SERBI

Prevalence of polymorphisms of the genes responsible for auto-inflammatory diseases among 202 patients with recurrent fever in a rheumatology institute in Japan

Pediatric Rheumatology Congress 2014 2014年09月20日 SERBI

Effects of the anti-RANKL antibody denosumab on joint structural damage in patients with rheumatoid arthritis treated with conventional synthetic disease-modifying antirheumatic drugs (DESIRABLE study): a randomised, double-blind, placebo-controlled phase 3 trial.

ObjectiveTo evaluate the efficacy of denosumab in suppressing joint destruction when added to conventional synthetic disease-modifying antirheumatic drug (csDMARD) therapy in patients with rheumatoid arthritis (RA).MethodsThis was a multi-centre, randomised, double-blind, parallel-group, placebo-controlled phase 3 study in Japan. Patients with RA aged ≥20 years receiving csDMARDs were randomly assigned (1:1:1) to denosumab 60 mg every 3 months (Q3M), denosumab 60 mg every 6 months (Q6M) or placebo. The change in the modified total Sharp score (mTSS) and effect on bone mineral density (BMD) at 12 months was evaluated.ResultsIn total, 654 patients received the trial drugs. Denosumab groups showed significantly less progression of joint destruction. The mean changes in the mTSS at 12 months were 1.49 (95% CI 0.99 to 1.99) in the placebo group, 0.99 (95% CI 0.49 to 1.49) in the Q6M group (p=0.0235) and 0.72 (95% CI 0.41 to 1.03) in the Q3M group (p=0.0055). The mean changes in bone erosion score were 0.98 (95% CI 0.65 to 1.31) in the placebo group, 0.51 (95% CI 0.22 to 0.80) in the Q6M group (p=0.0104) and 0.22 (95% CI 0.09 to 0.34) in the Q3M group (p=0.0001). No significant between-group difference was observed in the joint space narrowing score. The per cent change in lumbar spine (L1-L4) BMD in the placebo, Q6M and Q3M groups were -1.03%, 3.99% (p<0.0001) and 4.88% (p<0.0001). No major differences were observed among safety profiles.ConclusionsDenosumab inhibits the progression of joint destruction, increases BMD and is well tolerated in patients with RA taking csDMARD