1.Treatment Goals for Prevention of Vertebral Fractures in Patients with Rheumatoid Arthritis
Takeshi MOCHIZUKI ; Mari ANDO ; Koichiro YANO ; Ryo HIROSHIMA ; Katsunori IKARI ; Ken OKAZAKI
Journal of Bone Metabolism 2025;32(1):49-56
Background:
Patients with rheumatoid arthritis (RA) are at an increased risk of osteoporosis and vertebral fractures. This study aimed to investigate factors associated with vertebral fractures and treatment goals to prevent new vertebral fractures in patients with RA.
Methods:
The database used in this study included outpatient data of RA patients at the authors’ hospital of RA patients taken from 2018 to 2022. The patients underwent annual imaging evaluations to assess parameters, including bone mineral density of the lumbar spine (LS; L2-4), total hip, and femoral neck, as well as vertebral fractures. Vertebral fractures were evaluated using radiographic images of the T8 to L5 vertebrae.
Results:
The prevalence rates of new vertebral fractures in 2018–2019, 2019–2020, 2020– 2021, and 2021–2022 were 2.0%, 1.3%, 2.3%, and 2.0%, respectively. The presence of existing vertebral fractures was associated with new vertebral fractures (p=0.003; odds ratio, 0.241; 95% confidence interval, 0.093–0.624). The cut-off T-score values for the LS for new vertebral fractures in patients with or without pre-existing vertebral fractures were -0.7 (sensitivity, 40.9%; specificity, 100%) and -1.4 (sensitivity, 69.0%; specificity, 62.5%), respectively.
Conclusions
The presence of pre-existing vertebral fractures is an independent factor associated with new vertebral fractures. It is important to tailor treatment goals based on the presence or absence of vertebral fractures to effectively prevent new fractures.
2.Treatment Goals for Prevention of Vertebral Fractures in Patients with Rheumatoid Arthritis
Takeshi MOCHIZUKI ; Mari ANDO ; Koichiro YANO ; Ryo HIROSHIMA ; Katsunori IKARI ; Ken OKAZAKI
Journal of Bone Metabolism 2025;32(1):49-56
Background:
Patients with rheumatoid arthritis (RA) are at an increased risk of osteoporosis and vertebral fractures. This study aimed to investigate factors associated with vertebral fractures and treatment goals to prevent new vertebral fractures in patients with RA.
Methods:
The database used in this study included outpatient data of RA patients at the authors’ hospital of RA patients taken from 2018 to 2022. The patients underwent annual imaging evaluations to assess parameters, including bone mineral density of the lumbar spine (LS; L2-4), total hip, and femoral neck, as well as vertebral fractures. Vertebral fractures were evaluated using radiographic images of the T8 to L5 vertebrae.
Results:
The prevalence rates of new vertebral fractures in 2018–2019, 2019–2020, 2020– 2021, and 2021–2022 were 2.0%, 1.3%, 2.3%, and 2.0%, respectively. The presence of existing vertebral fractures was associated with new vertebral fractures (p=0.003; odds ratio, 0.241; 95% confidence interval, 0.093–0.624). The cut-off T-score values for the LS for new vertebral fractures in patients with or without pre-existing vertebral fractures were -0.7 (sensitivity, 40.9%; specificity, 100%) and -1.4 (sensitivity, 69.0%; specificity, 62.5%), respectively.
Conclusions
The presence of pre-existing vertebral fractures is an independent factor associated with new vertebral fractures. It is important to tailor treatment goals based on the presence or absence of vertebral fractures to effectively prevent new fractures.
3.Treatment Goals for Prevention of Vertebral Fractures in Patients with Rheumatoid Arthritis
Takeshi MOCHIZUKI ; Mari ANDO ; Koichiro YANO ; Ryo HIROSHIMA ; Katsunori IKARI ; Ken OKAZAKI
Journal of Bone Metabolism 2025;32(1):49-56
Background:
Patients with rheumatoid arthritis (RA) are at an increased risk of osteoporosis and vertebral fractures. This study aimed to investigate factors associated with vertebral fractures and treatment goals to prevent new vertebral fractures in patients with RA.
Methods:
The database used in this study included outpatient data of RA patients at the authors’ hospital of RA patients taken from 2018 to 2022. The patients underwent annual imaging evaluations to assess parameters, including bone mineral density of the lumbar spine (LS; L2-4), total hip, and femoral neck, as well as vertebral fractures. Vertebral fractures were evaluated using radiographic images of the T8 to L5 vertebrae.
Results:
The prevalence rates of new vertebral fractures in 2018–2019, 2019–2020, 2020– 2021, and 2021–2022 were 2.0%, 1.3%, 2.3%, and 2.0%, respectively. The presence of existing vertebral fractures was associated with new vertebral fractures (p=0.003; odds ratio, 0.241; 95% confidence interval, 0.093–0.624). The cut-off T-score values for the LS for new vertebral fractures in patients with or without pre-existing vertebral fractures were -0.7 (sensitivity, 40.9%; specificity, 100%) and -1.4 (sensitivity, 69.0%; specificity, 62.5%), respectively.
Conclusions
The presence of pre-existing vertebral fractures is an independent factor associated with new vertebral fractures. It is important to tailor treatment goals based on the presence or absence of vertebral fractures to effectively prevent new fractures.
4.Two-Year Outcomes of Daily and Twice-Weekly Teriparatide Treatment in Postmenopausal Women with Severe Osteoporosis: A Randomized Non-Blinded Prospective Study
Takeshi MOCHIZUKI ; Koichiro YANO ; Katsunori IKARI ; Ken OKAZAKI
Journal of Bone Metabolism 2024;31(2):162-168
Background:
The long-term effects of daily teriparatide (D-TPTD) and twice-weekly TPTD (W-TPTD) injections are compared among postmenopausal women with severe osteoporosis.
Methods:
A total of 102 patients were enrolled and randomly allocated into two groups for the administration of either D-TPTD or W-TPTD. Treatment efficacy was measured as the percentage change in bone mineral density (ΔBMD) from baseline in the lumbar spine, total hip, and femoral neck. The findings were compared between the two groups.
Results:
At 24 months after treatment, the persistence rates and medication possession ratios in the D-TPTD and W-TPTD groups were 68.6% and 56.9%, and 87.8% and 92.0%, respectively. The ΔBMD in the lumbar spine, total hip, and femoral neck were 15.6%±10.2%, 5.3%± 6.3%, and 5.5%±6.2%, respectively, in the D-TPTD group; and 9.5%±7.9%, 2.3%±6.2%, and 3.1%±7.4%, respectively, in the W-TPTD group following 24 months of treatment. The ΔBMD of the lumbar spine (p=0.008) at 24 months and total hip (p=0.024) at 18 months differed significantly between the two groups.
Conclusions
D-TPTD administration resulted in a significantly higher BMD in the lumbar spine and total hip, supporting this therapeutic regimen for postmenopausal women with severe osteoporosis.
5.Changes in SARS-CoV-2 antibody titers 6 months after the booster dose of BNT162b2 COVID-19 vaccine among health care workers
Takeshi MOCHIZUKI ; Takaki HORI ; Koichiro YANO ; Katsunori IKARI ; Ken OKAZAKI
Clinical and Experimental Vaccine Research 2023;12(2):116-120
Purpose:
In Japan, the data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody titers after the booster dose of the coronavirus disease 2019 (COVID-19) vaccine are insufficient. The aim of this study is to evaluate changes in SARS-CoV-2 antibody titers before, 1, 3, and 6 months after the booster dose of the BNT162b2 COVID-19 vaccine among health care workers.
Materials and Methods:
A total of 268 participants who received the booster dose of the BNT162b2 vaccine were analyzed. SARS-CoV-2 antibody titers were measured before (baseline) and at 1, 3, and 6 months after the booster dose. Factors associated with changes in SARS-CoV-2 antibody titers at 1, 3, and 6 months were analyzed. Cutoff values at baseline were calculated to prevent infection of the omicron variant of COVID-19.
Results:
The SARS-CoV-2 antibody titers at baseline, and 1, 3, and 6 months were 1,018.3 AU/mL, 21,396.5 AU/mL, 13,704.6 AU/mL, and 8,155.6 AU/mL, respectively. Factors associated with changes in SARS-CoV-2 antibody titers at 1 month were age and SARS-CoV-2 antibody titers at baseline, whereas changes in SARS-CoV-2 antibody titers at 3 and 6 months were associated with the SARS-CoV-2 antibody titers at 1 month. The cutoff values of the SARS-CoV-2 antibody titers at baseline were 515.4 AU/mL and 13,602.7 AU/mL at baseline and 1 month after the booster dose, respectively.
Conclusion
This study showed that SARS-CoV-2 antibody titers increase rapidly at 1 month after the booster dose of the BNT162b2 vaccine and begin to decrease from 1 to 6 months. Hence, another booster may be needed as soon as possible to prevent infection.
6.Two-year effectiveness of zoledronic acid with or without eldecalcitol in Japanese patients with osteoporosis: A randomized prospective study
Takeshi MOCHIZUKI ; Koichiro YANO ; Katsunori IKARI ; Ken OKAZAKI
Osteoporosis and Sarcopenia 2022;8(2):75-79
Objectives:
This study aims to examine the 2-year outcomes of zoledronic acid (ZOL) with or without eldecalcitol (ELD) on bone mineral density (BMD) and fracture in Japanese patients with osteoporosis.
Methods:
The subjects were 98 patients who were randomly (1:1) assigned to treatment with ZOL combined with ELD (ZOL + ELD group; n = 51) and ZOL alone (ZOL group; n = 47). Treatment efficacy was examined based on a comparison of changes in BMD from baseline (DBMD) in the lumbar spine, total hip, and femoral neck in the 2 groups.
Results:
The percent change from baseline in BMD values for the lumbar spine, total hip, and femoral neck at 24 months were 10.8% ± 6.1%, 6.0% ± 6.6%, and 5.1% ± 5.1%, respectively, in the ZOL + ELD group, and 7.7% ± 6.2%, 5.1% ± 5.6%, and 2.9% ± 8.3%, respectively, in the ZOL group. The percent change from baseline BMD for the lumbar spine at 24 months differed significantly between the 2 groups.
Conclusions
The effect of a combination of ZOL + ELD on BMD for 24 months was more favorable than that of ZOL alone. This drug combination is promising for the treatment of drug-naïve Japanese patients with primary osteoporosis.
7.Effects of romosozumab or denosumab treatment on the bone mineral density and disease activity for 6 months in patients with rheumatoid arthritis with severe osteoporosis: An open-label, randomized, pilot study
Takeshi MOCHIZUKI ; Koichiro YANO ; Katsunori IKARI ; Ken OKAZAKI
Osteoporosis and Sarcopenia 2021;7(3):110-114
Objectives:
To investigate effects of romosozumab treatment on disease activity and bone mineral density (BMD) in patients with rheumatoid arthritis (RA) and severe osteoporosis in comparison with effects of denosumab treatment.
Methods:
A total of 50 women were enrolled in this study. The subjects were randomized equally into 2 groups: the romosozumab group or the denosumab group. Disease activity score in 28 joints (DAS28)-erythrocyte sedimentation rate (ESR) and BMD at lumbar spine were evaluated.
Results:
The percent changes (Δ) in the BMD values at 3 and 6 months for the lumbar spine were as follows: romosozumab; 4.9% and 5.2%, denosumab: 2.3% and 3.2%. The ΔBMD for the lumbar spine at 3 months was significantly higher in the romosozumab group than in the denosumab group (P = 0.044). The DAS28-ESR at baseline, 3 and 6 months in the romosozumab group were 2.88, 2.60 (P = 0.427) and 2.58 (P = 0.588), respectively. The change from baseline in DAS28-ESR did not differ significantly between these 2 groups at any time point.
Conclusions
The present study revealed that romosozumab treatment is more effective than denosumab treatment in increasing BMD of the lumbar spine at 3 months. Furthermore, the present study suggested that romosozumab treatment has no effects on the disease activity of RA in patients with RA and severe osteoporosis for 6 months.
8.Effects of romosozumab or denosumab treatment on the bone mineral density and disease activity for 6 months in patients with rheumatoid arthritis with severe osteoporosis: An open-label, randomized, pilot study
Takeshi MOCHIZUKI ; Koichiro YANO ; Katsunori IKARI ; Ken OKAZAKI
Osteoporosis and Sarcopenia 2021;7(3):110-114
Objectives:
To investigate effects of romosozumab treatment on disease activity and bone mineral density (BMD) in patients with rheumatoid arthritis (RA) and severe osteoporosis in comparison with effects of denosumab treatment.
Methods:
A total of 50 women were enrolled in this study. The subjects were randomized equally into 2 groups: the romosozumab group or the denosumab group. Disease activity score in 28 joints (DAS28)-erythrocyte sedimentation rate (ESR) and BMD at lumbar spine were evaluated.
Results:
The percent changes (Δ) in the BMD values at 3 and 6 months for the lumbar spine were as follows: romosozumab; 4.9% and 5.2%, denosumab: 2.3% and 3.2%. The ΔBMD for the lumbar spine at 3 months was significantly higher in the romosozumab group than in the denosumab group (P = 0.044). The DAS28-ESR at baseline, 3 and 6 months in the romosozumab group were 2.88, 2.60 (P = 0.427) and 2.58 (P = 0.588), respectively. The change from baseline in DAS28-ESR did not differ significantly between these 2 groups at any time point.
Conclusions
The present study revealed that romosozumab treatment is more effective than denosumab treatment in increasing BMD of the lumbar spine at 3 months. Furthermore, the present study suggested that romosozumab treatment has no effects on the disease activity of RA in patients with RA and severe osteoporosis for 6 months.
9.Survey of Drug Prescription Patterns Among Patients with Nontuberculous Mycobacterial Disease Using the Database of Health Insurance Claims
Tomohide IWAO ; Ken YANO ; Tomohiro KURODA
Japanese Journal of Pharmacoepidemiology 2018;23(2):89-94
In recent years, the number of patients with non-tuberculosis mycobacteria (NTM) has rapidly increasing.According to the nationwide survey conducted in 2014, the number of patients with NTM was reported to increase 9.7 times compared to the survey in 1980. Among them, the patients with Mycobacterium avium complex (MAC) account for about 88.8% of them. It is the main cause of the rapid increase of NTM patients mainly in middle-aged and elderly woman. To treat patients with MAC, it is common to do chemotherapy over one year after the bacteria becomes negative. Among experts of NTM, it is recommended to do chemotherapy preventing generation of resistant bacteria by using clarithromycin (CAM) and rifampicin and ethambutol (EB) in combination. Meanwhile, a monotherapy of CAM and high-dose EB administration over a long period are not currently recommended due to side effects. However, it has not been clarified so far how many such drug prescriptions had existed. Therefore, in this study, we investigated the actual drug prescription of 571 patients who were presumed to be NTM in health insurance data collected from 2015 to 2016. As a result, about 5.1% (29 cases) of CAM monotherapy and 4.4% (15 cases) of EB high-dose prescription over 3 months were observed. In general, because NTM is a case where a long-term antibiotic treatment is required, it increases the possibility of any disadvantages exerting on patients. Hence, we consider it is an important and urgent matter to inform the correct information widely to clinical workers and sites.
10.Relationship between Bathing Habits and Physical and Psychological State
Taichi ISHIZAWA ; Satoshi WATANABE ; Shingo YANO ; Masaki ABURADA ; Ken-ichi MIYAMOTO ; Toshiyuki OJIMA ; Shinya HAYASAKA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2012;75(4):227-237
Background: Bathing is an important behavior for keeping the body clean and is one of the habits of daily life. Among other things, bathing is regarded as a means of relieving fatigue, refreshing oneself, benefiting health, and improving sleep. As such it can be considered a health-maintaining activity. Apart from a previous study by the authors, there has been very little research on the relationship between home bathing habits and health. Objective: The aim of this study was, therefore, to clarify how physical and mental health relate to daily bathing in the home, particularly the habit of full bath immersion. Method: The participants were 198 employees of a quasi-drug manufacturing company and their family members who could and cooperated in the present study. The study was conducted as a self-report survey from October 1-30, 2010, with questionnaires being distributed to and collected from subjects before and after this period. Participants were asked about their sex, age, frequency of bathing per week, frequency of use of bath additives per week, temperature of bath water, bathing duration, and water level when in the bath, health, and sleep quality. Health was assessed using the Profile of Mood States (POMS) inventory, and self-rated health and quality of sleep were assessed using a Visual Analog Scale (VAS). Results: Among bathing habits, the group with a high bath frequency had significantly low scores for tension-anxiety and depression-dejection mood scales, and significantly high self-rated health. In the present study, self-rated health and quality of sleep were significantly better in the group who frequently used bath additives. In the full bath group, Fatigue score was significantly low and self-rated health and quality of sleep scores were significantly high. Discussion and Conclusion: Taking a full bath frequently and frequent use of bath additives are bathing habits that increase physical and psychological health in the middle-aged.


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