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![Treatments available for rheumatoid arthritis in Japan Drug class Drugs available and ATC code, where applicable Oral NSAIDs Anti-inflammatory and antirheumatic products, non- steroids [M01A] NSAID patches Topical products for joint and muscular pain [M02]](profile/Naonobu-Sugiyama/publication/236114021/figure/tbl1/AS:601652734214193@1520456598913/Treatments-available-for-rheumatoid-arthritis-in-Japan-Drug-class-Drugs-available-and-ATC.png)
Treatments available for rheumatoid arthritis in Japan Drug class Drugs available and ATC code, where applicable Oral NSAIDs Anti-inflammatory and antirheumatic products, non- steroids [M01A] NSAID patches Topical products for joint and muscular pain [M02]
Source publication
Objectives:
The prevalence of rheumatoid arthritis (RA) and its current treatment practices in Japan are poorly documented. Therefore, we examined these factors in a Japanese health insurance database.
Methods:
We analyzed reimbursement data provided by health insurance societies for 1 million individuals, including healthy individuals, register...
Citations
... In the United States and Japan, the prevalence of RA is approximately 0.3-1.0% (1)(2)(3). The etiology of RA is multifactorial and results from a complex interplay of genetic, environmental, and hormonal factors. ...
Hypothesis
While conventional in silico immunogenicity risk assessments focus on measuring immunogenicity based on the potential of therapeutic proteins to be processed and presented by a global population-wide set of human leukocyte antigen (HLA) alleles to T cells, future refinements might adjust for HLA allele frequencies in different geographic regions or populations, as well for as individuals in those populations. Adjustment by HLA allele distribution may reveal risk patterns that are specific to population groups or individuals, which current methods that rely on global-population HLA prevalence may obscure.
Key findings
This analysis uses HLA frequency-weighted binding predictions to define immunogenicity risk for global and sub-global populations. A comparison of assessments tuned for North American/European versus Japanese/Asian populations suggests that the potential for anti-therapeutic responses (anti-therapeutic antibodies or ATA) for several commonly prescribed Rheumatoid Arthritis (RA) therapeutic biologics may differ, significantly, between the Caucasian and Japanese populations. This appears to align with reports of differing product-related immunogenicity that is observed in different populations.
Relevance to clinical practice
Further definition of population-level (regional) and individual patient-specific immunogenic risk profiles may enable prescription of the RA therapeutic with the highest probability of success to each patient, depending on their population of origin and/or their individual HLA background. Furthermore, HLA-specific immunogenicity outcomes data are limited, thus there is a need to expand HLA-association studies that examine the relationship between HLA haplotype and ATA in the clinic.
... This disorder affects approximately 1.5% of the global population [4]. Among Asian countries prevalence of RA estimated to be 0.42% in China [5], 0.6-1% in Japan [6], 0.7% in India [7], and 0.5% in Pakistan [8]. In Bangladesh, the prevalence of Rheumatoid arthritis is 1.6%, with women having a much greater frequency (2.4%) than men (0.7%) [9]. ...
Aim: The study aimed to demonstrate the association of serum 14-3-3ƞ protein level with Rheumatoid Arthritis and its disease severity. It also aimed to determine if the disease detection rate increased after the addition of this biomarker with current biomarkers.
... Compared to previous studies performed in Japan, the eligible patients in our study were younger and included a lower proportion of women: the proportion of patients aged C 60 years was around 30% lower than that in earlier studies based on Japanese health insurance data, and the proportion of females was around 10% lower [20,21]. The clinical characteristics of participants in the present study also differed from those in previous epidemiological studies, with the participants of the present study having higher disease activity and a longer disease duration (a higher proportion of patients had a disease duration of C 5 years). ...
IntroductionTo evaluate patient–physician communication and patients’ understanding of treatment goals in rheumatoid arthritis (RA).MethodsA cross-sectional online survey of patients with RA and physicians treating RA was conducted between 16 and 30 June 2021. Participants were asked to rate the importance of 17 goals on a 6-point Likert scale, and mean scores were compared between patients and physicians by the Wilcoxon rank sum test. Patients’ satisfaction with physician communication and their understanding of treatment goals were also assessed.ResultsThe responses of 502 patients and 216 physicians were analyzed. The most common patient age group was 50–59 years (28.5%), and the mean disease duration was 10.3 years. Physicians had a mean of 19.2 years of treatment experience and were treating a mean of 44.3 patients. Among the 17 goals assessed, patients placed significantly more importance on drug tapering or discontinuation as short-term goals (3–6 months) and on performing basic activities of daily living, being able to engage in daily tasks, achieving and maintaining remission, maintaining better laboratory values, and drug tapering or discontinuation as long-term goals (5–10 years; all adjusted p < 0.05). Patient treatment satisfaction was significantly associated with disease activity, a feeling of treatment effectiveness, satisfaction with physician communication, and agreement with physician goals.Conclusion
Differences exist among patients with RA and physicians treating RA regarding the importance of short- and long-term treatment goals. Good patient–physician communication appears to be important for improving patient satisfaction.Trial registrationUniversity Hospital Medical Information Network identifier: UMIN000044463.
... The introduction of biological/targeted synthetic diseasemodifying antirheumatic drugs (b/tsDMARDs) caused a paradigm shift in the treatment of rheumatoid arthritis (RA). About 20% of patients with RA in Japan use b/tsDMARDs, and the use of these drugs is continuously increasing [1][2][3][4]. Because of the rapid ageing of society in Japan, the proportion of older people with RA is also growing [4,5]. ...
... Eligible patients had to meet all the following criteria: (1) diagnosed with RA, defined as an ICD-10 code M05.x or M06.x (except for M06.1) without a flag for an uncertain diagnosis [14][15][16]19]; (2) prescribed a first b/tsDMARD in the period from 10 October 2014 to 28 February 2019 (the first date of prescription during this period was defined as the index date); (3) index date after the first diagnosis of RA (no limitations were placed on the period from the date of the first diagnosis to the index date); and (4) continuous 12-month baseline observable period before the index date. To improve the accuracy of the results, patients with any of the following criteria were excluded: (1) in hospital at the index date (because they may have had an HI for reasons other than b/tsDMARDs) and (2) at least one diagnosis of the following diseases for which b/tsDMARDs also can be used: Behcet's disease (M35.2), psoriasis (L40.x), ...
Objective:
We compared the incidence rates of hospitalized infections (HIs) between tocilizumab (TCZ) and other biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in adults aged ≥75 years with rheumatoid arthritis (RA).
Methods:
We used a Japanese claims database from Medical Data Vision Co., Ltd (Tokyo, Japan) to perform a retrospective longitudinal population-based study in patients with RA who were prescribed b/tsDMARDs between 2014 and 2019. We calculated adjusted risk ratios (aRRs) for HIs in three age groups (<65, ≥65 and <75, and ≥75 years).
Results:
Of 5506 patients, 2265 (41.1%) were <65 years, 1709 (31.0%) were 65-74 years, and 1532 (27.8%) were ≥75 years. Crude incidence rates (/100 person-years) of HIs were 3.99, 7.27, and 10.77, respectively. In the oldest group, aRRs (95% confidence interval) for HIs (b/tsDMARDs versus TCZ) were as follows: etanercept, 2.40 (1.24-4.61); adalimumab, 1.90 (0.75-4.83); golimumab, 1.21 (0.66-2.23); and abatacept, 0.89 (0.49-1.62). In the other age groups, the noticeable difference was a lower aRR of etanercept versus TCZ in the youngest group (0.30, 0.11-0.85).
Conclusion:
In patients with RA aged ≥75 years, b/tsDMARDs have a similar risk of HIs to tocilizumab except for etanercept.
... The introduction of biologic and targeted synthetic diseasemodifying anti-rheumatic drugs (b/tsDMARDs) has improved clinical management of rheumatoid arthritis (RA) [1], and the number of patients treated with b/tsDMARDs is continuously increasing [2,3]. However, b/tsDMARDs are more expensive to administer and monitor, so the increasing economic burden of these drugs in RA is a considerable concern for both patients and society [1,4]. ...
Objective
To assess cost-effectiveness of biologic and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) in rheumatoid arthritis.
Methods
We conducted 3 analyses: a lifetime analysis with a cohort model (study A) and 2 short-term analyses (studies B and C). Study A evaluated the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) gained from costs of standard treatments. Study B evaluated yearly costs per person achieving American College of Rheumatology (ACR) response (ACR20, ACR50, and ACR70), and study C, costs per person achieving previously defined claims-based effectiveness (equivalent to 28-joint Disease Activity Score [DAS28] ≤ 3.2). The proportion of ACR responders to the drugs of interest were determined by mixed treatment comparisons. Studies B and C estimated costs using a claims database.
Results
In study A, ICERs of all b/tsDMARDs were lower than 5.0 million JPY per QALY. In study B, yearly costs per person with ACR50 response were lower for subcutaneous tocilizumab (1.9 million JPY) and subcutaneous abatacept (2.3 million JPY). In study C, costs per person were lower for subcutaneous tocilizumab (1.3 million JPY) and intravenous tocilizumab (1.6 million JPY) and effectiveness rates were higher for intravenous tocilizumab (45.3%) and infliximab (43.0%).
Conclusion
The b/tsDMARDs with lower prices showed higher cost-effectiveness.
... Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by joint pain and stiffness that may progress to joint destruction and disability. 1 In addition to physical impairment and a shortened life expectancy, RA can result in substantial socioeconomic costs. 1,2 The prevalence of RA in Japan is estimated to be between 0.6% and 1.0%, 3 which is comparable with the prevalence in other parts of the world. 4 Thus, the socioeconomic impact of RA in Japan cannot be disregarded. ...
... Our approach took into consideration that there are only minor discrepancies in the prevalence and severity of RA (particularly among patients receiving bDMARDs) between the European/US and Japanese populations. 3,46 Markov modeling was also conducted by Kobelt to evaluate the cost-effectiveness of etanercept 25 mg/week in Sweden, using data from the PRESERVE trial and from a registry in Sweden to extrapolate the results to 10 years. 30 48 as well as the Nijmegen RA cohort 49 to model several dosetapering regimens for etanercept and adalimumab over 18 months. ...
Objectives
To use Markov modeling to estimate the cost-effectiveness of treatment with etanercept 25 mg once weekly plus methotrexate (MTX) in Japanese patients with rheumatoid arthritis who had achieved remission or low disease activity with etanercept 50 mg once weekly plus MTX.
Methods
Effectiveness data were estimated based on results from a clinical trial (PRESERVE) in patients with rheumatoid arthritis who had achieved remission or low disease activity and who were then randomized to receive etanercept 25 mg plus MTX or placebo plus MTX. A Markov model was established and included flare rates of 21% and 62% in the etanercept 25 mg and placebo groups, respectively. EQ-5D was calculated using an ordinary least-squares model that included the health assessment questionnaire disability index and pain visual analog scale. Worsening of the health assessment questionnaire score over 1 year was estimated to be 0.047 for patients with flare, and when associated with radiographic progression it was estimated to increase by 0.006 and 0.025 in the etanercept 25 mg and placebo groups, respectively. A cycle length of 1 year was applied to calculate the cumulative cost and effectiveness for a 10-year time span.
Results
Compared with the placebo group, the quality-adjusted life-years for the etanercept 25 mg group was increased by 0.841. The incremental cost-effectiveness ratio was ¥6 173 772.
Conclusion
These results suggest that maintenance treatment with etanercept 25 mg is cost-effective.
... RA is a progressive autoimmune disease characterized by the impairment of physical functions through chronic pain and joint damage. RA affects 0.6-1.0% of the Japanese population, has been reported in 1.24 million people (1% of the total population) and is more prevalent in women [1]. Owing to a recent paradigm shift in the diagnosis and treatment of RA, functional remission and maintenance of good health-related quality of life (QOL) have been included as treatment goals for patients with RA, in addition to clinical remission [1]. ...
... RA affects 0.6-1.0% of the Japanese population, has been reported in 1.24 million people (1% of the total population) and is more prevalent in women [1]. Owing to a recent paradigm shift in the diagnosis and treatment of RA, functional remission and maintenance of good health-related quality of life (QOL) have been included as treatment goals for patients with RA, in addition to clinical remission [1]. Hewlett et al. [2] found that patients wanted to be free of anxiety and worry, make progress in treatment, see improvements in activities of daily living (ADLs), be satisfied with their QOL and experience functional remission Key messages . ...
Objectives
It has been suggested that patients with rheumatoid arthritis (RA) are more likely to suffer from depression. Therefore, this study identified the factors associated with depressive states in female RA patients to inform future patient care.
Methods
A self-assessment questionnaire was administered to 150 female RA patients aged 20 years and older regarding their satisfaction with disease activity, pain (measured using the Visual Analogue Scale), self-rated depression scale (SDS), stress content (illness, work, family, difficulty in daily life, appearance, treatment, other), confidence in stress management, and satisfaction (treatment effect, health status, relationships with healthcare professionals). The factors related to depression and the presence of depressive tendencies were investigated.
Results
Data from 145 patients were analyzed. Eighteen patients (12.4%) showed depressive tendencies according to their SDS scores. Among these patients, SDS scores were positively correlated with disease activity, and with scores on the modified Health Assessment Questionnaire, Visual Analogue Scale for pain, and stress content. SDS was also negatively correlated with patients’ confidence in stress management and health status satisfaction.
Conclusion
Female RA patients had family problems and various stressors in their daily lives. Nurses need to conduct regular mental health assessments to monitor their self-management status and support them to improve their confidence and satisfaction in coping. To achieve this, it is important for health care teams, involving various healthcare professionals, to collaborate and cooperate.
... The estimated number of patients with rheumatoid arthritis (RA) in Japan is between 600,000 and 1,000,000 [1]. Strict management of RA at an early stage is effective in achieving remission or low disease activity [2,3]. ...
... For each pixel, a class with the maximum probability among seven probabilities (Regions A-G, background) is assigned to the label of the pixel. The loss function is used the categorical cross-entropy, E c , defined by Eq. (1). ...
Approximately 600,000 to 1,000,000 patients are diagnosed with rheumatoid arthritis (RA) in Japan. To provide appropriate treatment, it is necessary to accurately measure the progression of RA by diagnosing the disease several times a year. The modified total sharp score (mTSS) calculated from hand X-ray images is a standard diagnostic method for RA progression. However, this diagnostic method is time-consuming as the scores are rated at as many as 16 points per hand. Accordingly, in order to shorten the diagnosis time of RA patients and improve the quality of diagnosis, the development of computer-aided diagnosis (CAD) systems is expected. We have previously proposed a CAD system that can detect finger joint positions using a support vector machine and can estimate the mTSS using ridge regression. In this study, we propose a fully automatic detection method of RA score evaluation points in the carpal site from simple hand X-ray images using deep learning. The proposed method first segments the carpal site using deep learning. Next, the RA evaluation points are automatically determined from each segment based on prior knowledge. Experimental results on X-ray images of the hands of 140 patients with RA showed that the mTSS evaluation point at the carpal site could be detected with an average error of 25 pixels. This study enables the automatic detection of RA score evaluation points in the carpal site. In the diagnosis of RA, the time required for diagnosis can be reduced by automating the determination of diagnostic points by physician.
... 0.03-0.05%, and 0.05%, respectively Neurosurg Rev [20,32,36]. In this study, the prevalence of RA, SLE, and SS with SAH was 1.4%, 0.18%, and 0.14%, respectively, which were higher than those previously reported. ...
Spontaneous subarachnoid hemorrhage (SAH) occurs due to intracranial aneurysm rupture in most cases. Rheumatic disease may cause vessel wall inflammation, which can increase the risk of rupture. However, the characteristics of SAH with rheumatic disease are unknown. This study aimed to evaluate SAH features in patients with rheumatic disease. We retrospectively analyzed clinical data of 5066 patients from the Nagasaki SAH Registry Study who had been diagnosed with aneurysmal SAH between 2001 and 2018. We evaluated the SAH characteristics in patients with rheumatic disease using multivariable logistic regression analysis. In total, 102 patients (2.0%, 11 men and 91 women, median age 69.0 [57.0-75.5]) had rheumatic disease. In these patients, univariate logistic regression analysis showed that sex, hypertension, family history of SAH, smoking history, World Federation of Neurosurgical Societies grade on admission, aneurysm size, multiple aneurysms, treatment, and symptomatic spasms were associated with SAH. Multivariable logistic regression analysis showed that characteristics independently associated with SAH in rheumatic disease were female sex (odds ratio [OR] 3.38; 95% confidence interval [CI] 1.81-6.93, P < 0.001), hypertension (OR 0.60; 95% CI 0.40-0.90, P = 0.012), family history of SAH (OR 0.18; 95% CI 0.01-0.80, P = 0.020), small ruptured aneurysms (OR 1.50; 95% CI 1.02-2.24, P = 0.048), and multiple aneurysms (OR 1.69; 95% CI 1.09-2.58, P = 0.021) in comparison with SAH without rheumatic disease. In conclusion, SAH in patients with rheumatic disease was characterized by small multiple aneurysms, regardless of the low incidence of hypertension and family history of SAH.
... The rate of rheumatoid prevalence is increasing every year of 2.5 % of women and 2 % of men. Other countries like Denmark, Finland, Sweden and Norway the prevalence rate of rheumatoid arthritis has been increased from 200 to 500 people in 1 million population [60,61] . In addition, the Global Burden of the disease has also reported that the prevalence of rheumatoid arthritis that been increased from 0.5 % to 1.1 % globally. ...
Arthritis is a chronic inflammation in joints, which mostly affects the bones. In the global prevalence of joint inflammation, it’s means to be taken it as potential issues. Current treatments mostly targeting the inflammatory cytokines or effector molecules and oxidative stress involved in arthritis as pain relief temporarily. This review has mechanistically demonstrated the type of joint inflammation insights in to arthritis, such as osteoarthritis, gouty arthritis and rheumatoid arthritis to understand the clear background. This review has also highlighted the prevalence, mechanism and mediations used for arthritis, in which various causative agents are used to induce arthritis in preclinical studies that has been collectively elucidated. This review is first to be reported the mechanism of various arthritis causative agents. It pointed out the side effects of clinical medicine used for arthritis and suggested the natural products involved in medication for above-listed conditions. As comparatively natural products are low cost, easily available and beneficial than modern medicines with minimal side effects.
