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Yusuke Miwa - One of the best experts on this subject based on the ideXlab platform.
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Influence of renal complications on the efficacy and adverse events of tacrolimus combination therapy in patients with systemic lupus erythematosus (SLE) during a Maintenance Phase: a single-centre prospective study
Lupus science & medicine, 2015Co-Authors: Sho Ishii, Yusuke Miwa, K. Otsuka, Takahiro Tokunaga, Yoko Miura, Nao Oguro, Shinichiro Nishimi, Airi Nishimi, Mayu Saito, Ryo TakahashiAbstract:Objectives The study investigated whether renal complications affected the efficacy and safety of tacrolimus combination therapy in patients with systemic lupus erythematosus (SLE) during a Maintenance Phase. Methods Fifty-seven patients with SLE (A: 30 cases with renal complication, B: 27 cases without renal complications) were included. The presence of renal complications was defined as proteinuria ≥0.5 g/day and lupus nephritis on renal biopsy. Major outcome measures included SLE disease activity index (SLEDAI), steroid dose, serum anti-dsDNA Ab, C3 and creatinine (Cr) levels and estimated glomerular filtration rate (eGFR). The patient9s background factors included age, gender, disease duration and ACE-I/angiotensin II receptor blocker and statin therapies. We compared these outcome measures pre treatment and after 1 year of treatment. Results The SLEDAI and serum C3 levels improved in both groups from pretreatment period to post-treatment period: from 7.2±5.0 to 2.8±2.3 in A and 6.4±3.8 to 2.4±2.2 in B, p Conclusions Tacrolimus combination therapy had additive beneficial effects on reduced proteinuria and increased serum C3 levels in patients with SLE with renal complications during a Maintenance Phase.
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Steroid-Sparing Effect of Tacrolimus in the Maintenance Phase of Systemic Lupus Erythematosus: A Single-Center, Prospective Study
Clinical and Experimental Medical Sciences, 2014Co-Authors: K. Otsuka, Yusuke Miwa, Masayu Umemura, Takahiro Tokunaga, Sakiko Isojima, Sho Ishii, Shinya Seki, Yoko Miura, Nao Oguro, Ryo YanaiAbstract:Objective: The purpose of this study was to prospectively assess the steroid-sparing effect and safety of Tacrolimus (TAC) combination treatment during the Maintenance Phase of SLE. Methods: Thirty-eight patients were studied over a 1-year period from 2009 to 2012. If manifestations of mild active SLE, such as skin eruptions, arthritis, or asymptomatic nephritis, worsened and/or decreasing levels of serum complement (C3c) were observed, TAC combination treatment (from 1 mg to 5 mg once daily) was carried out. This was accomplished by adding TAC to the patient’s existing treatment regimen and decreasing in the usage of prednisolone (PSL). Scores on the SLE Disease Activity Index (SLEDAI), PSL dosage, and proteinuria, serum levels of C3c, anti-dsDNA levels were researched. Results: Twenty-eight patients received to TAC combination therapy. 1) The PSL dose was decreased from 11.7 ± 5.6 to 8.2 ± 4.2 mg/day (P
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AB0623 Efficacy of tacrolimus combination therapy during the Maintenance Phase of systemic lupus erythematosus
Annals of the Rheumatic Diseases, 2013Co-Authors: Kumiko Ohtsuka, Yusuke Miwa, H. Furuya, Ryo Yanai, Michihito Sato, Ryo Takahashi, Kuninobu Wakabayashi, Tsuyoshi Odai, Nobuyuki Yajima, Tsuyoshi KasamaAbstract:Background Corticosteroid therapy is effective for systemic lupus erythematosus (SLE), but many adverse effects have been observed. Tacrolimus (TAC) is an immunosuppressive agent that is used after organ transplantation. TAC is also used for induction therapy in SLE patients, but no investigations of TAC in Maintenance therapy have been reported. Objectives This study examined the efficacy of TAC combination therapy during the Maintenance Phase of SLE. Methods Thirty-five patients with SLE (27 females and 8 males) were assessed at baseline and following 6 months of TAC administration (from 1 mg to 5 mg per day) using changes in corticosteroid dose and clinical examination. Proteinuria, serum complement levels (C3c) and anti-double-stranded DNA (dsDNA) titers were assessed. The relapse rate of SLE and adverse effects were assessed. Results The mean patient age was 42.0±16.4 years at the initiation of therapy, and the mean disease duration was 76±52 months. Other immunosuppressive drugs (azathioprine, 1 patient; and mizoribine, 9 patients) were combined with corticosteroids, but these agents had been discontinued due to ineffectiveness and/or adverse effects. Corticosteroid doses were reduced from 12.3±8.3 at baseline to 10.4±8.5 mg per day following 6 months of TAC administration (p Conclusions TAC combination therapy during the Maintenance Phase of SLE was found in this study to be beneficial. TAC reduced corticosteroid doses, elevated serum complement level, and decreased proteinuria. No relapse of SLE or major adverse events was observed. Disclosure of Interest None Declared
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AB0377 Efficacy of tacrolimus combination therapy during the Maintenance Phase of systemic lupus erythematosus
Annals of the Rheumatic Diseases, 2013Co-Authors: K. Otsuka, Yusuke Miwa, H. Furuya, Ryo Yanai, Kuninobu Wakabayashi, Masayu Umemura, Hiroyuki Tsukamoto, Takahiro Tokunaga, Sakiko Isojima, Nobuyuki YajimaAbstract:Background In Japan, a placebo-controlled clinical trial of tacrolimus for lupus nephritis was performed to investigate the efficacy and safety of this agent. Based on the results obtained, administration of tacrolimus at an oral dose of 3 mg/day was approved for the treatment of lupus nephritis. Objectives The aim of this study was to prospectively evaluate the efficacy and safety of tacrolimus (TAC) combination therapy during the Maintenance Phase of systemic lupus erythematosus (SLE). TAC was added to the existing therapy if the clinical symptoms worsened and/or if there was a decrease in the serum complements titer because it allowed for a decrease in the dose of prednisolone (PSL). Methods From 2009 to 2012, 38 patients were included in the study period for 1 year. TAC combination therapy (dosage range: 1 mg to 5 mg once daily) was given if there was worsening of any mild manifestations of active SLE, such as arthritis, skin eruptions, or asymptomatic nephritis, and/or if there was a decrease in the serum complement titer (C3c). This study reviewed the SLE Disease Activity Index (SLEDAI) score, the dosage of PSL, the serum levels of C3c, the anti-dsDNA titers and proteinuria. Results Twenty-eight patients were treated with TAC combination therapy and showed symptom improvement with the following results: 1) the dosage of PSL was reduced from 11.7 ± 5.6 to 8.2 ± 4.2 (mg/day) (P Conclusions TAC combination therapy was clinically useful in the Maintenance Phase of SLE. Disclosure of Interest None Declared
K. Otsuka - One of the best experts on this subject based on the ideXlab platform.
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Influence of renal complications on the efficacy and adverse events of tacrolimus combination therapy in patients with systemic lupus erythematosus (SLE) during a Maintenance Phase: a single-centre prospective study
Lupus science & medicine, 2015Co-Authors: Sho Ishii, Yusuke Miwa, K. Otsuka, Takahiro Tokunaga, Yoko Miura, Nao Oguro, Shinichiro Nishimi, Airi Nishimi, Mayu Saito, Ryo TakahashiAbstract:Objectives The study investigated whether renal complications affected the efficacy and safety of tacrolimus combination therapy in patients with systemic lupus erythematosus (SLE) during a Maintenance Phase. Methods Fifty-seven patients with SLE (A: 30 cases with renal complication, B: 27 cases without renal complications) were included. The presence of renal complications was defined as proteinuria ≥0.5 g/day and lupus nephritis on renal biopsy. Major outcome measures included SLE disease activity index (SLEDAI), steroid dose, serum anti-dsDNA Ab, C3 and creatinine (Cr) levels and estimated glomerular filtration rate (eGFR). The patient9s background factors included age, gender, disease duration and ACE-I/angiotensin II receptor blocker and statin therapies. We compared these outcome measures pre treatment and after 1 year of treatment. Results The SLEDAI and serum C3 levels improved in both groups from pretreatment period to post-treatment period: from 7.2±5.0 to 2.8±2.3 in A and 6.4±3.8 to 2.4±2.2 in B, p Conclusions Tacrolimus combination therapy had additive beneficial effects on reduced proteinuria and increased serum C3 levels in patients with SLE with renal complications during a Maintenance Phase.
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Steroid-Sparing Effect of Tacrolimus in the Maintenance Phase of Systemic Lupus Erythematosus: A Single-Center, Prospective Study
Clinical and Experimental Medical Sciences, 2014Co-Authors: K. Otsuka, Yusuke Miwa, Masayu Umemura, Takahiro Tokunaga, Sakiko Isojima, Sho Ishii, Shinya Seki, Yoko Miura, Nao Oguro, Ryo YanaiAbstract:Objective: The purpose of this study was to prospectively assess the steroid-sparing effect and safety of Tacrolimus (TAC) combination treatment during the Maintenance Phase of SLE. Methods: Thirty-eight patients were studied over a 1-year period from 2009 to 2012. If manifestations of mild active SLE, such as skin eruptions, arthritis, or asymptomatic nephritis, worsened and/or decreasing levels of serum complement (C3c) were observed, TAC combination treatment (from 1 mg to 5 mg once daily) was carried out. This was accomplished by adding TAC to the patient’s existing treatment regimen and decreasing in the usage of prednisolone (PSL). Scores on the SLE Disease Activity Index (SLEDAI), PSL dosage, and proteinuria, serum levels of C3c, anti-dsDNA levels were researched. Results: Twenty-eight patients received to TAC combination therapy. 1) The PSL dose was decreased from 11.7 ± 5.6 to 8.2 ± 4.2 mg/day (P
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AB0377 Efficacy of tacrolimus combination therapy during the Maintenance Phase of systemic lupus erythematosus
Annals of the Rheumatic Diseases, 2013Co-Authors: K. Otsuka, Yusuke Miwa, H. Furuya, Ryo Yanai, Kuninobu Wakabayashi, Masayu Umemura, Hiroyuki Tsukamoto, Takahiro Tokunaga, Sakiko Isojima, Nobuyuki YajimaAbstract:Background In Japan, a placebo-controlled clinical trial of tacrolimus for lupus nephritis was performed to investigate the efficacy and safety of this agent. Based on the results obtained, administration of tacrolimus at an oral dose of 3 mg/day was approved for the treatment of lupus nephritis. Objectives The aim of this study was to prospectively evaluate the efficacy and safety of tacrolimus (TAC) combination therapy during the Maintenance Phase of systemic lupus erythematosus (SLE). TAC was added to the existing therapy if the clinical symptoms worsened and/or if there was a decrease in the serum complements titer because it allowed for a decrease in the dose of prednisolone (PSL). Methods From 2009 to 2012, 38 patients were included in the study period for 1 year. TAC combination therapy (dosage range: 1 mg to 5 mg once daily) was given if there was worsening of any mild manifestations of active SLE, such as arthritis, skin eruptions, or asymptomatic nephritis, and/or if there was a decrease in the serum complement titer (C3c). This study reviewed the SLE Disease Activity Index (SLEDAI) score, the dosage of PSL, the serum levels of C3c, the anti-dsDNA titers and proteinuria. Results Twenty-eight patients were treated with TAC combination therapy and showed symptom improvement with the following results: 1) the dosage of PSL was reduced from 11.7 ± 5.6 to 8.2 ± 4.2 (mg/day) (P Conclusions TAC combination therapy was clinically useful in the Maintenance Phase of SLE. Disclosure of Interest None Declared
Ryo Yanai - One of the best experts on this subject based on the ideXlab platform.
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Steroid-Sparing Effect of Tacrolimus in the Maintenance Phase of Systemic Lupus Erythematosus: A Single-Center, Prospective Study
Clinical and Experimental Medical Sciences, 2014Co-Authors: K. Otsuka, Yusuke Miwa, Masayu Umemura, Takahiro Tokunaga, Sakiko Isojima, Sho Ishii, Shinya Seki, Yoko Miura, Nao Oguro, Ryo YanaiAbstract:Objective: The purpose of this study was to prospectively assess the steroid-sparing effect and safety of Tacrolimus (TAC) combination treatment during the Maintenance Phase of SLE. Methods: Thirty-eight patients were studied over a 1-year period from 2009 to 2012. If manifestations of mild active SLE, such as skin eruptions, arthritis, or asymptomatic nephritis, worsened and/or decreasing levels of serum complement (C3c) were observed, TAC combination treatment (from 1 mg to 5 mg once daily) was carried out. This was accomplished by adding TAC to the patient’s existing treatment regimen and decreasing in the usage of prednisolone (PSL). Scores on the SLE Disease Activity Index (SLEDAI), PSL dosage, and proteinuria, serum levels of C3c, anti-dsDNA levels were researched. Results: Twenty-eight patients received to TAC combination therapy. 1) The PSL dose was decreased from 11.7 ± 5.6 to 8.2 ± 4.2 mg/day (P
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AB0623 Efficacy of tacrolimus combination therapy during the Maintenance Phase of systemic lupus erythematosus
Annals of the Rheumatic Diseases, 2013Co-Authors: Kumiko Ohtsuka, Yusuke Miwa, H. Furuya, Ryo Yanai, Michihito Sato, Ryo Takahashi, Kuninobu Wakabayashi, Tsuyoshi Odai, Nobuyuki Yajima, Tsuyoshi KasamaAbstract:Background Corticosteroid therapy is effective for systemic lupus erythematosus (SLE), but many adverse effects have been observed. Tacrolimus (TAC) is an immunosuppressive agent that is used after organ transplantation. TAC is also used for induction therapy in SLE patients, but no investigations of TAC in Maintenance therapy have been reported. Objectives This study examined the efficacy of TAC combination therapy during the Maintenance Phase of SLE. Methods Thirty-five patients with SLE (27 females and 8 males) were assessed at baseline and following 6 months of TAC administration (from 1 mg to 5 mg per day) using changes in corticosteroid dose and clinical examination. Proteinuria, serum complement levels (C3c) and anti-double-stranded DNA (dsDNA) titers were assessed. The relapse rate of SLE and adverse effects were assessed. Results The mean patient age was 42.0±16.4 years at the initiation of therapy, and the mean disease duration was 76±52 months. Other immunosuppressive drugs (azathioprine, 1 patient; and mizoribine, 9 patients) were combined with corticosteroids, but these agents had been discontinued due to ineffectiveness and/or adverse effects. Corticosteroid doses were reduced from 12.3±8.3 at baseline to 10.4±8.5 mg per day following 6 months of TAC administration (p Conclusions TAC combination therapy during the Maintenance Phase of SLE was found in this study to be beneficial. TAC reduced corticosteroid doses, elevated serum complement level, and decreased proteinuria. No relapse of SLE or major adverse events was observed. Disclosure of Interest None Declared
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AB0377 Efficacy of tacrolimus combination therapy during the Maintenance Phase of systemic lupus erythematosus
Annals of the Rheumatic Diseases, 2013Co-Authors: K. Otsuka, Yusuke Miwa, H. Furuya, Ryo Yanai, Kuninobu Wakabayashi, Masayu Umemura, Hiroyuki Tsukamoto, Takahiro Tokunaga, Sakiko Isojima, Nobuyuki YajimaAbstract:Background In Japan, a placebo-controlled clinical trial of tacrolimus for lupus nephritis was performed to investigate the efficacy and safety of this agent. Based on the results obtained, administration of tacrolimus at an oral dose of 3 mg/day was approved for the treatment of lupus nephritis. Objectives The aim of this study was to prospectively evaluate the efficacy and safety of tacrolimus (TAC) combination therapy during the Maintenance Phase of systemic lupus erythematosus (SLE). TAC was added to the existing therapy if the clinical symptoms worsened and/or if there was a decrease in the serum complements titer because it allowed for a decrease in the dose of prednisolone (PSL). Methods From 2009 to 2012, 38 patients were included in the study period for 1 year. TAC combination therapy (dosage range: 1 mg to 5 mg once daily) was given if there was worsening of any mild manifestations of active SLE, such as arthritis, skin eruptions, or asymptomatic nephritis, and/or if there was a decrease in the serum complement titer (C3c). This study reviewed the SLE Disease Activity Index (SLEDAI) score, the dosage of PSL, the serum levels of C3c, the anti-dsDNA titers and proteinuria. Results Twenty-eight patients were treated with TAC combination therapy and showed symptom improvement with the following results: 1) the dosage of PSL was reduced from 11.7 ± 5.6 to 8.2 ± 4.2 (mg/day) (P Conclusions TAC combination therapy was clinically useful in the Maintenance Phase of SLE. Disclosure of Interest None Declared
Allan H Young - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of mood stabilizers and antipsychotics in the Maintenance Phase of bipolar disorder a systematic review of randomized controlled trials
Bipolar Disorders, 2007Co-Authors: Lesley Smith, Victoria Cornelius, Adrian Warnock, Angus Bell, Allan H YoungAbstract:Background:? Bipolar disorder (BD) is a leading cause of disability. Systematic reviews of randomized trials for the treatment of the Maintenance Phase of BD are lacking. Objectives:? To determine the efficacy and tolerability of mood stabilizers and antipsychotics in the Maintenance treatment of BD. Methods:? We systematically reviewed randomized controlled trials of licensed medications for the treatment of any Phase of BD. We included randomized controlled trials comparing a medication to placebo or another medication. Comprehensive searches of electronic databases were conducted to March 2005. Outcomes investigated were relapse due to mania, depression or any mood episode, and withdrawal due to any reason or due to an adverse event. Data were combined through meta-analysis. Results:? Fourteen studies (n = 2,526) met the inclusion criteria. Lithium, lamotrigine, olanzapine and valproate semisodium each demonstrated evidence to support long-term use. Compared with placebo, all medications were more effective at preventing relapse because of any mood episode. Hazard ratios (HR) were 0.68 [95% confidence interval (CI) = 0.53–0.86] for lithium, 0.68 (95% CI = 0.55–0.85) for lamotrigine, and 0.82 (95% CI = 0.57–1.20) for valproate semisodium; for olanzapine, the risk ratio (RR) was 0.58 (95% CI = 0.49–0.69). Lithium and olanzapine significantly reduced manic relapses (HR = 0.53; 95% CI = 0.35–0.79 and RR = 0.37; 95% CI = 0.24–0.57, respectively). Lamotrigine and valproate semisodium significantly reduced depressive relapses (HR = 0.65; 95% CI = 0.46–0.91 and RR = 0.40; 95% CI = 0.20–0.82, respectively). Lithium significantly reduced manic relapses compared with lamotrigine (HR = 0.56; 95% CI = 0.34–0.92) and olanzapine significantly reduced manic relapses compared with lithium (RR = 1.69; 95% CI = 1.12–2.55). Withdrawal due to an adverse event was approximately twice as likely with lithium compared with valproate semisodium (RR = 1.81; 95% CI = 1.08–3.03) and lamotrigine (RR = 2.20; 95% CI = 1.31–3.70). There were few data for carbamazepine or medications given as adjunct therapy. Conclusions:? Mood stabilizers have differing profiles of efficacy and tolerability, suggesting complementary roles in long-term Maintenance treatment.
Nobuyuki Yajima - One of the best experts on this subject based on the ideXlab platform.
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AB0623 Efficacy of tacrolimus combination therapy during the Maintenance Phase of systemic lupus erythematosus
Annals of the Rheumatic Diseases, 2013Co-Authors: Kumiko Ohtsuka, Yusuke Miwa, H. Furuya, Ryo Yanai, Michihito Sato, Ryo Takahashi, Kuninobu Wakabayashi, Tsuyoshi Odai, Nobuyuki Yajima, Tsuyoshi KasamaAbstract:Background Corticosteroid therapy is effective for systemic lupus erythematosus (SLE), but many adverse effects have been observed. Tacrolimus (TAC) is an immunosuppressive agent that is used after organ transplantation. TAC is also used for induction therapy in SLE patients, but no investigations of TAC in Maintenance therapy have been reported. Objectives This study examined the efficacy of TAC combination therapy during the Maintenance Phase of SLE. Methods Thirty-five patients with SLE (27 females and 8 males) were assessed at baseline and following 6 months of TAC administration (from 1 mg to 5 mg per day) using changes in corticosteroid dose and clinical examination. Proteinuria, serum complement levels (C3c) and anti-double-stranded DNA (dsDNA) titers were assessed. The relapse rate of SLE and adverse effects were assessed. Results The mean patient age was 42.0±16.4 years at the initiation of therapy, and the mean disease duration was 76±52 months. Other immunosuppressive drugs (azathioprine, 1 patient; and mizoribine, 9 patients) were combined with corticosteroids, but these agents had been discontinued due to ineffectiveness and/or adverse effects. Corticosteroid doses were reduced from 12.3±8.3 at baseline to 10.4±8.5 mg per day following 6 months of TAC administration (p Conclusions TAC combination therapy during the Maintenance Phase of SLE was found in this study to be beneficial. TAC reduced corticosteroid doses, elevated serum complement level, and decreased proteinuria. No relapse of SLE or major adverse events was observed. Disclosure of Interest None Declared
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AB0377 Efficacy of tacrolimus combination therapy during the Maintenance Phase of systemic lupus erythematosus
Annals of the Rheumatic Diseases, 2013Co-Authors: K. Otsuka, Yusuke Miwa, H. Furuya, Ryo Yanai, Kuninobu Wakabayashi, Masayu Umemura, Hiroyuki Tsukamoto, Takahiro Tokunaga, Sakiko Isojima, Nobuyuki YajimaAbstract:Background In Japan, a placebo-controlled clinical trial of tacrolimus for lupus nephritis was performed to investigate the efficacy and safety of this agent. Based on the results obtained, administration of tacrolimus at an oral dose of 3 mg/day was approved for the treatment of lupus nephritis. Objectives The aim of this study was to prospectively evaluate the efficacy and safety of tacrolimus (TAC) combination therapy during the Maintenance Phase of systemic lupus erythematosus (SLE). TAC was added to the existing therapy if the clinical symptoms worsened and/or if there was a decrease in the serum complements titer because it allowed for a decrease in the dose of prednisolone (PSL). Methods From 2009 to 2012, 38 patients were included in the study period for 1 year. TAC combination therapy (dosage range: 1 mg to 5 mg once daily) was given if there was worsening of any mild manifestations of active SLE, such as arthritis, skin eruptions, or asymptomatic nephritis, and/or if there was a decrease in the serum complement titer (C3c). This study reviewed the SLE Disease Activity Index (SLEDAI) score, the dosage of PSL, the serum levels of C3c, the anti-dsDNA titers and proteinuria. Results Twenty-eight patients were treated with TAC combination therapy and showed symptom improvement with the following results: 1) the dosage of PSL was reduced from 11.7 ± 5.6 to 8.2 ± 4.2 (mg/day) (P Conclusions TAC combination therapy was clinically useful in the Maintenance Phase of SLE. Disclosure of Interest None Declared
