研究者詳細 - 西田　圭一郎

論文 - 西田　圭一郎

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関節リウマチにおける手指・手関節の超音波PDスコアと関節破壊の関連

沖田駿治, 中原龍一, 松橋美波, 渡辺雅仁, 木曽洋平, 大橋秀基, 那須義久, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 92 ( 8 ) S2052 - S2052 2018年8月

リウマチ性疾患治療中に発症し診断に難渋した手指屈筋腱腱鞘滑膜炎の3例

沖田駿治, 那須義久, 松橋美波, 渡辺雅仁, 木曽洋平, 大橋秀基, 中原龍一, 西田圭一郎, 尾崎敏文

日本骨・関節感染症学会プログラム・抄録集 41回 126 - 126 2018年7月

関節リウマチ前足部手術における術式別のTUGおよびJSSF-RA scaleの検討とX線学的解析

渡辺雅仁, 西田圭一郎, 那須義久, 中原龍一, 大橋秀基, 木曽洋平, 沖田駿治, 松橋美波, 尾崎敏文

関節の外科 45 ( 2 ) 96 - 96 2018年7月

生物学的製剤使用下における上肢手術〜現状と今後の展望〜生物学的製剤使用下の関節リウマチ手関節・手指手術の傾向

那須義久, 西田圭一郎

関節の外科 45 ( 2 ) 38 - 38 2018年7月

The role of lymphotoxin-α in rheumatoid arthritis

Tomohiro Hirose, Yuri Fukuma, Ayumu Takeshita, Keiichiro Nishida

Inflammation Research 67 ( 6 ) 495 - 501 2018年6月

記述言語：英語出版者・発行元：Birkhauser Verlag AG

Background: The role of tumor necrosis factor (TNF) in the inflammatory response in rheumatoid arthritis (RA) is well established, whereas less is known about the role of TNF’s close homolog, lymphotoxin alpha (LTα). Findings: Increased levels of LTα are found in the serum and synovial tissue of patients with RA, and in vitro studies found that LTα-induced proliferation of RA fibroblast-like synoviocytes was at a similar level to TNF. These findings support the idea that anti-LTα treatment could be beneficial in patients with RA, but pateclizumab, an anti-LTα antibody, was not as efficacious as the anti-TNF agent adalimumab in reducing symptoms of RA in a head-to-head study, suggesting that anti-LTα therapies might not represent a valid alternative treatment option in patients with RA. However, suppression of LTα activity might be relevant in the context of RA-related comorbidities, as patients with RA have an increased risk of myocardial infarction (MI) compared with the general population, and specific polymorphisms of the LTα gene have been linked to increased MI risk. Conclusions: In this review, we summarize the key characteristics of LTα and the most recent findings on the role of LTα in RA.

DOI： 10.1007/s00011-018-1139-6

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SETTING TREATMENT TARGET FOR JOINT SURGERY IN LOWER LIMBS IN PATIENTS WITH LONG-STANDING RHEUMATOID ARTHRITIS BASED ON MULTICENTER PROSPECTIVE COHORT STUDY; VALIDATION AND RELIABILITY OF OBJECTIVE INDEX OF ACTIVITY SPEED, TIMED UP AND GO TEST, FOR MEASURI

Kojima T, Ishikawa H, Tanaka S, Haga N, Nishida K, Yukioka M, Hashimoto J, Miyahara H, Niki Y, Kimura T, Oda H, Funahashi K, Asai S, Kojima M, Ishiguro N

ANNALS OF THE RHEUMATIC DISEASES 77 1333-1334 2018年6月

Characteristics of functional impairment in patients with long-standing rheumatoid arthritis based on range of motion of joints: Baseline data from a multicenter prospective observational cohort study to evaluate the effectiveness of joint surgery in the treat-to-target era 査読

Toshihisa Kojima, Hajime Ishikawa, Sakae Tanaka, Nobuhiko Haga, Keiichiro Nishida, Masao Yukioka, Jun Hashimoto, Hisaaki Miyahara, Yasuo Niki, Tomoatsu Kimura, Hiromi Oda, Shuji Asai, Koji Funahashi, Masayo Kojima, Naoki Ishiguro

Modern Rheumatology 28 ( 3 ) 474 - 481 2018年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Taylor and Francis Ltd

Objective: To explore the characteristics of functional impairment in patients with established rheumatoid arthritis (RA) based on the range of motion (ROM) of joints in a prospective observational study of RA patients undergoing joint surgery. Methods: We collected data on demographics, Health Assessment Questionnaire Disability Index (HAQ-DI), and the ROM of large joints including the shoulder, elbow, wrist, hip, knee, and ankle. Associations between the ROM of each joint and disability in the eight HAQ-DI categories were determined using receiver operating characteristic (ROC) and logistic regression analyses. ROM cut-off values of each joint for the absence of disability in each HAQ-DI category were determined using ROC curves. Results: A total of 460 patients were enrolled and analyzed in this study. Based on ROC analysis, the ROM of each joint was significantly associated with disability in each category. After adjusting for disease activity, age, and sex, shoulder abduction had the highest independent impact on disability in activity [cut-off: 139 degrees (OR: 5.26)], elbow flexion-extension in dressing [121 degrees (OR: 2.22)], wrist flexion-extension in reach [86 degrees (OR: 2.71)], hip flexion-extension in walking [126 degrees (OR: 3.42)], and knee flexion-extension in walking [134 degrees (OR: 2.97)]. Conclusions: Limited ROM of multiple joints was significantly associated with functional impairment in patients with long-standing RA. Motion in daily activity involves multiple joints, and at least two joints were independently involved in disability.

DOI： 10.1080/14397595.2017.1349593

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IL-6 is an independent predictive factor of drug survival after dose escalation of infliximab in patients with rheumatoid arthritis 査読

Koji Takasugi, Keiichiro Nishida, Masamitsu Natsumeda, Misuzu Yamashita, Wataru Yamamoto, Kazuhiko Ezawa

Modern Rheumatology 28 ( 3 ) 452 - 460 2018年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Taylor and Francis Ltd

Objective: We aimed to investigate factors predictive of increased serum infliximab (IFX) concentration with improvement of disease activity, as well as better 1-year continuation rate after dose escalation, in patients with rheumatoid arthritis (RA) who showed inadequate response to 3 mg/kg IFX. Methods: Among 42 patients allotted to receive 3 mg/kg IFX, 13 patients showed adequate response (DAS28 &lt
3.2) and 29 patients required dose escalation to 4.5 or 6 mg/kg after inadequate response (DAS28 ≥ 3.2) to 3 mg/kg IFX. DAS28, mHAQ, serum level of CRP, interleukin (IL)-6, IL-17, anti-infliximab antibody (AIA) titers and IFX concentration before and on average 2.7 months after dose escalation were examined to explore the baseline factors predictive of a clinically beneficial increase of serum IFX concentration and drug survival. Results: One year after IFX dose escalation, 25 patients completed the study protocol, and 16 patients (64%) continued to show a good response for one year, while 9 patients (36%) required switching of biologics because of inadequate response. Multivariate analyses revealed that a serum IL-6 level of less than 4.0 pg/mL at baseline was the only factor predictive of a clinically beneficial increase of serum IFX concentration in patients who required dose escalation. Receiver operating characteristic analysis revealed that 5.16 pg/mL of IL-6 was the cut-off value with sensitivity 0.833 and specificity of 0.769 (95%CI for AUC: 0.712–1.006). In patients with IL-6 levels of less than 5.16 pg/mL at baseline, the serum IFX concentration significantly increased after dose escalation with adequate response. The 1-year drug survival rates of patients with IL-6 levels less than 5.16 pg/mL and in those with levels greater than or equal to 5.16 pg/mL at baseline were 83.3% and 30.8%, respectively (log-rank test, p =.011). Conclusions: The results of our study indicated that a baseline serum level of IL-6 below 5.16 pg/mL might be a predictive factor for a clinically beneficial increase of serum IFX concentration with improvement of disease activity and better 1-year continuation rate after IFX dose escalation.

DOI： 10.1080/14397595.2017.1361802

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関節リウマチ患者のボディイメージに対する手術治療の影響

堀田昌宏, 西田圭一郎, 那須義久, 中原龍一, 林充, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 55 ( 特別号 ) 2 - 5 2018年5月

RAにおける大関節破壊の予測と評価関節リウマチの罹病期間・疾患活動性と関節破壊 modified Total Sharp ScoreとARASHI score

那須義久, 橋詰謙三, 西田圭一郎

日本整形外科学会雑誌 92 ( 5 ) 364 - 368 2018年5月

記述言語：日本語出版者・発行元：(公社)日本整形外科学会

生物学的製剤を投与中で、1年以上の間隔をあけて評価に必要な単純X線画像および臨床評価が得られた75例(平均62.6歳)を対象とした。調査期間中の大関節破壊の進行と患者背景との関係を調査するために、ARASHI change score(ACS)を大関節破壊進行群(ACS>0群)と非進行/改善群(ACS≦0群)の2群にわけて比較した。調査期間中、対象のCRP、modified Health assessment questionnaire(mHAQ)、DAS28-CRP、modified Total Sharp Score(mTSS)の平均値に有意な変化はなかった。調査開始時の平均mTSSとASSは、大関節と小関節の破壊の程度と有意な相関があった。ASSはDAS28-CRPなどの疾患活動性とは弱い有意な正の相関があった。最終調査時迄の変化はΔmTSSが平均2.25±9.93、ARASHI change score(ACS)が平均0.03±2.30であった。ACSで評価した大関節破壊の進行は16例(21.3%)に認めた。ACSはΔDAS28-CRP、ΔmHAQと有意な相関を示し、ACS>0群はACS≦0群よりも有意にΔDAS28-CRP、ΔCRP、ΔmHAQが高かった。

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サルコイドーシスの関節病変に対して外科的治療を行なった2例

松橋美波, 那須義久, 渡辺雅仁, 斎藤太一, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 35 ( 1 ) S774 - S774 2018年4月

RAに対する手関節部分固定術の中・長期治療成績

竹下歩, 西田圭一郎, 島村安則, 那須義久, 斎藤太一, 中道亮, 沖田駿治, 尾崎敏文

日本手外科学会雑誌 35 ( 1 ) S220 - S220 2018年4月

Dupuytren拘縮の術後成績

斎藤太一, 島村安則, 中道亮, 竹下歩, 沖田駿治, 松橋美波, 岡崎勇樹, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 35 ( 1 ) S147 - S147 2018年4月

【運動器画像診療の最前線】部位別・疾患別画像診療の最前線関節リウマチの画像診療

中原龍一, 西田圭一郎

関節外科 37 ( 4月増刊 ) 106 - 119 2018年4月

記述言語：日本語出版者・発行元：(株)メジカルビュー社

＜画像診療のポイント＞●関節リウマチ診療においては、それぞれの画像検査の特徴と使いどころを知ることが重要である。●単純X線検査は最も基本的な画像検査であり、定期的に撮影すれば微小な変化の検出に役立つ。●MRIは骨髄浮腫や滑膜炎の診断が可能であるが、コストが高く造影剤投与が必要であるため、超音波検査との使い分けが必要である。●超音波検査は近年注目されている画像検査であり、外来で簡便に関節評価が可能であるため、使い方に習熟すべきである。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00282&link_issn=&doc_id=20180406150011&doc_link_id=10.18885%2FJ00282.2018192549&url=https%3A%2F%2Fdoi.org%2F10.18885%2FJ00282.2018192549&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Outcomes of Resection and Joint-Preserving Arthroplasty for Forefoot Deformities for Rheumatoid Arthritis 査読

Masahiro Horita, Keiichiro Nishida, Kenzo Hashizume, Yoshihisa Nasu, Kenta Saiga, Ryuichi Nakahara, Takahiro Machida, Hideki Ohashi, Toshifumi Ozaki

Foot and Ankle International 39 ( 3 ) 292 - 299 2018年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：SAGE Publications Inc.

Background: We investigated the clinical outcomes of resection and joint-preserving arthroplasty for forefoot deformities in patients with rheumatoid arthritis. Methods: Sixteen feet of 14 women (average age, 67.1 years
range, 53-82) underwent resection arthroplasty of the metatarsal head (resection group), and 18 feet of 15 women (average age, 61.3 years
range, 40-73) underwent a metatarsophalangeal joint-preserving procedure with shortening oblique metatarsal osteotomies of the lesser toes (joint preservation group). The mean disease duration in the resection and joint preservation groups was 23.6 and 19.1 years, and the average follow-up period was 37.3 and 33.5 months, respectively. The classification of Larsen was used to assess the severity of destruction of the metatarsophalangeal (MTP) joint. Preoperative and postoperative clinical evaluation included Japanese Society for Surgery of the Foot (JSSF) score and postoperative complications. Results: The number of preoperative radiographic destruction of the MTP joints (Larsen grade II, III, IV, and V) was 0, 29, 39, and 12 joints in the resection group and 13, 67, 9, and 1 joints in the joint preservation group. The mean JSSF score improved significantly from 61.3 to 83.9 points in the resection group (P &lt
.001) and from 62.2 to 90.8 points in the joint preservation group (P &lt
.001). In the resection group, recurrence of callosities and claw toe deformity was observed in 6 and 3 feet, respectively. In the joint-preserving group, recurrence of callosities and hammer toe deformity was observed in 1 foot each. Conclusion: The resection arthroplasty and joint-preserving procedure showed satisfactory clinical outcomes. However, whether both procedures can maintain the good clinical results without the recurrence of forefoot deformity will require longer follow-up. Level of Evidence: Level III, retrospective comparative series.

DOI： 10.1177/1071100717743996

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関節リウマチの手術4:上肢・その他関節リウマチによる手指伸筋腱断裂症例の患者背景近年の傾向と薬物療法との関係

那須義久, 渡辺雅仁, 木曽洋平, 沖田駿治, 大橋秀基, 兼田大輔, 竹下歩, 中原龍一, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 586 - 586 2018年3月