Yoshikazu Nakashima

Publications (9)15.85 Total impact

• Article: Presence of ultrasound subclinical synovitis and increment of serum vascular endothelial growth factor in a patient with rheumatoid arthritis achieved in sustained clinical remission by treatment with adalimumab and methotrexate.

  Shin-Ya Kawashiri, Kazuhiko Arima, Takahisa Suzuki, Yoshikazu Nakashima, Yoshiro Horai, Akitomo Okada, Mami Tamai, Hideki Nakamura, Atsushi Kawakami
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  ABSTRACT: A 63-year-old male Japanese rheumatoid arthritis (RA) patient, in whom treatment with infliximab and methotrexate (MTX) had once led to drug-free remission, experienced a disease flare in July 2010. He was retreated with a combination of adalimumab and MTX, and clinical remission was achieved in 3 months. In contrast, power Doppler signals by ultrasonography with increased serum vascular endothelial growth factor still remained after he achieved sustained clinical remission, whereas no radiographic progression has been found.
  Modern Rheumatology 01/2013; · 1.58 Impact Factor
• Article: A case of cutaneous polyarteritis nodosa with elevated serum interleukin-6 levels complicated by leg arterial stenosis and destructive arthropathy of the left ankle.

  Yoshiro Horai, Ayuko Tokuyama, Remi Sumiyoshi, Yoshikazu Nakashima, Takahisa Suzuki, Akitomo Okada, Shin-Ya Kawashiri, Kunihiro Ichinose, Yasumori Izumi, Taiichiro Miyashita, Mami Tamai, Satoshi Yamasaki, Hideki Nakamura, Tomayoshi Hayashi, Tomoki Origuchi, Atsushi Kawakami
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  ABSTRACT: We report a case of a 60-year-old female with cutaneous polyarteritis nodosa (CPN) of the left ankle, accompanied by elevated serum interleukin (IL)-6 levels. Computed tomographic angiography revealed severe narrowing of medium-sized arteries in her left leg. Destructive arthropathy in the left ankle was identified by X-ray and magnetic resonance imaging. This is the first Japanese case of severe CPN complicated by destructive arthropathy. Quantification of serum IL-6 might be useful in diagnosis and evaluation of CPN.
  Modern Rheumatology 09/2012; · 1.58 Impact Factor
• Article: Takayasu arteritis developing during treatment of ulcerative colitis with infliximab.

  Yoshiro Horai, Oka Satoru, Samuel Lapalme-Remis, Remi Sumiyoshi, Yoshikazu Nakashima, Takahisa Suzuki, Akitomo Okada, Shin-Ya Kawashiri, Kunihiro Ichinose, Mami Tamai, Satoshi Yamasaki, Hideki Nakamura, Fuminao Takeshima, Tomoki Origuchi, Atsushi Kawakami
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  ABSTRACT: A 22-year-old female with ulcerative colitis that was successfully treated with infliximab (IFX), and remained stable following tapered discontinuation of prednisolone, developed anterior neck pain and elevation of C-reactive protein following her fourth administration of IFX. She was diagnosed with Takayasu arteritis (TA) based on neck ultrasound and computed tomography angiography. This is the first report describing the development of TA during treatment of UC with IFX.
  Modern Rheumatology 06/2012; · 1.58 Impact Factor
• Article: Significant improvement in MRI-proven bone edema is associated with protection from structural damage in very early RA patients managed using the tight control approach.

  Junko Kita, Mami Tamai, Kazuhiko Arima, Shin-Ya Kawashiri, Yoshiro Horai, Naoki Iwamoto, Akitomo Okada, Tomohiro Koga, Yoshikazu Nakashima, Takahisa Suzuki, Satoshi Yamasaki, Hideki Nakamura, Tomoki Origuchi, Hiroaki Ida, Kiyoshi Aoyagi, Masataka Uetani, Katsumi Eguchi, Atsushi Kawakami
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  ABSTRACT: OBJECTIVE: To identify the value of magnetic resonance imaging (MRI)-proven bone edema in patients with very early rheumatoid arthritis (RA). METHODS: All of the 13 patients included in the study were positive at entry for MRI-proven bone edema of the wrist and finger joints and anti-cyclic citrullinated peptide antibodies or IgM-rheumatoid factor. A tight control approach was applied for 12 months. Plain MRI and radiographs of both wrist and finger joints were examined every 6 months. MRI was scored by the RA MRI scoring (RAMRIS) technique and plain radiographs were scored using the Genant-modified Sharp score. Variables that were correlated with plain radiographic changes at 12 months were examined. RESULTS: Simplified disease activity index (SDAI) remission was achieved in 7 patients, and a significant reduction in the RAMRIS bone edema score, which declined to <33 % as compared with the baseline, was achieved in 8 out of 13 patients. Four patients showed plain radiographic progression while 9 patients did not. Significant reductions in the RAMRIS bone edema score (p = 0.007) and the time-integrated SDAI (p = 0.031) were the variables involved in plain radiographic progression. CONCLUSIONS: Improvement in bone edema may be associated with protection against structural damage in very early RA patients managed using the tight control approach.
  Modern Rheumatology 06/2012; · 1.58 Impact Factor
• Article: The diagnostic utility of anti-melanoma differentiation-associated gene 5 antibody testing for predicting the prognosis of Japanese patients with DM.

  Tomohiro Koga, Keita Fujikawa, Yoshiro Horai, Akitomo Okada, Shin-Ya Kawashiri, Naoki Iwamoto, Takahisa Suzuki, Yoshikazu Nakashima, Mami Tamai, Kazuhiko Arima, [......], Tomoki Origuchi, Yasuhito Hamaguchi, Manabu Fujimoto, Yuji Ishimatsu, Hiroshi Mukae, Masataka Kuwana, Shigeru Kohno, Katsumi Eguchi, Kiyoshi Aoyagi, Atsushi Kawakami
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  ABSTRACT: Interstitial lung disease (ILD), especially rapidly progressive ILD (RPILD), is a major poor prognostic factor in patients with DM. We investigated the association of anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab) with clinical characteristics and mortality in Japanese patients with DM. Seventy-nine DM patients, comprising 58 classic DM and 21 clinically amyopathic DM (CADM) patients, were enrolled. Serum Abs were screened by immunoprecipitation assays, and an immunosorbent assay (ELISA) was used for MDA5. The relationships of clinical characteristics and mortality with each Ab were investigated. Anti-MDA5 Ab was detected in 17 patients. Anti-clinically amyopathic DM 140  kDa polypeptide Abs (anti-CADM-140 Abs) were found in 16 of the 17 anti-MDA5 Ab(+) patients. Skin ulcers, palmar papules, CADM, RPILD and mediastinal emphysema were widely distributed in anti-MDA5 Ab(+) patients. Mortality at 6 months as well as 5 years was also significantly higher in anti-MDA5 Ab(+) patients than in anti-MDA5 Ab(-) patients. In a multivariable Cox regression analysis, mortality was independently associated with anti-MDA5 Ab (relative hazard 6.33; 95% CI 1.43, 28.0). All of the deaths in anti-MDA5 Ab(+) patients were attributed to respiratory failure of RPILD; however, RPILD did not worsen in any of the anti-MDA5 Ab(+) patients who survived the first 6 months. The presence of anti-MDA5 Ab identifies the characteristic skin, musculoskeletal, pulmonary and prognostic features in patients with DM. In addition, anti-MDA5 Ab seems to predict a group of patients with CADM-complicated fatal RPILD.
  Rheumatology (Oxford, England) 02/2012; 51(7):1278-84. · 4.24 Impact Factor
• Article: A case of Sjögren's syndrome presenting as trigeminal nerve palsy.

  Yoshiro Horai, Ayako Nishino, Yoshikazu Nakashima, Takahisa Suzuki, Akitomo Okada, Shin-ya Kawashiri, Mami Tamai, Satoshi Yamasaki, Hideki Nakamura, Tomoki Origuchi, Atsushi Kawakami
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  ABSTRACT: We herein report the case of a female with Sjogren's syndrome (SS) complicated with trigeminal nerve palsy. Although her sicca symptoms had been unnoticed, head magnetic resonance imaging (MRI) for detecting brain abnormalities revealed parotid gland changes associated with SS. SS should be considerd as a possible cause of trigeminal nerve disturbances. In addition, parotid gland changes related to SS should be aware in examination of cranial nerve disturbances with MRI.
  Japanese Journal of Clinical Immunology 01/2012; 35(3):199-202.
• Article: Treatment discontinuation in patients with very early rheumatoid arthritis in sustained simplified disease activity index remission after synthetic disease-modifying anti-rheumatic drug administration.

  Junko Kita, Mami Tamai, Kazuhiko Arima, Yoshikazu Nakashima, Takahisa Suzuki, Shin-Ya Kawashiri, Naoki Iwamoto, Akitomo Okada, Tomohiro Koga, Satoshi Yamasaki, Hideki Nakamura, Tomoki Origuchi, Hiroaki Ida, Kiyoshi Aoyagi, Masataka Uetani, Katsumi Eguchi, Atsushi Kawakami
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  ABSTRACT: We aimed to identify whether drug-free remission could be achieved in patients with very early rheumatoid arthritis (RA) with poor prognosis factors by treatment with synthetic disease-modifying antirheumatic drugs (DMARDs). Thirteen patients with very early RA, whose disease was considered to have highly erosive potential, were included. Magnetic resonance imaging (MRI)-proven bone edema and autoantibodies were determined in these patients. A treat-to-target strategy initiated with synthetic DMARDs was employed for 12 months. If the patients achieved simplified disease activity index (SDAI) remission along with a reduction of the RA MRI scoring bone edema score to <33% as compared with baseline at 12 months, DMARD treatment was stopped and the clinical status was further observed for the following 12 months. Synthetic DMARDs were stopped at 12 months in 5 patients. One of the 5 was lost to follow-up because of sustaining an injury that required orthopedic surgery. Three of the remaining 4 patients showed continued SDAI remission that was DMARD-free without any evidence of radiographic progression for the following 12 months. Although this was a small clinical trial, we have shown-for the first time-that true remission of very early RA with poor prognosis factors can be achieved by treatment with synthetic DMARDs.
  Modern Rheumatology 09/2011; 22(3):346-52. · 1.58 Impact Factor
• Article: Delayed treatment with tumor necrosis factor inhibitors in incomplete responders to synthetic disease-modifying anti-rheumatic drugs shows an excellent effect in patients with very early rheumatoid arthritis with poor prognosis factors.

  Junko Kita, Mami Tamai, Kazuhiko Arima, Yoshikazu Nakashima, Takahisa Suzuki, Shin-ya Kawashiri, Akitomo Okada, Tomohiro Koga, Satoshi Yamasaki, Hideki Nakamura, Tomoki Origuchi, Toshiyuki Aramaki, Munetoshi Nakashima, Keita Fujikawa, Toshiaki Tsukada, Hiroaki Ida, Kiyoshi Aoyagi, Masataka Uetani, Katsumi Eguchi, Atsushi Kawakami
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  ABSTRACT: We aimed to investigate whether delayed treatment with tumor necrosis factor (TNF) inhibitors in incomplete responders to synthetic disease-modifying anti-rheumatic drugs (DMARDs) was effective among patients with very early rheumatoid arthritis (RA) with poor prognosis factors. We examined 22 patients with very early RA who were positive for anti-cyclic citrullinated peptide antibodies or IgM-rheumatoid factor. The mean disease duration at entry was 14.1 weeks. A treat-to-target strategy, aiming at simplified disease activity index (SDAI) remission, was initiated with synthetic DMARDs. SDAI remission was not achieved in 9 of the 22 patients with synthetic DMARDs alone, and TNF inhibitors were added in these patients. SDAI values in these 9 patients were further examined for the following 6 months. The TNF inhibitors (infliximab 8, etanercept 1) were added at a mean interval of 34.1 weeks after the initiation of synthetic DMARDs. SDAI remission was achieved in 4 of the 9 patients (44.4%) at 3 months and in 8 of the 9 patients (88.9%) at 6 months after the introduction of the TNF inhibitors. Radiographic damage had not progressed in these patients. Delayed treatment with TNF inhibitors is effective and tolerable for patients with very early RA with poor prognosis factors.
  Modern Rheumatology 09/2011; 22(2):195-201. · 1.58 Impact Factor
• Article: Soluble urokinase plasminogen activator receptor as a useful biomarker to predict the response to adalimumab in patients with rheumatoid arthritis in a Japanese population.

  Tomohiro Koga, Akitomo Okada, Shinya Kawashiri, Junko Kita, Takahisa Suzuki, Yoshikazu Nakashima, Mami Tamai, Katsuya Satoh, Tomoki Origuchi, Naoki Iwamoto, Satoshi Yamasaki, Hideki Nakamura, Kiyoshi Migita, Hiroaki Ida, Yukitaka Ueki, Katsumi Eguchi, Atsushi Kawakami
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  ABSTRACT: To determine whether soluble urokinase plasminogen activator receptor is a useful biomarker to predict the response to adalimumab (ADA) in Japanese patients with rheumatoid arthritis. Rheumatoid arthritis (RA) patients administrated ADA (n=51) were classified as good responders (n=18) or nonresponders (n=9) according to the EULAR response criteria after 8 weeks of bi-weekly ADA administration. We examined the expression of cytokines and chemokines in these groups by antibody array methods. Positive results obtained by antibody array methods were further confirmed by ELISA. Antibody array has identified that the macrophage migration inhibitory factor (MIF), vascular endothelial growth factor (VEGF) and soluble urokinase plasminogen activator receptor (uPAR) decreased in the good responders to ADA whereas these changes were not observed in the non-responders. The decrement of serum uPAR was confirmed by ELISA in the good responders to ADA. Furthermore, serum uPAR at baseline was significantly high in non-responders compared with good responders. An antibody array is convenient for screening the expression of proteins of interest. Examination of serum uPAR at baseline and thereafter may be useful as a predictive biomarker for primary failure toward ADA in patients with RA.
  Clinical and experimental rheumatology 29(5):811-5. · 2.15 Impact Factor