Shingo Kato's research while affiliated with Saitama Medical University and other places

... Patients with IBD are treated with 5-ASA, corticosteroids, thiopurines, and molecular-targeting agents, depending on the extent and severity of the disease [9]. Therefore, both physicians and patients with IBD are concerned about developing COVID-19 in IBD patients while on immunomodulatory therapy. ...

... 11 According to a nationwide Japanese study, the incidence of VTE among patients with IBD was 1.03% (102.5 per 100,000 IBD person-years). 12 Although this incidence rate is lower than that in Western countries, 6,13,14 it is not negligible. Thus, identifying patients at a high risk of developing VTE is important. ...

... Recently, the measurement of biomarkers of IBD, such as fecal calprotectin and leucine-rich a2 glycoprotein, which are simple and less invasive to measure compared with biopsies, have been attracting attention. [23][24][25] Additionally, various substances in saliva have been associated with disease activity in IBD. Aleksandra Nielsen et al. 26 reported that measuring salivary interleukin-6 could be an additional method in conjunction with other measures for evaluating and monitoring IBD because this compound plays an important role in the inflammatory process. ...

... Our findings are in line with expert opinions stating that relapses often occur after discontinuation of biologic therapy [9]. The cumulative relapse risk of 29% at 12 months accords with previously found incidences [9][10][11][17][18][19][20][21][22][23][24], although some studies report higher incidences of up to almost 50% after 1 year [25][26][27][28][29][30][31]. The higher relapse risk of 47% at 36 months is also in line with previous studies [9]. ...

... Adalimumab and AZA combination therapy was not significantly better than adalimumab monotherapy in an open-label randomized control trial (the DIAMOND study) [26]. The combination group also experienced more frequent side effects, which subsequently resulted in a greater dropout rate from the trial [27]. ...

... The proportion of patients with elderly onset IBD varies from 3 to 21% for CD and 7 to 29% for UC [169]. Elderly patients with long-standing IBD who were diagnosed in younger adulthood may be clinically distinct from those with elderly onset IBD [170]. ...

... The FIT was originally developed for colorectal cancer screening, and in UC, it reflects bleeding caused by inflammation of the mucosa and has been reported to correlate with the endoscopic score [6]. FC and FIT have been reported to not only reflect endoscopic activity but also predict subsequent relapse in patients with UC in clinical remission [12][13][14][15]. In addition to these fecal biomarkers, serum leucine-rich alpha 2 glycoprotein (LRG) has been reported to be a useful marker that reflects endoscopic activity in UC and has been used in clinical practice [16][17][18]. ...

... Discontinuation of immunomodulator therapy in patients receiving combination treatment with anti-TNFa therapy should be considered separately to that of discontinuation of immunomodulator monotherapy. As shown in Supplementary Table 19 [240][241][242][243], results of different clinical studies are mixed but seem to suggest that immunomodulator discontinuation has less impact among patients on combination therapy than those receiving monotherapy. In particular, in the IMID study of 80 patients with CD, no long-term clinical benefit was observed from continuing immunomodulator therapy beyond 6 months in patients receiving scheduled infliximab, although patients who continued immunomodulator therapy had a lower frequency of infliximab antibodies and higher trough drug concentrations [243]. ...

... They showed equivalent relapse rates in those that continued combination therapy (27/56, 48%) and in those who continued IFX alone [27/55 (49%), RR 1.02, 95% CI 0.68-1.52]. Dohos et al. included the prospective RCT DIAMOND-2 study that examined outcomes following thiopurine withdrawal from maintenance ADA after 6 months of remission in adult CD in their meta-analysis on this question (69,70). The pooled data again showed no statistically significant difference in relapse rates between those stepped down to monotherapy and those continuing the combination regime (RR 1.30, 95% CI 0.81-−2.08, ...

... In addition, we could not evaluate potentially predictive factors, such as histological findings, fecal calprotectin [6][7][8][9], prostaglandin E-major urinary metabolite [40], or leucine-rich alpha-2 glycoprotein [34], since this was a retrospective study. As the number of elderly UC patients is increasing [41], the number of patients with comorbidities, immune dysfunction, polypharmacy, and other factors affecting NLR values is also increasing. Prospective multicenter studies seem necessary to confirm the usefulness of NLR in the real world. ...