Satoshi Takanashi

Of the patients with RA, 10.1% were still difficult to treat in clinical practice, despite intensive treatment. Their characteristics were distinct by the reasons of D2T RA, which suggests the need for a personalized approach to D2T RA.

Early recognition and diagnosis of IgG4-related FM is essential because a delay in appropriate treatment initiation leads to progressive fibrosis with irreversible organ damage and poor prognosis. Our cases highlight CT-guided percutaneous needle biopsy as a promising option for histological examination in patients with IgG4-related FM.

Serum KL-6 is a useful biomarker for assessing the disease activity of myositis-associated ILD.

Lymphadenopathy in IgG4-RD represents a phenotype associated with high disease activities, eosinophilia and relapsing disease. Eotaxin-3 is a novel biomarker related to IgG4-RD with lymphadenopathy.

Interstitial lung disease (ILD) associated with idiopathic inflammatory myopathy is a life-threatening organ involvement [1–4]. Particularly, anti-melanoma differentiation-associated gene 5 (MDA5) antibody is associated with rapid progressive and refractory ILD [1,2], and the prognosis of patients with anti-MDA5-positive ILD is extremely poor, with the mortality of 31.7–45.0% [2,5]. Thus, establishment of optimal treatment strategy is an urgent task. Recently, the effectiveness of combined immun

Despite remarkable advances in the management of RA, there are still unmet needs that rheumatologists need to address. In this review, we focused on difficult-to-treat RA (D2T RA) and late-onset RA (LORA), and summarized their characteristics and management. The prevalence of D2T RA is reported to be 6-28% and many factors have been identified as risk factors for D2T RA, including female sex, long disease duration, seropositivity for rheumatoid factor and anti-cyclic citrullinated peptide antibo

IgG4-related disease (IgG4-RD) is an immune-mediated systemic disease characterized by the development of mass lesions in or the enlargement of multiple organs. Whereas the optimum treatment has not been established yet, moderate to high dose of glucocorticoids is recommended as an initial treatment, and the response of the disease to glucocorticoids is generally good [1]. After remission induction, glucocorticoids can be tapered gradually, even stopped in some cases, however, 15–33% of patients

Further modifications in RA treatment are useful for resolving D2T RA. Multiple comorbidities and glucocorticoid use are associated with mortality.

Aging is an independent contributor for seronegative RA in patients who are female, have a nonsmoking history, and a BMI < 25.

The clinical and immunological phenotypes of IgG4-RD differ among those with underlying diseases.

B-cell depletion by rituximab may be a useful treatment option for patients with lymphoproliferative disorder and rheumatoid vasculitis.