Inhibitory effects of combination therapy of denosumab, anti-RANKL antibody, and biological DMARD on bone and cartilage destruction in patients with rheumatoid arthritis

• Project/Area Number: 26462290
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Orthopaedic surgery
• Research Institution: Nagoya University
• Principal Investigator: Kojima Toshihisa 名古屋大学, 医学部附属病院, 講師 (70378032)
• Co-Investigator(Kenkyū-buntansha): 石黒 直樹 名古屋大学, 医学系研究科, 教授 (20212871) ; 高橋 伸典 名古屋大学, 医学部附属病院, 病院講師 (20570196) ; 舟橋 康治 名古屋大学, 医学部附属病院, 病院助教 (80566977) ; 浅井 秀司 名古屋大学, 医学部附属病院, 特任助教 (00770893)
• Co-Investigator(Renkei-kenkyūsha): KOJIMA Masayo 名古屋市立大学, 医学研究科, 准教授 (30326136)
• Research Collaborator: YOSHIOKA Yutaka 半田市立半田病院, 整形外科 ; FUNAHASHI Koji 刈谷豊田総合病院, 整形外科 ; HIRABARA shinya 萩原整形外科リウマチクリニック ; HIRANO Yuji 豊橋市民病院, リウマチ科, 部長 ; HAYASHI Masatoshi 長野赤十字病院, 整形外科 ; YABE Yuichiro JCHO東京新宿メディカルセンター, リウマチ科, 主任部長 ; OGUCHI Takeshi 安城更生病院, 整形外科 ; FUJIBAYASHI Takayoshi 愛知厚生連江南厚生病院, 整形外科リウマチ科, 部長 ; TAKAGI Hideki 名古屋セントラル病院, 整形外科 ; KANAYAMA Yasuhide 豊田厚生病院, 整形外科
• Project Period (FY): 2014-04-01 – 2017-03-31
• Project Status: Completed (Fiscal Year 2016)
• Budget Amount: ¥5,070,000 (Direct Cost: ¥3,900,000、Indirect Cost: ¥1,170,000); Fiscal Year 2016: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000); Fiscal Year 2015: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000); Fiscal Year 2014: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
• Keywords: rheumatoid arthritis / biologics / osteoporosis / denosumab / toll like receptor / 臨床 / 関節リウマチ / 骨代謝 / 生物学的製剤

Outline of Final Research Achievements

The purpose of this research project was to focus on the effect of antibody Denosumab on RANKL, which is particularly deeply related to bone resorption, and to elucidate the bone metabolism in rheumatoid arthritis (RA) and factors related to 1). The observation study of patients with Denosumab (TBCR-Bone), and 2). the specimen collection and analysis from RA surgical patients were encouraged. 1) About 76 registered RA patients were verified under real clinical practice up to 12 months, improved bone density, and suppression of bone metabolic markers were confirmed. The effects of disease activity were suggested. Ra-Bio, the steroid administration had no effect on Denosumab's effects. 2), bone cartilage collected during surgery from 25 patients, immunostaining and pathological evaluation of synovial membranes was performed.

Research Products

• [Int'l Joint Research] Montreal University(Canada)
• [Journal Article] Hyaluronan Inhibits Tlr-4-Dependent RANKL Expression in Human Rheumatoid Arthritis Synovial Fibroblasts (2016)
  • Author(s): Tatsuo Watanabe, Nobunori Takahashi, Shinya Hirabara, Naoki Ishiguro, Toshihisa Kojima
  • Journal Title: PLOS ONE Volume: in press Issue: 4 Pages: e0153142-e0153142
  • DOI: 10.1371/journal.pone.0153142
  • Peer Reviewed / Open Access
• [Journal Article] Respiratory mechanics measured by forced oscillation technique in rheumatoid arthritis-related pulmonary abnormalities: frequency-dependence, heterogeneity and effects of smoking. (2016)
  • Author(s): Sokai R, Ito S, Iwano S, Uchida A, Aso H, Kondo M, Ishiguro N, Kojima T, Hasegawa Y.
  • Journal Title: SpringerPlus Volume: 5 Issue: 1 Pages: 335-335
  • DOI: 10.1186/s40064-016-1952-8
  • Peer Reviewed / Open Access
• [Journal Article] Longterm Retention Rate and Risk Factors for Adalimumab Discontinuation Due To Efficacy and Safety in Japanese Patients with Rheumatoid Arthritis: An Observational Cohort Study. (2016)
  • Author(s): Hattori Y, Kojima T, Kaneko A, Kida D, Hirano Y, Fujibayashi T, Terabe K, Yabe Y, Miyake H, Kato T, Takagi H, Hayashi M, Ito T, Kanayama Y, Oguchi T, Takahashi N, Ishikawa H, Funahashi K, Ishiguro N.
  • Journal Title: The Journal of Rheumatology Volume: 43(8) Issue: 8 Pages: 1475-9
  • DOI: 10.3899/jrheum.151006
  • Peer Reviewed
• [Journal Article] Hyaluronan Oligosaccharides Induce MMP-1 and -3 via Transcriptional Activation of NF-kappaB and p38 MAPK in Rheumatoid Synovial Fibroblasts. (2016)
  • Author(s): Hanabayashi M, Takahashi N, Sobue Y, Hirabara S, Ishiguro N, Kojima T.
  • Journal Title: PLoS One Volume: 11（８）
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] mproved safety of biologic therapy for rheumatoid arthritis over the 8-year period since implementation in Japan: long-term results from a multicenter observational cohort study (2016)
  • Author(s): Kojima, T., Takahashi, N., Funahashi, K., Asai, S., Terabe, K., Kaneko, A., Hirano, Y., Hayashi, M., Miyake, H., Oguchi, T., Takagi, H., Kanayama, Y., Yabe, Y., Watanabe, T., Fujibayashi, T., Shioura, T., Ito, T., Yoshioka, Y., Ishikawa, H., Asai, N., Takemoto, T., Kojima, M., Ishiguro, N.
  • Journal Title: Clinical Rheumatology Volume: 35 Issue: 4 Pages: 863-71
  • DOI: 10.1007/s10067-016-3201-5
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Predictive factors for achieving low disease activity at 52 weeks after switching from tumor necrosis factor inhibitors to abatacept: results from a multicenter observational cohort study of Japanese patients (2016)
  • Author(s): Kojima, T., Takahashi, N., Kaneko, A., Kida, D., Hirano, Y., Fujibayashi, T., Yabe, Y., Takagi, H., Oguchi, T., Miyake, H., Kato, T., Watanabe, T., Hayashi, M., Shioura, T., Kanayama, Y., Funahashi, K., Asai, S., Yoshioka, Y., Terabe, K., Takemoto, T., Asai, N., Ishiguro, N.
  • Journal Title: Clinical Rheumatology Volume: 35 Issue: 1 Pages: 219-25
  • DOI: 10.1007/s10067-015-3135-3
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Importance of methotrexate therapy concomitant with tocilizumab treatment in achieving better clinical outcomes for rheumatoid arthritis patients with high disease activity: an observational cohort study (2015)
  • Author(s): Kojima, T.,Yabe, Y.,Kaneko, A.,Takahashi, N.,Funahashi, K.,Kato, D.,Hanabayashi, M.,Asai, S.,Hirabara, S.,,Asai, ,.Hirano, Y.,Hayashi, M.,Miyake, H.,Kojima, M.,Ishiguro, N.
  • Journal Title: Rheumatology (Oxford) Volume: 54（1） Issue: 1 Pages: 113-120
  • DOI: 10.1093/rheumatology/keu302
  • Peer Reviewed
• [Journal Article] Drug retention rates of second biologic agents after switching from tumor necrosis factor inhibitors for rheumatoid arthritis in Japanese patients on low-dose methotrexate or without methotrexate (2015)
  • Author(s): Kobayakawa, T.,Kojima, T.,Takahashi, N.,Hayashi, M.,Yabe, Y.,Kaneko, A.,Shioura, T.,Saito, K.,Hirano, Y.,Kanayama, Y.,Miyake, H.,Asai, N.,Funahashi, K.,Hirabara, S.,Hanabayashi, M.,Asai, S.,Ishiguro, N.
  • Journal Title: Mod Rheumatol Volume: 25（2） Issue: 2 Pages: 251-256
  • DOI: 10.3109/14397595.2014.953668
  • Peer Reviewed
• [Journal Article] Longterm retention rate and risk factor for discontinuation due to insufficient efficacy and adverse events in Japanese patients with rheumatoid arthritis receiving etanercept therapy (2014)
  • Author(s): Matsubara H, Kojima T, Kaneko A, Hirano Y, Ishikawa H, Hattori Y, Miyake H, Oguchi T, Takagi H, Yabe Y, Kato T, Ito T, Fukaya N, Kanayama Y, Shioura T, Hayashi M, Fujibayashi T, Takahashi N, Funahashi K, Kato D, Hanabayashi M, Terabe K, Ishiguro N.
  • Journal Title: J Rheumatol Volume: 41 Issue: 8 Pages: 1583-9
  • DOI: 10.3899/jrheum.130901
  • Peer Reviewed
• [Journal Article] Clinical efficacy of abatacept, tocilizumab, and etanercept in Japanese rheumatoid arthritis patients with inadequate response to anti-TNF monoclonal antibodies (2014)
  • Author(s): Y.,Fujibayashi, T.,Sugiura, F.,Hayashi, M.,Funahashi, K.,Hanabayashi, M.,Asai, S.,Ishiguro, N.,Kojima, T.
  • Journal Title: Clin Rheumatol Volume: 33（９） Issue: 9 Pages: 1247-1254
  • DOI: 10.1007/s10067-014-2711-2
  • Peer Reviewed
• [Presentation] Mechanisms of Cartilage destruction in osteoarthritis and rheumatoid arthritis (2017)
  • Author(s): 小嶋俊久
  • Organizer: 日本軟骨代謝学会
  • Place of Presentation: 京都市勧業館みやこめっせ（京都府京都市）
  • Year and Date: 2017-03-03
  • Invited
• [Presentation] 関節リウマチ治療におけるJAK阻害薬 (2016)
  • Author(s): 小嶋俊久
  • Organizer: 日本関節病学会
  • Place of Presentation: 別府国際コンベンションセンター（大分県別府市）
  • Year and Date: 2016-11-11
  • Invited
• [Presentation] リウマチ性疾患の疼痛マネージメント (2016)
  • Author(s): 小嶋俊久
  • Organizer: 日本臨床リウマチ学会
  • Place of Presentation: 京王プラザホテル（東京都新宿区）
  • Year and Date: 2016-10-29
  • Invited
• [Presentation] The Predictors for Twelve Months Efficacy of Denosumab, an Anti­RANKL Antibody, on Osteoporosis in Rheumatoid Arthritis Patients from Japanese Multicenter Study (TBCR­BONE) (2016)
  • Author(s): Y. Hirano, Y. Kanayama, M. Isono, N. Ishiguro, T. Kojima, on behalf of TBCR-BONE
  • Organizer: ＡＳＢＭＲ
  • Place of Presentation: Atlanta（ＵＳＡ）
  • Year and Date: 2016-09-16
  • Int'l Joint Research
• [Presentation] Influence of glucocorticoids on effect of denosumab on osteoporosis in patients with Japanese rheumatoid arthritis; 12 months of follow­up ~a Multicenter Registry Study~ (2016)
  • Author(s): Y. Kanayama, Y. Hirano, N. Takahashi, S. Asai, N. Ishiguro, T. Kojima, on behalf of TBCR-BONE Study Group
  • Organizer: ＡＳＢＭＲ
  • Place of Presentation: Atlanta（ＵＳＡ）
  • Year and Date: 2016-09-16
  • Int'l Joint Research
• [Presentation] 名古屋大学医学部附属病院でのリウマチ治療におけるチーム医療 (2016)
  • Author(s): 小嶋俊久
  • Organizer: 中部リウマチ学会
  • Place of Presentation: ザ・グランユアーズフクイ（福井県福井市）
  • Year and Date: 2016-09-02
  • Invited
• [Presentation] THE PREDICTORS FOR 12 MONTHS EFFICACY OF DENOSUMAB, AN ANTI-RANKL ANTIBODY, ON OSTEOPOROSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS FROM MULTICENTER STUDY (TBCR-BONE) (2016)
  • Author(s): Y. Hirano, Y. Kanayama, M. Isono, N. Ishiguro, T. Kojima, on behalf of TBCR-BONE
  • Organizer: ＥＵＬＡＲ
  • Place of Presentation: London（ＵＫ）
  • Year and Date: 2016-06-08
  • Int'l Joint Research
• [Presentation] DRUG SURVIVAL OF GOLIMUMAB IN JAPANESE PATIENTS WITH RHEUMATOID ARTHRITIS IS INDEPENDENT OF METHOTREXATE AND PREDNISOLONE CONCOMITANCE: RESULTS FROM THE MULTICENTER BIOLOGICS REGISTRY (2016)
  • Author(s): M. Hayashi, T. Kanamono, H. Matsubara, K. Kishimoto, N. Takahashi, T. Kojima, N. Ishiguro
  • Organizer: ＥＵＬＡＲ
  • Place of Presentation: London（ＵＫ）
  • Year and Date: 2016-06-08
  • Int'l Joint Research
• [Presentation] EFFICACY OF INFLIXIMAB FOR SUPPRESSING RADIOGRAPHIC PROGRESSION OF CERVICAL LESIONS IN PATIENTS WITH RHEUMATOID ARTHRITIS COMPARISON WITH METHOTREXATE; TWO YEARS OF FOLLOW-UP A MULTICENTER REGISTRY STUDY (2016)
  • Author(s): Y. Kanayama, T. Kojima, Y. Hirano, N. Takahashi, Y. Yabe, N. Ishiguro, on behalf of TBCR Study Group
  • Organizer: ＥＵＬＡＲ
  • Place of Presentation: London（ＵＫ）
  • Year and Date: 2016-06-08
  • Int'l Joint Research
• [Presentation] RETENTION RATE OF BIOLOGIC AGENTS AFTER REMISSION INDUCED WITH AND WITHOUT CONCOMITANT GLUCOCORTICOID TREATMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS: A PROPENSITY SCORE MATCHED ANALYSIS (2016)
  • Author(s): S. Asai, T. Kojima, N. Takahashi, K. Funahashi, N. Ishiguro, on behalf of TBCR Study Group
  • Organizer: ＥＵＬＡＲ
  • Place of Presentation: London（ＵＫ）
  • Year and Date: 2016-06-08
  • Int'l Joint Research
• [Presentation] INFLUENCE OF ORAL PREDNISOLONE ON EFFECT OF DENOSUMAB ON OSTEOPOROSIS IN PATIENTS WITH JAPANESE RHEUMATOID ARTHRITIS; 12 MONTHS OF FOLLOW-UP A MULTICENTER REGISTRY STUDY (2016)
  • Author(s): Y. Kanayama, Y. Hirano, N. Takahashi, S. Asai, N. Ishiguro, T. Kojima, on behalf of TBCR-BONE Study Group
  • Organizer: ＥＵＬＡＲ
  • Place of Presentation: London（ＵＫ）
  • Year and Date: 2016-06-08
  • Int'l Joint Research
• [Presentation] DAILY TERIPARATIDE TREATMENT AFTER BISPHOSPHONATE THERAPY IN OSTEOPOROSIS OF PATIENTS WITH RHEUMATOID ARTHRITIS (2016)
  • Author(s): Y. Hirano, M. Isono, J. Fukui, J. Hasegawa, N. Ishiguro, T. Kojima
  • Organizer: ＥＵＬＡＲ
  • Place of Presentation: London（ＵＫ）
  • Year and Date: 2016-06-08
  • Int'l Joint Research
• [Presentation] RELATIONSHIP BETWEEN BIOLOGICAL DMARDS TREATMENT AND COMPLICATIONS AFTER SURGICAL TREATMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS (2016)
  • Author(s): Y. Hirano, S. Hirabara, M. Isono, N. Ishiguro, T. Kojima.
  • Organizer: ＥＵＬＡＲ
  • Place of Presentation: London（ＵＫ）
  • Year and Date: 2016-06-08
  • Int'l Joint Research
• [Presentation] SERO-POSITIVITY FOR RHEUMATOID FACTOR IS AN INDEPENDENT PREDICTOR FOR ACHIEVEMENT OF GOOD EULAR RESPONSE AT 24 WEEKS IN ACPA POSITIVE RHEUMATOID ARTHRITIS PATIENTS TREATED WITH ABATACEPT: RESULTS FROM JAPANESE MULTICENTER REGISTRY (2016)
  • Author(s): N. Takahashi, T. Kojima, K. Funahashi, N. Ishiguro, on behalf of TBCR Study Group
  • Organizer: ＥＵＬＡＲ
  • Place of Presentation: London（ＵＫ）
  • Year and Date: 2016-06-08
  • Int'l Joint Research
• [Presentation] PROGNOSTIC FACTORS FOR ABATACEPT RETENTION IN PATIENTS WITH RHEUMATOID ARTHRITIS IN A JAPANESE MULTICENTER REGISTRY (2016)
  • Author(s): M. Hanabayashi, N. Takahashi, Y. Yokota, H. Miyake, T. Kojima, N. Ishiguro, on behalf of TBCR
  • Organizer: ＥＵＬＡＲ
  • Place of Presentation: London（ＵＫ）
  • Year and Date: 2016-06-08
  • Int'l Joint Research
• [Presentation] THE ASSOCIATION BETWEEN METHOTREXATE USE AND EFFECTS OF TREATMENT WITH A SECOND BIOLOGIC AGENT IN RHEUMATOID ARTHRITIS (2016)
  • Author(s): Y. Ogawa, T. Kojima, N. Takahashi, K. Funahashi, N. Ishiguro
  • Organizer: ＥＵＬＡＲ
  • Place of Presentation: LonDon（ＵＫ）
  • Year and Date: 2016-06-08
  • Int'l Joint Research
• [Presentation] 周術期における生物学的製剤の使い方 (2016)
  • Author(s): 小嶋俊久
  • Organizer: 日本整形外科学会
  • Place of Presentation: パシフィコ横浜及びヨコハマグランドインターコンチネンタルホテル（神奈川県横浜市）
  • Year and Date: 2016-05-12
  • Invited
• [Presentation] 現在そして今後のリウマチ治療を考える (2016)
  • Author(s): 小嶋俊久
  • Organizer: 日本整形外科学会
  • Place of Presentation: パシフィコ横浜及びヨコハマグランドインターコンチネンタルホテル（神奈川県横浜市）
  • Year and Date: 2016-05-12
  • Invited
• [Presentation] Hyaluronan Inhibits TLR-4 Dependent RANKL Expression in Human Rheumatoid Arthritis Synovial Fibroblast (2016)
  • Author(s): Watanabe T, Takahashi N, Ishiguro N, Kojima T
  • Organizer: 第29回日本軟骨代謝学
  • Place of Presentation: 広島大学（広島県広島市）
  • Year and Date: 2016-02-19
• [Presentation] Predictive Factors for Achieving Low Disease Activity at 52 Weeks after Switching from Tumor Necrosis Factor Inhibitors to Abatacept: Results from a Multicenter Observational Cohort Study of Japanese Patients (2015)
  • Author(s): Kojima T , Takahashi N, Kaneko A, Kida D, Hirano Y, Fujibayashi T, Yabe Y, Takagi H, Oguchi T, Miyake H, Kato T, Watanabe T, Hayashi M, Shioura T, Kanayama Y, Funahashi K, Asai S, Yoshioka Y, Terabe K, Takemoto T, Asai N, Ishiguro N
  • Organizer: ACR 2015
  • Place of Presentation: San Francisco, CA, U.S.A.
  • Year and Date: 2015-11-06
  • Int'l Joint Research
• [Presentation] THE SHORT-TERM EFFICACY OF DENOSUMAB IN OSTEOPOROSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS FROM A JAPANESE MULTICENTER REGISTRY (2015)
  • Author(s): Hirano Y, Kanayama Y, Hirabara S, Asai S, Takahashi N, Ito T, Ishiguro N, Kojima T
  • Organizer: ASBMR2015 Annual Meeting
  • Place of Presentation: Seattle, WA, U.S.A.
  • Year and Date: 2015-10-09
  • Int'l Joint Research
• [Presentation] 関節リウマチの骨粗鬆症に対するデノスマブの短期臨床成績～TBCR-BONEより～Tsurumai Biologics Communication Registry-BONE (TBCR-BONE) (2015)
  • Author(s): 平野裕司 金山康秀 浅井秀司 高橋伸典 石黒直樹 小嶋俊久
  • Organizer: 第17回日本骨代謝学会
  • Place of Presentation: 広島国際会議場（広島県広島市）
  • Year and Date: 2015-09-17
• [Presentation] Importance of both disease activity at 12 weeks and clinical response up to 12 weeks to predict achievement of low disease activity at 52 weeks during abatacept treatment in biologics-switching patients with rheumatoid arthritis: a multicenter observational cohort study in Japan (2015)
  • Author(s): Kojima T , Takahashi N, Kaneko A, Kida D, Hirano Y, Fujibayashi T, Yabe Y, Takagi H, Oguchi T, Miyake H, Kato T, Watanabe T, Hayashi M, Shioura T, Kanayama Y, Funahashi K, Asai S, Yoshioka Y, Terabe K, Takemoto T, Asai N, Ishiguro N
  • Organizer: EULAR 2015
  • Place of Presentation: Rome, Italy
  • Year and Date: 2015-06-10
  • Int'l Joint Research
• [Presentation] HYALURONAN INHIBITS TLR-4 DEPENDENT RANKL EXPRESSION IN HUMAN RHEUMATOID ARTHRITIS SYNOVIAL FIBROBLASTS (2015)
  • Author(s): Watanabe T, Takahashi N, Ishiguro N, Kojima T
  • Organizer: ISHAS HA 2015 Conference
  • Place of Presentation: Firenze, Italy
  • Year and Date: 2015-06-07
  • Int'l Joint Research
• [Presentation] 関節リウマチの骨粗鬆症に対するデノスマブの早期効果‐多施設研究TBCR-BONE より‐ (2015)
  • Author(s): 平野 裕司, 金山 康秀, 浅井 秀司, 平原 慎也, 小嶋 俊久, 石黒 直樹
  • Organizer: 第59回日本リウマチ学会
  • Place of Presentation: 愛知県名古屋市：名古屋国際会議場
  • Year and Date: 2015-04-23 – 2015-04-25
• [Presentation] 関節リウマチの骨粗鬆症に対するデノスマブの早期効果 -多施設研究TBCR-BONEより- (2015)
  • Author(s): 平野裕司 金山康秀 浅井秀司 平原慎也 小嶋俊久 石黒直樹
  • Organizer: 第59回日本リウマチ学会
  • Place of Presentation: 名古屋国際会議場（愛知県名古屋市）
  • Year and Date: 2015-04-23
• [Presentation] Improving of safety in treatment with biologics during first seven-years experience; Long-term results from observational cohort study of clinical paractice using multicenter registry in Japan (2014)
  • Author(s): T. Kojima, N. Takahashi, K. Funahashi, Atsushi Kaneko, Yuji Hirano, Yuichiro Yabe,Yasuhide Kanayama,S. Asai, Y. Yoshioka, K. Terabe, T. Takemoto, N. Asai, N. Ishiguro
  • Organizer: American College of Rheumatology
  • Place of Presentation: Boston,USA
  • Year and Date: 2014-11-15 – 2014-11-19
• [Presentation] EFFICACY OF DAILY TERIPARATIDE FOR TWO YEARS ON OSTEOPOROSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS - IS IT APPROPREATE TO COMBINE DAILY TERIPARATIDE AND BIOLOGICAL AGENTS? (2014)
  • Author(s): Y. Hirano, Y. Oishi, G. Takemoto, T. Okada, T. Kojima, N. Ishiguro.
  • Organizer: EULAR
  • Place of Presentation: Paris,France
  • Year and Date: 2014-06-11 – 2014-06-14
• [Presentation] IMPORTANCE OF CONCOMITANT METHOTREXATE WITH TOCILIZUMAB AND ASSESSMENT OF STRUCTUAL DAMAGE FOR ACHIEVING BETTER CLINICAL OUTCOMES FOR RHEUMATOID ARTHRITIS PATIENTS WITH HIGH DISEASE ACTIVITY:AN OBSERVATIONAL COHORT STUDY (2014)
  • Author(s): T. Kojima, N. Takahashi, K. Funahashi, S. Asai, S. Hirabara, M. Hanabayashi, Y. Yoshioka, Y. Yabe, N. Ishiguro, On behalf of Tsurumai Biologics Communication Registry (TBCR)
  • Organizer: EULAR
  • Place of Presentation: Paris,France
  • Year and Date: 2014-06-11 – 2014-06-14