title: Assessment of risks of pulmonary infection during 12 months following immunosuppressive treatment for active connective tissue diseases: a large-scale prospective cohort study.
abstract: OBJECTIVE
  Pulmonary infections (PI) are leading causes of death in patients with connective tissue diseases (CTD). The PREVENT study (Pulmonary infections in patients REceiving immunosuppressiVE treatmeNT for CTD) assessed risk of PI in patients with active CTD in the contemporary era of advanced immunosuppressive therapy.
  
  
  METHODS
  In patients who started corticosteroids (n = 763), conventional immunosuppressants or biologics for active CTD were enrolled. Clinical and laboratory data, usage of drugs, and occurrence of PI were collected for 12 months. Baseline risk factors were investigated using Cox regression analysis. A nested case-control (NCC) study was performed with 1:2 matched case-control pairs to assess the risk for each drug category.
  
  
  RESULTS
  During the observation period, 32 patients died (4.2%) and 66 patients were lost to followup (8.6%). Patients with PI (n = 61, 8%) had a significantly worse accumulated survival rate than patients without (p < 0.01). Cox hazard regression analysis using baseline data showed that these factors were significantly associated with PI: age ≥ 65 years (HR 3.87, 95% CI 2.22-6.74), ≥ 20 pack-years of smoking (2.63, 1.37-5.04), higher serum creatinine level (1.21, 1.05-1.41 per 1.0 mg/dl increase), and maximum prednisolone (PSL) dose during the first 2 weeks of treatment (2.81, 1.35-5.86 per 1.0 mg/kg/day increase). Logistic regression analysis by an NCC study revealed that maximum PSL dose within 14 days before PI (OR 4.82, 95% CI 1.36-17.01 per 1.0 mg/dl increase; 2.57, 1.28-5.16 if ≥ 0.5 mg/kg/day) was significantly associated with the events, while other immunosuppressants were not.
  
  
  CONCLUSIONS
  Physicians should be aware of the higher risks for corticosteroids of PI than other immunosuppressants and assess these risk factors before immunosuppressive treatment, to prevent PI.
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Hayato
authors: H
authors: Yamazaki
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Ryoko
authors: R
authors: Sakai
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Ryuji
authors: R
authors: Koike
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Yasunari
authors: Y
authors: Miyazaki
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Michi
authors: M
authors: Tanaka
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Toshihiro
authors: T
authors: Nanki
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Kaori
authors: K
authors: Watanabe
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Shinsuke
authors: S
authors: Yasuda
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Takashi
authors: T
authors: Kurita
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Yuko
authors: Y
authors: Kaneko
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Yoshiya
authors: Y
authors: Tanaka
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Yasuhiko
authors: Y
authors: Nishioka
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Yoshinari
authors: Y
authors: Takasaki
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Kenji
authors: K
authors: Nagasaka
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Hayato
authors: H
authors: Nagasawa
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Shigeto
authors: S
authors: Tohma
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Makoto
authors: M
authors: Dohi
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Takahiko
authors: T
authors: Sugihara
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Haruhito
authors: H
authors: Sugiyama
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Yasushi
authors: Y
authors: Kawaguchi
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Naohiko
authors: N
authors: Inase
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Sae
authors: S
authors: Ochi
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Hiroyuki
authors: H
authors: Hagiyama
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Hitoshi
authors: H
authors: Kohsaka
authors: From the Department of Pharmacovigilance, Department of Medicine and Rheumatology, and Department of Integrated Pulmonology, Graduate School of Medical and Dental Sciences, the Clinical Research Center, and the Global Center of Excellence (GCOE) Program, and the International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University (TMDU); Division of Rheumatology, and Department of Internal Medicine, Keio University School of Medicine, Tokyo; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine; Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo; Department of Rheumatology, Tokyo Metropolitan Geriatric Hospital; Department of Respiratory Medicine, National Center for Global Health and Medicine; Institute of Rheumatology, Tokyo Women's Medical University; Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo; Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu; Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima; Department of Rheumatology, Ome Municipal General Hospital, Ome; Department of Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara; and the Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.H. Yamazaki, MD; R. Sakai, PhD; M. Tanaka, MD, PhD; T. Nanki, MD, PhD; K. Watanabe, MD, PhD; M. Harigai, MD, PhD, Professor, Department of Pharmacovigilance, and Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, TMDU; R. Koike, MD, PhD, Departme
authors: Nobuyuki
authors: N
authors: Miyasaka
authors: Masayoshi
authors: M
authors: Harigai
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D003240:Connective Tissue Diseases / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007239:Infections / Q000209:etiology* / Q000401:mortality; D008171:Lung Diseases / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D018570:Risk Assessment; D015996:Survival Rate
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents
keywords: COHORT STUDIES; CONNECTIVE TISSUE DISEASES; CORTICOSTEROIDS; IMMUNOSUPPRESSIVE AGENTS; INFECTION