Novel SLE treatment-Belimumab
・new phase 3
・Long term Safety IV Belimumab
・pediatric- Phase 2 PLUTO
Novel SLE treatment-immunosuppressive therapy
summary of evidence
・Effective in inducing renal remission and preventing renal failure.
・Low dose(Euro-dosing)is as effective and appears to have less toxicity.
・evidence of effectiveness
・Effective as maintenance after both IVCY and MMF induction
・Appears to have less toxicity than IVCY
・as effective as IVCY in menbranous GN
・Significantly higher rate of renal relapse after completion of 1 yr treatment
Novel SLE treatmentーHydroxy chloroquine
Beyond disease activity~Multiethnic longitudinal cohort (n=635)~
reduced damage accrual
decrease in renal damage
decrease in skin-damage
decrease in vascular events.
Rertina-weight based dosing:Toxicity near 1% after 5-7years:Cumulative dose of 1000g :Baseline then annual after 5 yrs.
Muscle-Curvilinear bodies:muscle fiber atrophy:Vacuolar changes
Toxic-Myocardial Disease:47cases median doses 1050g for CQ and 1542g for HCQ Chronic heart failure.
Excreted by kidney
High risk patients-concomitant tamoxifen(increase risk 5-fold)
Risk is <2% up to 10 yrs but rises to 20 % after 20 years.
safe rule is 5x5 Screen after 5 yrs use and <5mg/kg real weight
[picture: a sunday on La Grande Jatte]
AmericanCollege of Rheumatology in Chicago
I started checking “Lupus nephritis”.
Here is Dr. Igawa, who worked for us lang time ago and He worked catheterization in Shimonoseki, does the research in Nagasaki Univ. about Lupus nephritis. He investigated the
Cause of Lupus nephritis.
Good Job! Dr. Igawa
American College of Rheumatology in Chicago
We can see "TRUMP TOWER!".
Let's see ......go back to meeting and study!
10th anniversary in Kawata-Junko Clinic
Thanks you for 10 years anniversary in Kawata-Junko clinic.
We came lomg way.
Human-being are social creature.
I felt strange power for ten years.
lecture ofconnective tissure diseases in Kaiko Messe in Shimonoseki
We had typhoon today.
I did that during the storm.
Thank you for coming.
I talked about Nobel prize winner,Yamaguchi-native DR. Honsyo,
What he had done , and immunology.
We are planing to have it next end of March.
Academic meeting for radiological technologists
There are meeting for radiological technologists.
Over 2000 people crowded into the bar and pubs.
Dr. Mart Mannik
Mart Mannik M.D., Professor, Head of division of Rheumatology in Univ. of Washington from 1967-2001 passed away on Wed. August 22th in 2018 at the age of 86. Refugee of WW II born in Estonia. Received M.D. in Cleveland OHIO, Residency training in MGH. Mannik had long career in UW rheumatology.
He played commanding role in shaping Rheumatology in Pacific Northwest in U.S.A. He was P.I.(Primary investigator), he supervised 100 rheumatologist. Dr. Mannik helped to transform this region of the Country from Low awareness and skills in Rheumatologic disorders to a stronghold of high quality clinical care and outstanding basic rheumatologic investigation.