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Axial Spondyloarthritis in Japan

  • Spondyloarthritis (M Khan and N Akkoc, Section Editors)
  • Published:
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Abstract

Purpose of Review

The differences in the epidemiology and management of patients with axial spondyloarthritis (axSpA) among regions and countries largely depend on the positivity of human leukocyte antigen (HLA)-B27 and the health care system. This review article focused on axSpA in Japan, where the prevalence of HLA-B27 is extremely low (0.3%) and the universal health insurance system typically provides a 70% or more copayment by the government.

Recent Findings

A nationwide survey was conducted in Japan in 2018, which estimated that there were 3200 patients (95% confidence interval [CI]: 2400–3900) with ankylosing spondylitis (AS), a term interchangeable with radiographic axSpA (r-axSpA), and 800 patients (95% CI: 530–1100) had non-radiographic (nr)-axSpA. These data indicate a prevalence of 2.6/100,000 or 0.0026% for AS and 0.6/100,000 or 0.0006% for nr-axSpA. Patients with AS, but not those with nr-axSpA, are designated as suffering from intractable diseases in Japan; thus, their medical expenses are reduced by grant under the Act on Medical Care for Patients with Intractable Diseases. As of February 2022, infliximab, adalimumab, secukinumab, ixekizumab, and brodalumab have been approved for AS, and secukinumab, ixekizumab, and brodalumab have been approved for nr-axSpA. An algorithm for nr-axSpA in Japan has been developed for the proper diagnosis and use of these therapeutic agents.

Summary

A low prevalence of axSpA, especially that of nr-axSpA, was found in Japan. Early referral and the resultant diagnosis and appropriate treatment of these patients by rheumatologists are crucial issues in Japan, as in other countries.

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Acknowledgements

This work was partly supported by Health and Labour Sciences Research Grants for Research on Intractable Diseases (The Research Team for Autoimmune Diseases and A Large-scale Multi-institutional Research Committee aiming at an epidemiological survey of spondyloarthritis, creation of diagnostic criteria, and development of clinical guidelines) from the Ministry of Health, Labour and Welfare of Japan for HK. The authors thank Editage Japan for editing the manuscript.

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Authors and Affiliations

  1. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Toho University (Ohashi Medical Center), 2-22-36 Ohashi, Meguro-ku, Tokyo, Japan

    Hideto Kameda

  2. Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan

    Mitsumasa Kishimoto

  3. Department of Internal Medicine and Rheumatology, Juntendo University Koshigaya Hospital, Saitama, Japan

    Shigeto Kobayashi

  4. Department of Orthopedic Biomaterial Science, Osaka University Graduate School of Medicine, Osaka, Japan

    Tetsuya Tomita

  5. Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Akimichi Morita

  6. Center for Rheumatology, Okayama Saiseikai General Hospital, Okayama, Japan

    Masahiro Yamamura

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  1. Hideto Kameda
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Correspondence to Hideto Kameda.

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Conflict of Interest

H. Kameda has received consulting fees, speaking fees, and/or honoraria from AbbVie G.K., Eli Lilly Japan K.K., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma, and Novartis Pharma K.K., and has received research grants from AbbVie G.K., Eisai Co., Ltd., and Mitsubishi Tanabe Pharma.

M. Kishimoto has received consulting fees and/or speaker fees from AbbVie, Amgen, Asahi-Kasei Pharma, Astellas, Ayumi Pharma, BMS, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Janssen, Novartis, Tanabe-Mitsubishi, and UCB Pharma.

S. Kobayashi has received consulting fees and/or speaker fees from Kyowa Kirin Co., Ltd, Novartis Pharma K.K., Eli Lilly Japan K.K., Chugai Parma, Asahi-Kasei Pharma, Gilead Sciences Inc., and Janssen Pharmaceutical K.K.

T. Tomita has received consultancy and speaker fees from AbbVie, Astellas, Bristol-Myers Squibb, Eisai, Eli Lilly and Company, Janssen, Kyowa Kirin, Mitsubishi-Tanabe, Novartis, and Pfizer.

A. Morita has received research grants, consulting fees, and/or speaker’s fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Eli Lilly, Eisai, Janssen, Kyowa Hakko Kirin, LEO Pharma, Maruho, Mitsubishi Tanabe, Nichi-Iko, Nippon Kayaku, Novartis, Pfizer, Sun Pharmaceutical Industries Taiho Pharmaceutical, Torii Pharmaceutical, Ushio, and UCB Pharma.

M. Yamamura has received consulting fees, speaking fees, and/or honoraria from Eli Lilly Japan K.K., and Novartis Pharma K.K.

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Kameda, H., Kishimoto, M., Kobayashi, S. et al. Axial Spondyloarthritis in Japan. Curr Rheumatol Rep 24, 149–155 (2022). https://doi.org/10.1007/s11926-022-01068-4

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