Inoue, Nagamu



School of Medicine, Center for Preventive Medicine (Shinanomachi)


Associate Professor (Non-tenured)

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Career 【 Display / hide

  • 1989.05


  • 1991.05


  • 1991.05


  • 1993.08


  • 1995.07


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Academic Degrees 【 Display / hide

  • 博士(医学), 慶應義塾大学, 2002.09

Licenses and Qualifications 【 Display / hide

  • 医師免許, 1989


Papers 【 Display / hide

  • Adalimumab for the treatment of japanese patients with intestinal behçet's disease

    Tanida Satoshi, Inoue Nagamu, Kobayashi Kiyonori, Naganuma Makoto, Hirai Fumihito, Iizuka Bunei, Watanabe Kenji, Mitsuyama Keiichi, Inoue Takuya, Ishigatsubo Yoshiaki, Suzuki Yasuo, Nagahori Masakazu, Motoya Satoshi, Nakamura Shiro, Arora Vipin, Robinson Anne M., Thakkar Roopal B., Hibi Toshifumi

    Clinical Gastroenterology and Hepatology 13 ( 5 ) 940 - 948 2015.05

    ISSN  1542-3565

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    <p>Background &amp; Aims: Behçet's disease is a chronic, relapsing inflammatory disease that can involve the mouth, skin, eyes, genitals, and intestines. Active intestinal Behçet's disease can be complicated by gastrointestinal (GI) bleeding and perforation. We performed a multicenter, open-label, uncontrolled study to evaluate the efficacy and safety of adalimumab, a fully human monoclonal antibody against tumor necrosis factor α, in patients with intestinal Behçet's disease who were refractory to corticosteroid and/or immunomodulator therapies. Methods: The study was conducted at 12 sites in Japan, from November 2010 through October 2012. Twenty patients were given 160 mg adalimumab at the start of the study and 80 mg 2 weeks later, followed by 40 mg every other week for 52 weeks; for some patients, the dose was increased to 80 mg every other week. A composite efficacy index, combining GI symptom and endoscopic assessments, was used to evaluate efficacy. The primary efficacy end point was the percentage of patients with scores of 1 or lower for GI symptom and endoscopic assessments at week 24. Secondary end points included complete remission and resolution of non-GI Behçet's-related symptoms. Results: Nine patients (45%) had GI symptom and endoscopic assessment scores of 1 or lower at week 24 of treatment, and 12 patients (60%) had these scores by week 52. Four patients (20%) achieved complete remission at weeks 24 and 52. Individual global GI symptom and endoscopic scores improved for most patients at weeks 24 and 52. Two thirds of patients with oral aphthous ulcers, skin symptoms, and genital ulcers, and 88% of patients with erythema nodosum had complete resolution of these conditions at week 52. A total of 9 of 13 patients (69%) taking steroids at baseline were able to taper (n= 1) or completely discontinue steroids (n= 8) during the study. No new safety signals were observed. Conclusions: Adalimumab is a potentially effective treatment for intestinal Behçet's disease in Japanese patients who are refractory to conventional treatments. number: NCT01243671.</p>

  • Modified bowel preparation regimen for use in second-generation colon capsule endoscopy in patients with ulcerative colitis

    Usui Shingo, Hosoe Naoki, Matsuoka Katsuyoshi, Kobayashi Taku, Nakano Masaru, Naganuma Makoto, Ishibashi Yuka, Kimura Kayoko, Yoneno Kazuaki, Kashiwagi Kazuhiro, Hisamatsu Tadakazu, Inoue Nagamu, Serizawa Hiroshi, Hibi Toshifumi, Ogata Haruhiko, Kanai Takanori

    Digestive Endoscopy 26 ( 5 ) 665 - 672 2014.09

    ISSN  0915-5635

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    <p>Background and Aim We have reported that second-generation colon capsule endoscopy (CCE-2) might be feasible for assessing the severity of mucosal inflammation in ulcerative colitis (UC). However, because of the low rate (69%) of complete evaluation of the colon and owing to inadequate cleansing. We believe that the method of bowel preparation could be improved by reducing volume. In the present study, we attempted to improve the colon-cleansing regimen in order to optimize the usefulness of CCE-2 in the management of UC patients.</p><p>Methods: Twenty patients with histologically confirmed UC were enrolled. Patients took a maximum 2.2 L lavage solution (polyethylene glycol solution and magnesium citrate) in two or three divided doses. To assess the effectiveness of the modified bowel preparation regimen, we evaluated the rate of total colonobservation, the effectiveness of bowel cleansing, andinterobserver agreement in assessing UC disease activity. We used a four-point grading scale (poor, fair, good, and excellent) for evaluating the quality of bowel cleansing. Matts' endoscopic score was used to evaluate disease activity.</p><p>Results: The rate of total colon observation was 85%, and 15 patients (75%) excreted the CCE-2 within 8 h. The proportion of excellent plus good cleansing was approximately 60%. There was a substantial interobserver agreement (κ = 0.777) in assessment of overall cleansing, which was still substantial at the fair cleansing level (κ = 0.700).</p><p>Conclusion: Using CCE-2, the modified bowel preparation regimen, with reduced volume has the potential to succeed in the evaluation of mucosal severity in UC.</p>

  • Risk factors for decreased bone mineral density in inflammatory bowel disease

    Wada Yasuyo, Hisamatsu Tadakazu, Naganuma Makoto, Matsuoka Katsuyoshi, Okamoto Susumu, Inoue Nagamu, Yajima Tomoharu, Kouyama Keisuke, Iwao Yasushi, Ogata Haruhiko, Hibi Toshifumi, Abe Takayuki, Kanai Takanori

    Clinical Nutrition  2014.06

    ISSN  0261-5614

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    <p>Background &amp; aim: Although inflammatory bowel disease (IBD) patients are at risk for metabolic bone disease, studies analyzing this correlation have identified various risk factors, including disease phenotype, age, sex and steroid therapy. Furthermore, few studies have assessed risk factors for bone loss in Japanese IBD patients. This study analyzed risk factors for metabolic bone disease in Japanese IBD patients. Methods: This cross-sectional study assessed 388 patients with IBD aged 20-50 years, including 232 with ulcerative colitis (UC) and 156 with Crohn's disease (CD). Bone mineral density of the femoral neck, total femur and lumbar spine was quantified by dual-energy X-ray absorptiometry. The blood concentrations of bone metabolism markers were measured. History of smoking and bone fracture, and nutritional intake were assessed using questionnaires. Results: Of the 388 patients with IBD, 78 (20.1%; UC, 17.2%; CD, 24.4%) had osteopenia and 17 (4.4%; UC, 3.4%; CD, 5.8%) had osteoporosis, as assessed by T-score. Bone mineral density of the lumbar vertebrae was lower in males than in females. Multivariate regression analysis showed that risk factors for bone loss in UC patients were male sex, low body mass index (BMI), high steroid dose and disease location. Risk factors for bone loss in CD patients were male sex and low BMI. Conclusion: Among Japanese patients with IBD, male sex and low BMI were associated with increased risk for metabolic bone disease. In addition, Steroid therapy shouldn't be indiscriminate in UC patients. These findings may help identify patients at particularly high risk of metabolic bone disease and may help implement appropriate therapies in a timely manner and improve long-term quality of life.</p>

  • The 2nd edition of consensus statements for the diagnosis and management of intestinal Behçet's disease

    Hisamatsu Tadakazu, Ueno Fumiaki, Matsumoto Takayuki, Kobayashi Kiyonori, Koganei Kazutaka, Kunisaki Reiko, Hirai Fumihito, Nagahori Masakazu, Matsushita Mitsunobu, Kobayashi Kenji, Kishimoto Mitsumasa, Takeno Mitsuhiro, Tanaka Masanori, Inoue Nagamu, Hibi Toshifumi

    Journal of Gastroenterology 49 ( 1 ) 156 - 162 2014.01

    ISSN  0944-1174

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    <p>Background: Clinical evidence regarding intestinal Behçet's disease (BD) management is lacking and intestinal lesions are a poor prognostic factor. In 2007, the Japan consensus statement for diagnosis and management of intestinal BD was developed. Recently, the efficacy of anti-tumor necrosis factor (TNF)α monoclonal antibodies (mAbs), and infliximab (IFX) was reported and adalimumab (ADA) was approved for intestinal BD in Japan. This study renewed consensus-based practice guidelines for diagnosis and treatment of intestinal BD focusing on the indication of anti-TNFα mAbs. Methods: An expert panel of Japanese gastroenterology and rheumatology specialists was involved. Clinical statements for ratings were extracted from the literature, a professional group survey, and by an expert panel discussion, which rated clinical statements on a nine-point scale. After the first round of ratings, a panelist meeting discussed areas of disagreement and clarified areas of uncertainty. The list of clinical statements was revised after the panelist meeting and a second round of ratings was conducted. Results: Fifteen relevant articles were selected. Based on the first edition consensus statement, improved clinical statements regarding indications for anti-TNFα mAbs use were developed. After a two-round modified Delphi approach, the second edition of consensus statements was finalized. Conclusions: In addition to standard therapies in the first edition, anti-TNFα mAbs (ADA and IFX) should be considered as a standard therapy for intestinal BD. Colchicines, thalidomide, other pharmacological therapy, endoscopic therapy, and leukocytapheresis were deemed experimental therapies. © 2013 The Author(s).</p>

  • Risk and management of intra-abdominal abscess in crohn's disease treated with infliximab

    Yoneno Kazuaki, Hisamatsu Tadakazu, Matsuoka Katsuyoshi, Okamoto Susumu, Takayama Tetsuro, Ichikawa Riko, Sujino Tomohisa, Miyoshi Jun, Takabayashi Kaoru, Mikami Yohei, Mizuno Shinta, Wada Yasuyo, Yajima Tomoharu, Naganuma Makoto, Inoue Nagamu, Iwao Yasushi, Ogata Haruhiko, Hasegawa Hirotoshi, Kitagawa Yuko, Hibi Toshifumi, Kanai Takanori

    Digestion 89 ( 3 ) 201 - 208 2014

    ISSN  0012-2823

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    <p>Background and Aims: Infliximab (IFX) is a monoclonal antibody used to treat patients with Crohn's disease (CD). Intra-abdominal abscess formation is a major complication of CD with negative effects on patient prognosis. We have analyzed risk factors for abscess formation in CD patients treated with IFX. Methods: CD patients who received IFX between January 2000 and April 2011 at Keio University Hospital were analyzed retrospectively. Risk factors for abscess formation were assessed by univariate and multivariate logistic regression analyses. Results: Intra-abdominal abscess was seen in 15 of 258 patients. Univariate analyses showed serum C-reactive protein (CRP) concentration at 14 weeks after initiation of IFX (p = 0.021), serum albumin concentration at week 0 (p = 0.022) and week 14 (p = 0.004), the presence of anal lesions (p = 0.036), progression of intestine deformation (p = 0.015) and early loss of response to IFX (p &lt; 0.0001) to be risk factors. Multivariate analysis showed that CRP concentration at 14 weeks [odds ratio (OR) 1.361] and loss of IFX response within 6 months (OR 5.361) were independent risk factors. Conclusions: Abscess formation should be suspected in patients with symptoms of CD recurrence during IFX therapy. Uncontrolled CRP concentration and early loss of response to IFX are risk factors. © 2014 S. Karger AG, Basel.</p>

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Papers, etc., Registered in KOARA 【 Display / hide

Presentations 【 Display / hide

  • Endscope activity index is useful for choice of treatment and evaluation of therapeutic effect in ulcerative colitis

    Inoue Nagamu, Naganuma Makoto, Takaishi Hiromasa, Ogata Haruhiko, Iwao Yashushi, Hibi Toshifumi

    Annual Scientific Meeting of the American College of Gastroenterology, 2002.10, Oral Presentation(general)

  • 炎症性腸疾患における腸間膜リンパ節樹状細胞の解析

    Sakuraba atsushi, Satou toshirou, Kishi yuusuke, Hitotsumatsu osamu, Yoshizawa shigeo, Inoue nagamu, Koganei kazutaka, Fukushima, Ishii masahiro, Hibi toshifumi

    第44回日本消化器病学会, 2002.10

  • 炎症性腸疾患における腸間膜リンパ節樹状細胞の解析

    Sakuraba Atsushi, Satou Toshirou, Kishi Yuusuke, Hitotsumatsu Osamu, Yoshizawa Shigeo, Inoue Nagamu, Koganei Kazutaka, Fukushima Tsuneo, Ishii Hiromasa, Hibi Toshifumi

    第44回日本消化器病学会, 2002.10, Other

  • 潰瘍性大腸炎の炎症粘膜上皮におけるNF-κB活性化機構の解析

    Ogata haruhiko, Inoue nagamu, Kishi yuusuke, Hitotsumatsu osamu, Arai jun, Koike yuuji, Iwao yasushi, Ishii masahiro, Kanai takanori, Watanabe mamoru, Hibi toshifumi

    第44回日本消化器病学会, 2002.10

  • 潰瘍性大腸炎の炎症粘膜上皮におけるNF-κB活性化機構の解析

    Ogata Haruhiko, Inoue Nagamu, Kishi Yuusuke, Hitotsumatsu Osamu, Arai Jun, Koike Yuiji, Iwaoyasushi, Ishii Masahiro, Kanai Takanori, Watanabe Mamoru, Hibi Toshifumi

    第44回日本消化器病学会, 2002.10, Poster (general)

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Research Projects of Competitive Funds, etc. 【 Display / hide

  • Establishment of novel screening strategy predicting risk of colorectal cancer using artificial intelligence


    MEXT,JSPS, Grant-in-Aid for Scientific Research, 井上 詠, Grant-in-Aid for Scientific Research (C), Principal Investigator

  • Prediction of treatment efficacy for severe ulcerative colitis


    MEXT,JSPS, Grant-in-Aid for Scientific Research, 井上 詠, Grant-in-Aid for Scientific Research (C), Principal Investigator

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    We explored the association of a variety of factors including endoscopic activity of patients in clinical remission with their long-term clinical outcome. Mayo endoscopic score 1 (hazard ratio (HR): 2.86) and score 2 (HR: 3.60) was significant risk factor for clinical relapse against endoscopic score 0. Univariate analysis also identified significant association with relapse for moderate clinical activity of last flare, remission induction with cytapheresis (CAP), maintenance with imuunomodulator, shorter duration of remission and higher histological activity. Cox regression analysis revealed that endoscopic activity, histological activity, duration of remission and remission induction with CAP were found to be independent determinants of relapse. The Kaplan-Meier estimate of non-relapse rate by endoscopic activity groups demonstrated significant difference. While there was significance between score 0 and 1, there were no significance between score 1 and 2.