|Koji Todaka||Last modified date：2019.06.07|
Associate Professor / Center for Clinical and Translational Research / Center for Clinical and Translational Research(CCTR) / Kyushu University Hospital
|1.||Nakano K, Matoba T, Koga JI, Kashihara Y, Fukae M, Ieiri I, Shiramoto M, Irie S, Kishimoto J, Todaka K, Egashira K., Safety, Tolerability, and Pharmacokinetics of NK-104-NP., Int Heart J, 10.1536/ihj.17-555, 59, 5, 1015-1025, 2018.09.|
|2.||戸高 浩司, Junji Kishimoto, Masayuki Ikeda, Koji Ikeda, Haruko Yamamoto, Impact of Risk-Benefit Perception and Trust on Medical Technology Acceptance in Relation to Drug and Device Lag: A Tripartite Cross-Sectional Survey, Therapeutic Innovation & Regulatory Science, 10.1177/2168479017739267, 52, 5, 629-640, First Published November 29, 2017, 2018.09, [URL], Background: New drug and medical device introduction in Japan usually lags behind that in the West. Many reports indicate that in Japan, the associated risks are considered greater than the benefits recognized in other countries. This study aimed to compare the relationship between risk-benefit perception and acceptance of medical technologies in 3 leading markets. Methods: A tri- partite cross-sectional survey of the general public was used. In total, 3345 adults in the United Kingdom, the United States, and Japan participated, and sexes and age groups were equally represented. Questions about the perception of risk, benefit, and acceptance of medical and other scientific technologies, and trust of medical product providers or regulatory authorities were included. Results: Five-step Likert coding for risk/benefit/acceptance of 4 medical items (x-rays, antibiotics, vaccines, and cardiac pacemakers) and 6 general items (such as automobiles and airplanes) were collected. Relationships between benefit perception and acceptance were linear for 4 medical technologies. The relationship had a similar slope but was shifted downward in Japan compared with the UK and US (P < .01), suggesting a lower acceptance in Japan for all benefit perceptions. The trend was the same between risk perception and acceptance, except for slopes that were negative. Correspondence analysis showed a strong correlation among acceptance of medical technologies, benefits of medical technologies, trust in doctors, and trust in the Department of Health. The UK and US attributes were clustered with positive responses such as “useful,” “acceptable,” and “trustworthy,” whereas Japan was clustered with intermediate to negative responses such as “neither” and “untrustworthy.” Conclusions: Acceptance of medical technologies was low in Japan because of significant differences in trust for doctors and authorities compared with that in the UK and US. This is a possible basis for delays of 24 to 60 months for medical product approval in Japan..|
|3.||木村 公則, 戸高 浩司, Nakanishi Y, Safety, Tolerability, and Preliminary Efficacy of the Anti-Fibrotic Small Molecule PRI-724, a CBP/β-Catenin Inhibitor, in Patients with Hepatitis C Virus-related Cirrhosis: A Single-Center, Open-Label, Dose Escalation Phase 1 Trial., EBioMedicine, 10.1016/j.ebiom.2017.08.016, 23, 79-87, 2017.09, BACKGROUND:
There is currently no anti-fibrotic drug therapy available to treat hepatitis C virus (HCV) cirrhosis. The aim of this study was to assess the safety, tolerability, and anti-fibrotic effect of PRI-724, a small-molecule modulator of Wnt signaling, in patients with HCV cirrhosis.
In this single-center, open-label, phase 1 trial, we sequentially enrolled patients with HCV cirrhosis who were classified as Child-Pugh (CP) class A or B. PRI-724 was administered as a continuous intravenous infusion of 10, 40, or 160mg/m2/day for six cycles of 1week on and 1week off. The primary endpoints were frequency and severity of adverse events. The secondary endpoint was efficacy of PRI-724 in treating cirrhosis based on CP score and liver biopsy. This study is registered with ClinicalTrials.gov (no. NCT02195440).
Between Sept 3, 2014 and May 2, 2016, 14 patients were enrolled: CP class A:B, 6:8; median age, 62 (range: 43 to 74) years; male:female, 10:4. Twelve of the 14 patients completed six cycles of treatment; one was withdrawn from the study due to possible study drug-related liver injury (grade 3) in the 160mg/m2/day dose cohort and one withdrew for personal reasons. Serious adverse events occurred in three patients [21% (3/14)], one of which was possibly related to PRI-724. The most common adverse events were nausea [29% (4/14)] and fatigue [21% (3/14)]. After PRI-724 administration, the CP scores worsened by 1 point in two patients in the 10mg/m2/day cohort, improved in three patients at 1, 1, and 2 points in the 40mg/m2/day cohort, and improved in one patient by 3 points in the 160mg/m2/day cohort. The histology activity index scores of the liver tissue improved in two patients and exacerbated in two patients in the 10mg/m2/day cohort, and improved in one patient in the 40mg/m2/day cohort.
This study showed that administration of 10 or 40mg/m2/day intravenous PRI-724 over 12weeks was well-tolerated by patients with HCV cirrhosis; however, liver injury as a possible related serious adverse event was observed in the 160mg/m2/day cohort.
|4.||西川 拓也, 朔 啓太, 戸高 浩司, Hiroyuki Tsutsui, Sunagawa K, The challenge of magnetic vagal nerve stimulation for myocardial infarction -preliminary clinical trial., Conf Proc IEEE Eng Med Biol Soc., 10.1109/EMBC.2017.8037812, 2017, 4321-4324, 2017.07, Numerous studies have shown in animal models that vagal nerve stimulation (VNS) strikingly reduces infarct size of acute myocardial infarction (AMI) and prevents heart failure. However, the lack of techniques to noninvasively stimulate the vagal nerve hinders VNS from clinical applications. Transcranial magnetic stimulation is noninvasive and capable of stimulating central neurons in patients. In this study, we examined whether the magnetic stimulation could noninvasively activate the cervical vagal nerve in healthy human. Sixteen healthy males and 4 females were enrolled in this study. We used Magstim Rapid2 with a 70-mm double coil in the right neck. We randomly assigned the subjects to 5 Hz or 20 Hz stimulation. We defined the maximum intensity of stimulation (MAX) which is the intensity just below the threshold of adverse effects. We defined HALF as a half of MAX. Protocols comprised 2 sets of MAX and 2 sets of HALF. Each stimulation continued for 3 minutes. We monitored heart rate (HR) and assessed the bradycardic response as an index of successful VNS. Nineteen subjects completed all protocols. They had no problematic adverse events during and/or after magnetic VNS. The magnetic VNS induced transient bradycardic responses in some subjects, whereas failed to induce sustained bradycardia in pooled data in any settings. Arterial pressure did not change either. Successful magnetic stimulation requires technical improvements including narrowing the magnetic focus and optimization of stimulation site. These improvements may enable us to apply magnetic VNS in the management of AMI..|
|5.||Takase S, Tetsuya Matoba, Nakashiro S, Yasushi Mukai, Inoue S, Keiji Oi, Taiki Higo, Katsuki S, Takemoto M, Suematsu N, Eshima K, Miyata K, Yamamoto M, Usui M, Sadamatsu K, Satoh S, Kadokami T, Hironaga K, 戸高 浩司, Ezetimibe in Combination with Statins Ameliorates Endothelial Dysfunction in Coronary Arteries after Stenting: The CuVIC Trial, a Multicenter Randomized Controlled Trial, Arterioscler Thromb Vasc Biol., ３７, 2, 350-358, 2017.02.|
|6.||Uchida T, Ikeno F, Ikeda K, Suzuki Y, 戸高 浩司, Yokoi H, Thompson G, Krucoff M, Saito S, Global Cardiovascular Device Innovation: Japan-USA Synergies., Circ J, 77, 1714-1718, 2013.07, Background: Global medical devices have become more popular, but investment money for medical device development is not easily available in the market. Worldwide health-care budget constraints mean that efficient medical device development has become essential. To achieve efficient development, globalization is a key to success. Spending large amounts of money in different regions for medical device development is no longer feasible. Methods and Results: In order to streamline processes of global medical device development, an academic, governmental, and industrial consortium, called the Harmonization by Doing program, has been set up. The program has been operating between Japan and the USA since 2003. The program has 4 working groups: (1) Global Cardiovascular Device Trials; (2) Study on Post-Market Registry; (3) Clinical Trials; and (4) Infrastructure and Methodology Regulatory Convergence and Communication. Each working group has as its goals the achievement of speedy and efficient medical device development in Japan and the USA. The program has held multiple international meetings to deal with obstacles against efficient medical device development. Conclusions: This kind of program is very important to deliver novel medical devices. Involvement of physicians in this type of activity is also very helpful to achieve these goals..|
|7.||Shimizu J, Todaka K, Burkhoff D, Load dependence of ventricular performance explained by model of calcium-myofilament interactions, American Journal of Physiology, 2002 Mar;282(3):H1081-91, 2002.03.|
|8.||Todaka K, Wang J, Yi GH, Gu A, Zhu SM, Zhang H, Burkhoff D, Effect of BAY y 5959 on myocardial function and metabolism in normal and failing hearts., American Journal of Physiology, 274(5 Pt 2):H1560-8, 1998.05.|
|9.||Todaka K, Ogino K, Gu A, Burkhoff D, Effect of ventricular stretch on contractile strength, calcium transient, and cAMP in intact canine hearts, American Journal of Physiology, 274, 3, H990-H1000, 274(3 Pt 2):H990-1000, 1998.03.|
|10.||Todaka K, Wang J, Yi GH, Knecht M, Stennett R, Packer M, Burkhoff D, Impact of exercise training on ventricular properties in a canine model of congestive heart failure., American Journal of Physiology, 272(3 Pt 2):H1382-90, 1997.03.|
|11.||Dickstein ML, Todaka K, Burkhoff D, Left-to-right systolic and diastolic ventricular interactions are dependent on right ventricular volume., American Journal of Physiology, 272(6 Pt 2):H2869-74, 1997.06.|
|12.||Todaka K, Leibowitz D, Homma S, Fisher PE, DeRosa C, Stennett R, Packer M, Burkhoff D, Characterizing ventricular mechanics and energetics following repeated coronary microembolization., American Journal of Physiology, 272(1 Pt 2):H186-94, 1997.01.|
|13.||Todaka K, Jiang T, Chapman JT, Gu A, Zhu SM, Herzog E, Hochman JS, Steinberg SF, Burkhoff D, Functional consequences of acute collagen degradation studied in crystalloid perfused rat hearts., Basic Research in Cardiology, 92(3):147-58, 1997.06.|
|14.||Todaka K, Wang J, Yi GH, Stennett R, Knecht M, Packer M, Burkhoff D, Effects of levosimendan on myocardial contractility and oxygen consumption., Journal of Pharmacology & Experimental Therapeutics, 279(1):120-7, 1996.10.|