Greetings
We provide comprehensive, integrated care for the full spectrum of connective tissue and autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus and related disorders—many of which are designated as “intractable diseases” in Japan. As a Kanagawa Prefecture–commissioned Intractable Disease Research Center, our hospital serves a broad region that spans western Kanagawa (from Yokohama and Kawasaki) to neighboring Shizuoka. In step with national reforms under the Act on Medical Care for Patients with Intractable Diseases, we collaborate closely with regional hospitals and fulfill our role as a core center for advanced care in these conditions.
Chief of the Rheumatology
Takeshi Oku
Treatment details
In outpatient practice, we pursue sustained remission across the spectrum of connective-tissue and autoimmune diseases—including rheumatoid arthritis, systemic lupus erythematosus, and related disorders—through early, vigorous, treat-to-target strategies employing disease-modifying therapies and biologics, while maintaining stringent control and preventing relapse. In the inpatient setting, we manage complex, intractable presentations—such as SLE and systemic sclerosis with major organ involvement (interstitial lung disease, glomerulonephritis, central nervous system disease), polymyositis/dermatomyositis, and systemic vasculitides—using glucocorticoids and immunosuppressants, complemented when appropriate by advanced modalities including biologics, therapeutic plasma exchange, and high-dose intravenous immunoglobulin.
Main target diseases
Our remit includes the classic collagen vascular diseases—rheumatoid arthritis, systemic lupus erythematosus, polymyositis/dermatomyositis, systemic sclerosis, and vasculitis—as well as related conditions such as Sjögren’s syndrome, mixed connective tissue disease, adult-onset Still’s disease, antiphospholipid syndrome, Behçet’s disease, and other autoimmune diseases (e.g., idiopathic thrombocytopenic purpura, autoimmune hemolytic anemia).
Main medical achievements
The number of outpatients is approximately 4,500, and the number of inpatients per year is approximately 200.
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We treat approximately 3,000 patients with rheumatoid arthritis on an outpatient basis. In addition to disease-modifying antirheumatic drugs such as methotrexate, we proactively introduce biological agents to control rheumatoid inflammation early on, resulting in a high remission rate.
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Systemic lupus erythematosus often accompanies severe organ damage, so we work with other departments to make early diagnoses and improve the condition by using a combination of corticosteroids, immunosuppressants, biological agents, blood purification therapy, etc. We also work with obstetrics and Obstetrics and Gynecology to provide medical care regarding pregnancy and childbirth in patients with antiphospholipid syndrome.
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Systemic sclerosis and mixed connective tissue disease are known to be complicated by pulmonary hypertension, which is difficult to treat and affects the prognosis, so we work in collaboration with Cardiology to proactively introduce new medications such as prostacyclin preparations, endothelin receptor antagonists, and PDE5 inhibitors.
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For difficult-to-treat cases of polymyositis/dermatomyositis, such as those resistant to corticosteroids or those complicated by interstitial pneumonia, we have achieved good results by attempting early diagnosis using laboratory-level autoantibody measurements and cutting-edge treatments such as multiple immunosuppressants, high-dose immunoglobulin therapy, and plasma exchange therapy.
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For refractory vasculitis, in addition to treatment with corticosteroids and immunosuppressants, plasma exchange therapy is performed in particularly severe cases.
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In addition, we also diagnose and treat other rheumatic diseases besides those mentioned above. In particular, good results have been obtained with biological agents in intractable cases of ankylosing spondylitis and psoriatic arthritis.
Main medical achievements
We care for approximately 5,000 outpatients and 200 inpatients each year. Of these, about 3,000 are living with rheumatoid arthritis and approximately 900 with systemic lupus erythematosus—one of the largest SLE patient populations in Japan. Through early, intensive, treat-to-target use of disease-modifying therapies and biologics, we have achieved high remission rates in rheumatoid arthritis, while pursuing durable, organ-preserving control in SLE and related conditions.
Multidisciplinary Expertise
Because connective tissue diseases are intrinsically systemic, we regard a robust, multidisciplinary framework as indispensable. Accordingly, we partner closely with allied specialties to secure early diagnosis and timely, combination therapy—glucocorticoids, immunosuppressants, biologics, and therapeutic plasma exchange—when severe organ involvement is present. We work hand in glove with Obstetrics and Gynecology to support pregnancy and childbirth in patients with antiphospholipid syndrome; with Cardiology to manage pulmonary hypertension complicating systemic sclerosis and mixed connective tissue disease, introducing pharmacotherapy such as prostacyclin analogues, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors; and, in difficult-to-treat polymyositis/dermatomyositis (including steroid-refractory cases or those with interstitial lung disease), we emphasize precise early diagnosis—grounded in comprehensive myositis-specific and myositis-associated autoantibody profiling—and deploy multiple immunosuppressants, high-dose intravenous immunoglobulin, and plasma exchange to improve outcomes. For refractory vasculitides, we combine glucocorticoids with appropriate immunosuppressive agents, employing plasma exchange in fulminant disease, and we offer state-of-the-art biologic therapy for challenging spondyloarthritis and psoriatic arthritis.
Most recently, we have deepened our partnership with the Department of Rehabilitation Medicine, developing coordinated clinical pathways and joint research initiatives aimed at preserving—and, where possible, enhancing—activities of daily living in patients with rheumatoid arthritis.
Safety, Prevention, and Patient Education
Potent therapies—especially glucocorticoids and immunosuppressants—demand rigorous safety management. We work proactively to prevent and treat adverse effects such as steroid-induced osteoporosis and therapy-associated infections, while ensuring patients receive clear, thorough information about their diseases and treatments. Even where definitive standards have yet to be established, we endeavor to offer the most up-to-date options, including newly approved medications.
Other important points
The treatment of rheumatoid arthritis and collagen diseases requires strong treatment, including corticosteroids. Therefore, side effects of drugs can be problematic. In addition to treating the underlying disease, our department actively works to prevent side effects such as steroid-induced osteoporosis and infections associated with immunosuppressive therapy, and strives to provide patients with as much information as possible about diseases and treatments. Although there are many areas in which treatment methods have not yet been established, we are always striving to provide patients with the best treatment, including the latest drug therapies.
Doctor List
Department Head: Takeshi Oku
Assistant Chief Physician of Ward 12A: Yuichiro Ota
Outpatient: 0463 (93) 1121 extension 6021, 6022
Professor Kenji Oku
| Specialization | Rheumatology and Collagen Diseases |
|---|---|
| Specialist | Certified physician, instructor, and specialist General Internal Medicine from the Japanese Society of Internal Medicine / Specialist and instructor of the Japanese Rheumatology Association / Specialist in the Japanese Society of Allergology / Geriatrics specialist and instructor from the Japan Geriatrics Society / Certified immunotherapy physician from the Japanese Society of Clinical Immunology / Certified physician from the Japanese Society of Thrombosis and Hemostasis / Balneotherapy specialist from the Japanese Society of Balneology, Climatology, and Physical Medicine |
| Specialized Areas | Diagnosis and treatment of rheumatism and collagen diseases, especially systemic lupus erythematosus, antiphospholipid syndrome, and rheumatoid arthritis |
| Outpatient medical day | Monday, Tuesday, Thursday |
Lecturer: Chiho Yamada
| Specialization | Rheumatology and Collagen Diseases |
|---|---|
| Specialist | Certified Internal Medicine Physician and Instructor of the Japan Society of Internal Medicine / Instructor and Specialist of the Japan Rheumatism Association |
| Specialized Areas | Diagnosis and treatment of rheumatism and collagen diseases, especially systemic lupus erythematosus |
| Outpatient medical day | Tuesday, Wednesday, Friday |
Assistant Professor Ayumi Ishii
| Specialization | Rheumatology and Collagen Diseases |
|---|---|
| Specialist | Certified internist and General Internal Medicine specialist by the Japanese Society of Internal Medicine / Instructor and specialist of the Japanese College of Rheumatology |
| Specialized Areas | Diagnosis and treatment of rheumatism and collagen diseases, especially rheumatoid arthritis |
| Outpatient medical day | Friday |
Assistant Professor Yuichiro Ota
| Specialization | Rheumatology and Collagen Diseases |
|---|---|
| Specialist | Certified internist, instructor, and General Internal Medicine specialist of the Japanese Society of Internal Medicine / instructor and specialist of the Japanese College of Rheumatology |
| Specialized Areas | Diagnosis and treatment of rheumatism and collagen diseases, especially rheumatoid arthritis |
| Outpatient medical day | Mondays and Thursdays |
Mai Sugiyama Clinical Assistant
| Specialist | Specialist in Internal Medicine, Japanese Society of Internal Medicine |
|---|---|
| Specialized Areas | Diagnosis and treatment of rheumatism and collagen diseases |
| Outpatient medical day | Tuesday, Wednesday, Friday |
Azusa Kojima, Clinical Assistant
| Specialization | Rheumatology and Collagen Diseases |
|---|---|
| Specialized Areas | Diagnosis and treatment of rheumatism and collagen diseases |
| Outpatient medical day | Wednesday |
Yasushi Kondo (Part-time doctor)
| Specialist | Certified internist by the Japanese Society of Internal Medicine / Instructor and specialist of the Japanese College of Rheumatology |
|---|---|
| Specialized Areas | Diagnosis and treatment of rheumatism and collagen diseases, especially rheumatoid arthritis |
Kazuki Hirano (Part-time doctor)
| Specialist | Certified Internal Medicine Physician of the Japanese Society of Internal Medicine/Specialist of the Japanese College of Rheumatology |
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| Outpatient medical day | Thursday |
Assistant Professor Keigo Shimura
| Specialist | Specialist in Internal Medicine, Japanese Society of Internal Medicine/Specialist in the Japanese College of Rheumatology |
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| Outpatient medical day | Friday |
Sawako Abe (Part-time doctor)
| Specialization | Rheumatology and Collagen Diseases |
|---|---|
| Specialist | Certified physician by the Japan Society of Internal Medicine |
| Specialized Areas | Diagnosis and treatment of rheumatism and collagen diseases |
| Outpatient medical day | Saturday (1st and 3rd) |
Doctor List
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Department Head: Kenji Oku
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Lecturer: Chiho Yamada
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Assistant Chief Physician, Ward 12A: Yuichiro Ota
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Assistant Professor: Ayumi Ishii
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Clinical Assistants: Mai Sugiyama; Azusa Kojima
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Part-time Physicians: Yasushi Kondo; Kazuki Hirano; Keigo Shimura; Sawako Abe