Greetings
Rheumatology is responsible for the treatment of rheumatoid arthritis, various collagen diseases and related disorders, and other autoimmune diseases. Many of these diseases are eligible for medical assistance as "intractable diseases," and our hospital also functions as Intractable Disease Research Center commissioned by Kanagawa Prefecture. In recent years, the treatment of rheumatoid arthritis has advanced dramatically, and many patients can now achieve remission. In our department, we actively combine methotrexate, the anchor drug for rheumatoid arthritis treatment, with biological agents and JAK inhibitors to achieve high remission rates.Furthermore, for intractable conditions of other collagen diseases such as systemic lupus erythematosus, inflammatory muscle diseases, and vasculitis syndromes, we strive to improve the condition and prevent relapse by using not only glucocorticoids (so-called steroids) and immunosuppressants, but also the latest treatments such as blood purification therapy and high-dose immunoglobulin therapy. In particular, in recent years, there has been a growing emphasis on achieving rapid remission and suppressing complications through the minimal use (or early discontinuation) of glucocorticoids and effective combinations with other medications, and we also strive to provide treatment in this manner.
Furthermore, we are actively introducing short-term diagnostic hospitalizations to comprehensively improve the prognosis of patients with rheumatoid arthritis and collagen diseases by evaluating treatment options, complications such as interstitial lung disease, and muscle strength and ADL (Activities of Daily Living) such as sarcopenia and frailty. Our department's service area extends from western Kanagawa Prefecture, including Yokohama and Kawasaki, to Shizuoka Prefecture. The government is also working on reforms to address intractable diseases, and new systems are being developed, such as expanding the range of diseases eligible for medical expense subsidies based on the Act on Medical Care for Patients with Intractable Diseases and establishing intractable disease medical base hospitals in each tertiary medical area. Our department will also work in cooperation with local hospitals and strive every day to be of service to the people of the region as a core hospital for the treatment of intractable diseases.
Chief of the Rheumatology
Takeshi Oku
Treatment details
Our hospital treats collagen diseases, such as rheumatoid arthritis, related collagen diseases, and other autoimmune diseases. Many of these diseases are designated as "intractable diseases," and our hospital also functions as Intractable Disease Research Center commissioned by Kanagawa Prefecture. In outpatient care, we aim for remission of rheumatoid arthritis through disease-modifying antirheumatic drug therapy, and aggressive treatment with biological agents and JAK inhibitors. We also strive to control other diseases and prevent recurrence. In inpatient care, we mainly control intractable conditions such as systemic lupus erythematosus, polymyositis/dermatomyositis, and vasculitis accompanied by severe organ damage such as interstitial lung disease, glomerulonephritis, and central nervous system disorders, using biological agents, immunosuppressants, and glucocorticoids.
Main target diseases
In addition to classic collagen diseases such as rheumatoid arthritis, systemic lupus erythematosus, polymyositis/dermatomyositis, systemic scleroderma, and vasculitis, other collagen diseases and related disorders such as Sjögren's disease, mixed connective tissue disease, adult-onset Still's disease, antiphospholipid antibody syndrome, and Behçet's disease, as well as other autoimmune diseases (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.
-
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.
-
Systemic lupus erythematosus (SLU) often involves severe organ damage, and we strive for early diagnosis in collaboration with other departments, focusing on treatment with immunosuppressants and biological agents to improve the patient's condition. We also collaborate with Obstetrics and Gynecology to provide care for pregnancy and childbirth in patients with antiphospholipid antibody syndrome. We will continue to lead clinical and basic research on SLU, through our activities in the Ministry of Health, Labour and Welfare's task force meetings and the Asia Pacific College of Rheumatology's Special Interest Group, and on antiphospholipid antibody syndrome through our activities in the Japanese Society on Thrombosis and Hemostasis's divisions.
-
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.
-
For polymyositis/dermatomyositis, particularly in refractory cases such as those with low glucocorticoid resistance or complications like interstitial pneumonia, we have achieved favorable results through early diagnosis using autoantibody measurements at the laboratory level and advanced treatments including multi-drug immunosuppressant therapy, high-dose immunoglobulin therapy, and plasmapheresis.
-
For refractory vasculitis, in addition to treatment with glucocorticoids and immunosuppressants, plasmapheresis is performed, especially in severe cases.
-
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
In immunosuppressive therapy for rheumatoid arthritis and collagen diseases, minimizing the risk of complications is always a priority. In particular, we actively work to prevent side effects such as various infections, glucocorticoid-induced osteoporosis, arteriosclerotic diseases (thrombosis), and cataracts, while also striving to provide patients with ample information about their illnesses and medications. Although there are many areas where treatment methods are not yet established, we constantly strive to provide patients with the best possible 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 | Monday and 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/Specialist in the Japanese College of Rheumatology |
|---|---|
| Specialized Areas | Diagnosis and treatment of rheumatism and collagen diseases |
| Outpatient medical day | Tuesday, Wednesday, Friday |
Toshiki Ohisa, 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 | Mondays and Wednesdays |
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 |
|---|---|
| Outpatient medical day | Thursday |
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
-
Department Head: Kenji Oku
-
Lecturer: Chiho Yamada
-
Assistant Chief Physician, Ward 12A: Yuichiro Ota
-
Assistant Professor: Ayumi Ishii
-
Clinical Assistants: Mai Sugiyama; Azusa Kojima
-
Part-time Physicians: Yasushi Kondo; Kazuki Hirano; Keigo Shimura; Sawako Abe