大宮直木

オオミヤナオキ (Naoki Ohmiya)

基本情報

所属: 藤田医科大学医学部医学科先端光学診療学講座

学位: 博士(医学）

J-GLOBAL ID: 200901011108502975
researchmap会員ID: 6000005568

患者さんの立場にたって、安全かつ最高の医療を提供できるよう努力します。

研究キーワード

研究分野

ライフサイエンス / 消化器内科学 / 消化管

委員歴

2024年2月 - 現在

日本消化器内視鏡学会小腸内視鏡診療ガイドライン（第2版）評価委員
2023年7月 - 現在

日本消化器内視鏡学会英文誌編集委員会 Digestive Endoscopy Deputy Editor-in-Chief
2023年2月 - 現在

日本消化管学会北陸・東海・甲信越支部支部長
2022年9月 - 現在

日本カプセル内視鏡学会カプセル内視鏡診療ガイドライン作成委員、オブザーバー
- 現在

日本消化管学会総務委員会委員、倫理委員会委員

もっとみる

受賞

2022年10月

日本消化器内視鏡学会学会賞日本消化器内視鏡学会

大宮直木
2019年10月

Poster of Excellence 欧州消化器病学会週間

大宮直木
2015年10月

Poster of excellence 欧州消化器病学会週間

大宮直木
2000年5月

Poster of Distinction アメリカ消化器病学会週間

大宮直木

論文

266

Risankizumab for Ulcerative Colitis

Edouard Louis, Stefan Schreiber, Remo Panaccione, Peter Bossuyt, Luc Biedermann, Jean-Frederic Colombel, Gareth Parkes, Laurent Peyrin-Biroulet, Geert D’Haens, Tadakazu Hisamatsu, Britta Siegmund, Kaichun Wu, Brigid S. Boland, Gil Y. Melmed, Alessandro Armuzzi, Phillip Levine, Jasmina Kalabic, Su Chen, Ling Cheng, Lei Shu, W. Rachel Duan, Valerie Pivorunas, Yuri Sanchez Gonzalez, Ronilda D’Cunha, Ezequiel Neimark, Kori Wallace, Raja Atreya, Marc Ferrante, Edward V. Loftus, Domingo Balderramo, Silvina Goncalves, Juan Lasa, Abel Novillo, Orlando Ruffinengo, Sonja Heeren, Walter Reinisch, Filip Baert, Peter Bossuyt, Arnaud Colard, Olivier Dewit, Marc Ferrante, Denis Franchimont, Edouard Louis, Jean-Francois Rahier, Carlos Francesconi, Roberto Kaiser Junior, Rogerio Parra, Ligia Sassaki, Plamen Penchev, Desislav Stanchev, Kenneth Atkinson, Melanie Beaton, Talat Bessissow, Susan Greenbloom, Jean-Rene Lachance, Allen Lim, Remo Panaccione, Jean- Michel Samson, Scott Shulman, Jesse Siffledeen, Ignacio Alfaro, Carlos Valenzuela, Gustavo Walsen, Ping An, Qian Cao, Yan Chen, Youxiang Chen, Xiang Gao, Xiaohua Hou, Naizhong Hu, YAN Li, Fei Liu, Mei Liu, Lu Lungen, Zhihua Ran, Tongyu Tang, Xin Wang, Shaoqi Yang, Qiang Zhan, Guoxin Zhang, Hu Zhang, Jie Zhang, Xiaolan Zhang, Jie Zhong, Xiaoping Zou, Eligio Alvarez, Juan Ricaurte, Vladimir Borzan, Zeljko Krznaric, Zeljko Puljiz, Martin Bortlik, Pavel Svoboda, Jan Ulbrych, Tomas Vanasek, Jens Kjeldsen, Lars Munck, Anja Poulsen, Ezzat Ali, Osama Salem, Hisham Sawah, Imam Waked, Romain Altwegg, Mathurin FLAMANT, Mathurin Fumery, Xavier Hebuterne, David Laharie, Laurent Peyrin-Biroulet, Xavier Roblin, Xavier Treton, Raja Atreya, Herbert Deppe, Peter Hasselblatt, Arne Kandulski, Jochen Klaus, Thomas Krause, Torsten Kucharzik, Jessica Mertens, Michael Mross, Axel Naumann, Wolfgang Reindl, Ingolf Schiefke, Stefan Schreiber, Stefan Schubert, Britta Siegmund, Andreas Sturm, Georgios Bamias, Ioannis Koutroubakis, Spilios Manolakopoulos, Gerassimos Mantzaris, Maria Tzouvala, Irit Avni-Biron, Eran Goldin, Lior Katz, Adi Lahat-Zok, Arik Segal, Sandro Ardizzone, Alessandro Armuzzi, Michele Cicala, Antonio Colecchia, Rocco Cosintino, Antonio Gasbarrini, Andrea Geccherle, Edoardo Giovanni Giannini, Paolo Gionchetti, Francesco Luzza, Giovanni Monteleone, Antonino Privitera, Simone Saibeni, Marcello Vangeli, Yasuhiko Abe, Nobuo Aoyama, Kunio Asonuma, Yutaka Endo, Motohiro Esaki, Toshimitsu Fujii, Katsuyuki Fukuda, Fumihito Hirai, Yasuhiro Hisanaga, Noriyuki Horiki, Mikitaka Iguchi, Keisuke Ishigami, Yoh Ishiguro, Hiroaki Ito, Yoichi Kakuta, Koji Kamikozuru, Jun Kato, Teruki Kawanishi, Taku Kobayashi, Hiroyuki Kuge, Atsuo Maemoto, Tomoyuki Masuda, Katsuyoshi Matsuoka, Kayoko Matsushima, Masashi Matsushima, Satoshi Motoya, Katsuhiko Nakai, Koichi Nakajima, Masanao Nakamura, Atsushi Nishida, Takahiro Nishikawa, Nobuaki Nishimata, Toshiaki Ochiai, Naoki Ohmiya, Yoshifumi Ohnishi, Shiro Oka, Keiji Ozeki, Daisuke Saito, Masayuki Saruta, Makoto Sasaki, Masahito Shimizu, Ken Sugimoto, Tomohisa Sujino, Takayoshi Suzuki, Hajime Takatori, Noritaka Takatsu, Hidetoshi Takedatsu, Ken Takeuchi, Hiroki Tanaka, Satoki Tokito, Tatsuya Toyokawa, Yoshito Uenoyama, Takatsugu Yamamoto, Takayuki Yamamoto, Hiroshi Yasuda, Kaoru Yokoyama, Aleksejs Derovs, Aldis Pukitis, Laimas Jonaitis, Edita Kazenaite, Lourdes Lol-be Pinzon Te, Geert D'Haens, Maurice Lutgens, James Brooker, Richard Gearry, Ben Griffiths, Stephen Inns, Michael Schultz, Jerzy Eszyk, Jaroslaw Kierkus, Dariusz Kleczkowski, Adam Kopon, Robert Petryka, Jaroslaw Regula, Tomasz Romanczyk, Grazyna Rydzewska-Wyszkowska, Piotr Sikorski, Michal Talarek, Rute Cerqueira, Tiago Goncalves, Susana Lopes, Paula Ministro, Francisco Portela, Helena Tavares, Mihai-Mircea Diculescu, Adrian Goldis, Andrada Seicean, Alina Agafina, Anton Edin, Evgenia Gerasimova, Maryana Gettueva, Vladimir Kashnikov, Vladimir Rafalskiy, Ksenia Sharapova, Elena Smolyarchuk, Daria Varganova, Sasa Grgov, Igor Jovanovic, Petar Svorcan, Dino Tarabar, Khoon Lin Ling, Jozef Balaz, Juraj Durina, Milos Gregus, Martin Laclav, David Drobne, Eduan Deetlefs, Jonny Peter, Muhammad Rajabally, Jennifer Rosa, Jan van Zyl, John Wright, Jae Hee Cheon, Byung Ik Jang, Sang-Bum Kang, Dukhwan Kim, Tae Oh Kim, Young-Ho Kim, Jonghun Lee, Kang-Moon Lee, Dong Il Park, Geun Am Song, Luisa Castro Laria, Ana Echarri Piudo, Santiago Garcia Lopez, Vincent Hernandez Ramirez, Maria Dolores Martin Arranz, Pilar Varela Trastoy, Maria Vera Mendoza, Mikael Lordal, Luc Biedermann, Benjamin Misselwitz, Chung-Hsin Chang, Jen-Wei Chou, Chia-Jung Kuo, Ching-Pin Lin, Chia-Hung Tu, Huseyin Alkim, Yusuf Erzin, Irfan Soykan, Tetiana Kravchenko, Nataliia Tsarynna, Vira Vyshyvanyuk, Tariq Ahmad, Fraser Cummings, Kapil Kapur, Arthur Kaser, Alexandra Kent, Gareth Parkes, Kamal Patel, Richard Speight, Alan Steel, Faten Aberra, Humberto Aguilar, Badr Al Bawardy, Ashwin Ananthakrishnan, Matthew Barnes, Kendall Beck, Charles Berkelhammer, Brigid Boland, Jeff Bullock, Adeeti Chiplunker, Robin Dalal, Sushila Dalal, Belkis Delgado, Michael DiGiovanna, George Aaron DuVall, Curtis Freedland, Keith Friedenberg, Philip Ginsburg, Tarek Hassanein, Peter Higgins, John Hong, Jason Hou, Vivek Huilgol, Nikhil Inamdar, Saurabh Kapur, David Kerman, Henry Levine, Nilesh Lodhia, Edward Loftus, Jaime Mayoral, Donald McNeil, Gil Melmed, Andria Mushahwar, Harry Ojeas, Bhaktasharan Patel, Raymond Phillips, Joe Pouzar, Harry Sarles Jr., Joel Schock, Shahriar Sedghi, Nirav Shah, Junaid Siddiqui, David Stokesberry, Le-Chu Su, Arun Swaminath, Dharmendra Verma, John Weber, Ziad Younes, Timothy Zisman

JAMA 2024年7月22日査読有り

Importance The clinical effects of risankizumab (a monoclonal antibody that selectively targets the p19 subunit of IL-23) for the treatment of ulcerative colitis are unknown. Objective To evaluate the efficacy and safety of risankizumab when administered as an induction and a maintenance therapy for patients with ulcerative colitis. Design, Setting, and Participants Two phase 3 randomized clinical trials were conducted. The induction trial was conducted at 261 clinical centers (in 41 countries) and enrolled 977 patients from November 5, 2020, to August 4, 2022 (final follow-up on May 16, 2023). The maintenance trial was conducted at 238 clinical centers (in 37 countries) and enrolled 754 patients from August 28, 2018, to March 30, 2022 (final follow-up on April 11, 2023). Eligible patients had moderately to severely active ulcerative colitis; a history of intolerance or inadequate response to 1 or more conventional therapies, advanced therapies, or both types of therapies; and no prior exposure to risankizumab. Interventions For the induction trial, patients were randomized 2:1 to receive 1200 mg of risankizumab or placebo administered intravenously at weeks 0, 4, and 8. For the maintenance trial, patients with a clinical response (determined using the adapted Mayo score) after intravenous treatment with risankizumab were randomized 1:1:1 to receive subcutaneous treatment with 180 mg or 360 mg of risankizumab or placebo (no longer receiving risankizumab) every 8 weeks for 52 weeks. Main Outcomes and Measures The primary outcome was clinical remission (stool frequency score ≤1 and not greater than baseline, rectal bleeding score of 0, and endoscopic subscore ≤1 without friability) at week 12 for the induction trial and at week 52 for the maintenance trial. Results Among the 975 patients analyzed in the induction trial (aged 42.1 [SD, 13.8] years; 586/973 [60.1%] were male; and 677 [69.6%] were White), the clinical remission rates at week 12 were 132/650 (20.3%) for 1200 mg of risankizumab and 20/325 (6.2%) for placebo (adjusted between-group difference, 14.0% [95% CI, 10.0%-18.0%], P &amp;lt; .001). Among the 548 patients analyzed in the maintenance trial (aged 40.9 [SD, 14.0] years; 313 [57.1%] were male; and 407 [74.3%] were White), the clinical remission rates at week 52 were 72/179 (40.2%) for 180 mg of risankizumab, 70/186 (37.6%) for 360 mg of risankizumab, and 46/183 (25.1%) for placebo (adjusted between-group difference for 180 mg of risankizumab vs placebo, 16.3% [97.5% CI, 6.1%-26.6%], P &amp;lt; .001; adjusted between-group difference for 360 mg of risankizumab vs placebo, 14.2% [97.5% CI, 4.0%-24.5%], P = .002). No adverse event signals were detected in the treatment groups. Conclusion and Relevance Compared with placebo, risankizumab improved clinical remission rates in an induction trial and in a maintenance trial for patients with moderately to severely active ulcerative colitis. Further study is needed to identify benefits beyond the 52-week follow-up. Trial Registration ClinicalTrials.gov Identifiers: NCT03398148 and NCT03398135
Clinical, Pathological and Endoscopic Features of Neoplastic or Non-neoplastic Reddish Depressed Lesions after Helicobacter pylori Eradication.

Tomomitsu Tahara, Noriyuki Horiguchi, Hyuga Yamada, Tsuyoshi Terada, Dai Yoshida, Masaaki Okubo, Kohei Funasaka, Yoshihito Nakagawa, Tomoyuki Shibata, Naoki Ohmiya

Journal of gastrointestinal and liver diseases : JGLD 33(2) 164-169 2024年6月29日査読有り

BACKGROUND AND AIMS: Early gastric cancers (EGCs) after Helicobacter pylori (H. pylori) eradication often appear as reddish depressed lesions (RDLs); the same features are also appeared in benign stomachs after eradication. We compared clinic-pathological and endoscopic features of benign and neoplastic RDLs after H. pylori eradication. METHODS: 228 neoplastic RDLs after H. pylori eradication were studied. All lesions were divided into neoplastic RDLs (differentiated carcinoma or adenoma, n=114) and benign RDLs (n=114) according to the histology. Clinical and pathological characteristics were compared in neoplastic and benign groups. Endoscopic diagnostic yields using the white light (WL) endoscopy, chromoendoscopy (CE) using indigo carmine dye and the magnifying endoscopy with narrow-band imaging (ME-NBI) were also evaluated in relation to the pathological diagnosis. RESULTS: Size of neoplastic RDLs was larger than that of benign RDLs (p<0.01). Sensitivity, specificity and accuracy for predicting pathological types of RDLs was 70.1%, 52.6% and 61.4% for the WL, 65.8%, 63.1% and 65.4% for the CE, while the ME-NBI scored better with the 88.6%, 88.6%, 99.1% and 93.9% of sensitivity, specificity and accuracy. The accuracy of the ME-NBI was 99.9% (113/114) in the benign RDLs and 89.4% (101/114) for the neoplastic RDLs. Undiagnosed neoplastic RDLs using the ME-NBI were associated with more differentiated tumors such as adenoma and well-differentiated adenocarcinoma (tub1) and the presence of an unclear demarcation line. CONCLUSIONS: ME-NBI is useful to diagnose RDLs after H. pylori eradiation, while some of neoplastic lesions are difficult to diagnose using the ME-NBI.
Clinicopathological features and prognosis of primary small bowel adenocarcinoma: a large multicenter analysis of the JSCCR database in Japan.

Ken Yamashita, Shiro Oka, Takeshi Yamada, Keigo Mitsui, Hironori Yamamoto, Keiichi Takahashi, Akio Shiomi, Kinichi Hotta, Yoji Takeuchi, Toshio Kuwai, Fumio Ishida, Shin-Ei Kudo, Shoichi Saito, Masashi Ueno, Eiji Sunami, Tomoki Yamano, Michio Itabashi, Kazuo Ohtsuka, Yusuke Kinugasa, Takayuki Matsumoto, Tamotsu Sugai, Toshio Uraoka, Koichi Kurahara, Shigeki Yamaguchi, Tomohiro Kato, Masazumi Okajima, Hiroshi Kashida, Yoshito Akagi, Hiroaki Ikematsu, Masaaki Ito, Motohiro Esaki, Masaya Kawai, Takashi Yao, Madoka Hamada, Takahiro Horimatsu, Keiji Koda, Yasumori Fukai, Koji Komori, Yusuke Saitoh, Yukihide Kanemitsu, Hiroyuki Takamaru, Kazutaka Yamada, Hiroaki Nozawa, Tetsuji Takayama, Kazutomo Togashi, Eiji Shinto, Takehiro Torisu, Akira Toyoshima, Naoki Ohmiya, Takeshi Kato, Eigo Otsuji, Shinji Nagata, Yojiro Hashiguchi, Kenichi Sugihara, Yoichi Ajioka, Shinji Tanaka

Journal of gastroenterology 59(5) 376-388 2024年5月査読有り

BACKGROUND: The clinicopathological features and prognosis of primary small bowel adenocarcinoma (PSBA), excluding duodenal cancer, remain undetermined due to its rarity in Japan. METHODS: We analyzed 354 patients with 358 PSBAs, between January 2008 and December 2017, at 44 institutions affiliated with the Japanese Society for Cancer of the Colon and Rectum. RESULTS: The median age was 67 years (218 males, 61.6%). The average tumor size was 49.9 (7-100) mm. PSBA sites consisted of jejunum (66.2%) and ileum (30.4%). A total of 219 patients (61.9%) underwent diagnostic small bowel endoscopy, including single-balloon endoscopy, double-balloon endoscopy, and capsule endoscopy before treatment. Nineteen patients (5.4%) had Lynch syndrome, and 272 patients (76.8%) had symptoms at the initial diagnosis. The rates for stages 0, I, II, III, and IV were 5.4%, 2.5%, 27.1%, 26.0%, and 35.6%, respectively. The 5-year overall survival rates at each stage were 92.3%, 60.0%, 75.9%, 61.4%, and 25.5%, respectively, and the 5-year disease-specific survival (DSS) rates were 100%, 75.0%, 84.1%, 59.3%, and 25.6%, respectively. Patients with the PSBA located in the jejunum, with symptoms at the initial diagnosis or advanced clinical stage had a worse prognosis. However, multivariate analysis using Cox-hazard model revealed that clinical stage was the only significant predictor of DSS for patients with PSBA. CONCLUSIONS: Of the patients with PSBA, 76.8% had symptoms at the initial diagnosis, which were often detected at an advanced stage. Detection during the early stages of PSBA is important to ensure a good prognosis.
Outcomes of Metastatic and Unresectable Small Bowel Adenocarcinoma in Japan According to the Treatment Strategy: A Nationwide Observational Study.

Yoshitaka Nishikawa, Takahiro Horimatsu, Shiro Oka, Takeshi Yamada, Keigo Mitsui, Hironori Yamamoto, Keiichi Takahashi, Akio Shiomi, Kinichi Hotta, Yoji Takeuchi, Toshio Kuwai, Fumio Ishida, Shin-Ei Kudo, Shoichi Saito, Masashi Ueno, Eiji Sunami, Tomoki Yamano, Michio Itabashi, Kazuo Ohtsuka, Yusuke Kinugasa, Takayuki Matsumoto, Tamotsu Sugai, Toshio Uraoka, Koichi Kurahara, Shigeki Yamaguchi, Tomohiro Kato, Masazumi Okajima, Hiroshi Kashida, Fumihiko Fujita, Hiroaki Ikematsu, Masaaki Ito, Motohiro Esaki, Masaya Kawai, Takashi Yao, Madoka Hamada, Keiji Koda, Yasumori Fukai, Koji Komori, Yusuke Saitoh, Yukihide Kanemitsu, Hiroyuki Takamaru, Kazutaka Yamada, Hiroaki Nozawa, Tetsuji Takayama, Kazutomo Togashi, Eiji Shinto, Takehiro Torisu, Akira Toyoshima, Naoki Ohmiya, Takeshi Kato, Eigo Otsuji, Shinji Nagata, Yojiro Hashiguchi, Kenichi Sugihara, Yoichi Ajioka, Shinji Tanaka

JCO global oncology 10 e2300392 2024年2月

PURPOSE: Limited information is available regarding the characteristics and outcomes of stage IV small bowel adenocarcinoma (SBA) in Japan. This study examined the clinical and pathological characteristics and outcomes according to the treatment strategies in patients with stage IV SBA. METHODS: This retrospective observational study used the data of patients with jejunal or ileal adenocarcinoma collected by the Small Bowel Malignant Tumor Project of the Japanese Society for Cancer of the Colon and Rectum. Descriptive statistics were expressed as the mean (standard deviation) or median (range). Survival analysis was performed using Kaplan-Meier curves and pairwise log-rank tests. RESULTS: Data from 128 patients were analyzed. The treatment strategies were chemotherapy alone (26 of 128, 20.3%), surgery alone (including palliative surgery; 21 of 128, 16.4%), surgery + chemotherapy (74 of 128, 57.8%), and best supportive care (7 of 128, 5.5%). The median (range) overall survival was 16 (0-125) months overall, and 11 (1-38) months, 8 (0-80) months, 18 (0-125) months, and 0 (0-1) months for the chemotherapy, surgery, surgery + chemotherapy, and best supportive care groups, respectively. Three main categories of chemotherapeutic regimen were used: a combination of fluoropyrimidine and oxaliplatin (F + Ox), fluoropyrimidine and irinotecan (F + Iri), and single-agent fluoropyrimidine. Among patients treated with chemotherapy, the median (range) OS was 16 (1-106) months overall, and 17 (1-87) months, 29 (7-39) months, and 16 (1-106) months in patients treated with fluoropyrimidine, F + Iri, and F + Ox, respectively. CONCLUSION: Patients treated with surgery, chemotherapy, or both had a better prognosis than those who received best supportive care. Among patients who received chemotherapy, survival did not differ according to the chemotherapeutic regimen.
Prospective study of diagnostic yields of flexible spectral imaging color enhancement installed in colon capsule endoscopy for colorectal polyps and tumors.

Takafumi Omori, Yasutaka Jodai, Kohei Maeda, Naoki Ohmiya

Gastrointestinal endoscopy 99(2) 245-253 2024年2月

BACKGROUND AND AIMS: We prospectively determined the efficacy of flexible spectral imaging color enhancement (FICE) used with second-generation colon capsule endoscopy (CCE) for colorectal polyps and tumors (CRTs). METHODS: This study included optical colonoscopy within 4 months after CCE. Two colonoscopists independently reviewed CCE using white-light images (CCE-WL) and CCE using FICE images (CCE-FICE), respectively. Based on colonoscopic findings as the criterion standard, the diagnostic accuracy for CRTs was compared between CCE-WL and CCE-FICE. RESULTS: Of 89 enrolled patients (65 men and 24 women; 75 with CRTs including 36 with serrated lesions, 63 with adenomas, and 9 with adenocarcinomas), the per-patient detectability of CCE-FICE for the representative CRTs was significantly higher than that of CCE-WL: overall CRTs (CCE-WL, 79%; CCE-FICE, 88%; P = .0001), 6- to 9-mm CRTs (CCE-WL, 63%; CCE-FICE, 94%; P = .0055), and ≥6-mm CRTs (CCE-WL, 78%; CCE-FICE, 93%; P = .0159). The per-lesion sensitivity of CCE-FICE was significantly higher than that of CCE-WL for CRTs: overall (CCE-WL, 61%; CCE-FICE, 79%; P < .0001), <6 mm (CCE-WL, 53%; CCE-FICE, 69%; P < .0001), 6- to 9-mm CRTs (CCE-WL, 65%; CCE-FICE, 93%; P = .0007), slightly elevated CRTs (CCE-WL, 53%; CCE-FICE, 75%; P < .0001), tubular adenomas (CCE-WL, 61%; CCE-FICE, 79%; P < .0001), and serrated polyps (CCE-WL, 57%; CCE-FICE, 74%; P = .0022). Both modes detected all adenocarcinomas. No significant differences were found between CCE-WL and CCE-FICE of the per-lesion sensitivity for ≥10-mm CRTs (CCE-WL, 81%; CCE-FICE, 94%; P = .1138) or protruding CRTs (CCE-WL, 77%; CCE-FICE, 86%; P = .0614). Kappa coefficients for overall CRTs for CCE-WL and CCE-FICE were .66 and .64, respectively, which indicated substantial agreement. CONCLUSIONS: CCE-FICE improved the detection rates for all CRTs except adenocarcinomas, ≥10-mm polyps, and protruding polyps when compared with CCE-WL. (Clinical trial registration number: UMIN 000021125.).