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Faculty of Medicine School of Medicine Department of Internal Medicine, Hematology, Respirology, Rheumatology, Infectious Diseases, and Neurology |
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MIYAZAKI Taiga
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Papers 【 display / non-display 】
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Miyazaki T, Hosogaya N, Fukushige Y, Takemori S, Morimoto S, Yamamoto H, Hori M, Ozawa Y, Shiko Y, Inaba Y, Kurokawa T, Hanaoka H, Iwanami S, Kim K, Iwami S, Watashi K, Miyazawa K, Umeyama T, Yamagoe S, Miyazaki Y, Wakita T, Sumiyoshi M, Hirayama T, Izumikawa K, Yanagihara K, Mukae H, Kawasuji H, Yamamoto Y, Tarumoto N, Ishii H, Ohno H, Yatera K, Kakeya H, Kichikawa Y, Kato Y, Matsumoto T, Saito M, Yotsuyanagi H, Kohno S
Microbiology spectrum 11 ( 3 ) e0431122 2023.5
Authorship：Lead author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Microbiology Spectrum
Nelfinavir, an orally administered inhibitor of human immunodeficiency virus protease, inhibits the replication of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) in vitro. We conducted a randomized controlled trial to evaluate the clinical efficacy and safety of nelfinavir in patients with SARS-CoV-2 infection. We included unvaccinated asymptomatic or mildly symptomatic adult patients who tested positive for SARS-CoV-2 infection within 3 days before enrollment. The patients were randomly assigned (1:1) to receive oral nelfinavir (750 mg; thrice daily for 14 days) combined with standard-of-care or standard-of-care alone. The primary endpoint was the time to viral clearance, confirmed using quantitative reverse-transcription PCR by assessors blinded to the assigned treatment. A total of 123 patients (63 in the nelfinavir group and 60 in the control group) were included. The median time to viral clearance was 8.0 (95% confidence interval [CI], 7.0 to 12.0) days in the nelfinavir group and 8.0 (95% CI, 7.0 to 10.0) days in the control group, with no significant difference between the treatment groups (hazard ratio, 0.815; 95% CI, 0.563 to 1.182; P = 0.1870). Adverse events were reported in 47 (74.6%) and 20 (33.3%) patients in the nelfinavir and control groups, respectively. The most common adverse event in the nelfinavir group was diarrhea (49.2%). Nelfinavir did not reduce the time to viral clearance in this setting. Our findings indicate that nelfinavir should not be recommended in asymptomatic or mildly symptomatic patients infected with SARS-CoV-2. The study is registered with the Japan Registry of Clinical Trials (jRCT2071200023). IMPORTANCE The anti-HIV drug nelfinavir suppresses the replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro. However, its efficacy in patients with COVID-19 has not been studied. We conducted a multicenter, randomized controlled trial to evaluate the efficacy and safety of orally administered nelfinavir in patients with asymptomatic or mildly symptomatic COVID-19. Compared to standard-of-care alone, nelfinavir (750 mg, thrice daily) did not reduce the time to viral clearance, viral load, or the time to resolution of symptoms. More patients had adverse events in the nelfinavir group than in the control group (74.6% [47/63 patients] versus 33.3% [20/60 patients]). Our clinical study provides evidence that nelfinavir, despite its antiviral effects on SARSCoV-2 in vitro, should not be recommended for the treatment of patients with COVID-19 having no or mild symptoms.
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Nakada-Motokawa N, Miyazaki T, Ueda T, Yamagishi Y, Yamada K, Kawamura H, Kakeya H, Mukae H, Mikamo H, Takesue Y, Kohno S
Mycoses 64 ( 12 ) 1498 - 1507 2021.12
Authorship：Corresponding author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Mycoses
Background: Several severity indexes have been reported for critically ill patients. The Pitt bacteremia score (PBS) is commonly used to predict the risk of mortality in patients with bacteraemia. Objectives: To develop a scoring system for predicting mortality in candidaemia patients. Methods: Medical records at five Japanese tertiary hospitals were reviewed. Factors associated with mortality were analysed using logistic regression modelling. The discriminatory power of scoring models was evaluated by assessing the area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Results: In total, 422 candidaemia patients were included. Higher PBS, dialysis and retainment of central venous catheter were independent risk factors for all-cause 30-day mortality. However, among the five PBS components, fever was not associated with mortality; therefore, we developed a modified version of the PBS (mPBS) by replacing fever with dialysis. AUC for PBS and mPBS were 0.74 (95% confidence interval [CI]: 0.68–0.80) and 0.76 (95% CI: 0.71–0.82), respectively. The increase in predictive ability of mPBS for 30-day mortality was statistically significant as assessed by NRI (0.24, 95% CI: 0.01–0.46, p =.04) and IRI (0.04, 95% CI: 0.02–0.06, p =.0008). When patients were stratified by mPBS into low (scores 0–3), moderate (4–7) and high risk (≥8), there were significant differences among the survival curves (p <.0001, log-rank test), and 30-day mortality rates were 13.8% (40/290), 36.8% (28/76) and 69.4% (34/49), respectively. Conclusions: mPBS can be a useful tool for predicting mortality in candidaemia patients.
DOI： doi:10.1111/myc.13380. Epub 2021 Oct 23. PMID: 34655487.
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Incomplete antiviral treatment may induce longer durations of viral shedding during SARS-CoV-2 infection. Reviewed
Kim KS, Iwanami S, Oda T, Fujita Y, Kuba K, Miyazaki T, Ejima K, Iwami S
Life Sci Alliance 4 ( 10 ) e202101049 2021.8
Publishing type：Research paper (scientific journal)
DOI： doi:10.26508/lsa.202101049. PMID: 34344719; PMCID: PMC8340032.
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Revisiting the guidelines for ending isolation for COVID-19 patients. Reviewed
Jeong YD, Ejima K, Kim KS, Iwanami S, Bento AI, Fujita Y, Jung IH, Aihara K, Watashi K, Miyazaki T, Wakita T, Iwami S, Ajelli M.
Elife 10 e69340 2021.7
Publishing type：Research paper (scientific journal)
DOI： doi:10.7554/eLife.69340. PMID: 34311842; PMCID: PMC8315804.
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Detection of significant antiviral drug effects on COVID-19 with reasonable sample sizes in randomized controlled trials: A modeling study. Reviewed
Iwanami S, Ejima K, Kim KS, Noshita K, Fujita Y, Miyazaki T, Kohno S, Miyazaki Y, Morimoto S, Nakaoka S, Koizumi Y, Asai Y, Aihara K, Watashi K, Thompson RN, Shibuya K, Fujiu K, Perelson AS, Iwami S, Wakita T.
PLoS Med 18 ( 7 ) e1003660 2021.6
Publishing type：Research paper (scientific journal)
DOI： doi:10.1371/journal.pmed.1003660. PMID: 34228712; PMCID: PMC8259968.
Books 【 display / non-display 】
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内科学 第12版
宮崎泰可（ Role： Sole author , クリプトコックス症）
朝倉書店 2022
Total pages：2572 Responsible for pages：358-359 Book type：Textbook, survey, introduction
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今日の治療指針2021年版
宮崎泰可（ Role： Sole author , 深在性真菌症）
医学書院 2021
Total pages：2192 Responsible for pages：234-236 Book type：Textbook, survey, introduction
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別冊日本臨牀社 領域別症候群シリーズ 呼吸器症候群 第三版（IV） -その他の呼吸器疾患を含めて-
住吉誠、宮崎泰可（ Role： Joint author , グラム陰性細菌による肺炎）
日本臨牀社 2021
Total pages：388 Responsible for pages：14-17 Book type：Textbook, survey, introduction
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呼吸器内科
平山達朗、宮崎泰可（ Role： Joint author , COVID-19に合併する真菌感染症）
(有)科学評論社 2021
Responsible for pages：40(4) 372-377 Book type：Scholarly book
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臨床と研究
平山達朗、宮崎泰可（ Role： Joint author , Withコロナ時代の肺炎診療. 肺真菌症）
大道学館 2021
Responsible for pages：98(11) 1327-1332 Book type：Scholarly book
MISC 【 display / non-display 】
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Candida auris
平山達朗、宮崎泰可
臨床と微生物 特集 Priority Pathogen List (PPL) に取り上げられる耐性菌 50 ( 1 ) 74 - 79 2023.1
Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)
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高齢者における最近のTOPICS
宮崎泰可（監修）
エキスパートが解説する vol. 5 5 1 - 4 2022.12
Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)
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特集 新型コロナ最前線 ワクチンと治療-今を知り,これからを考える ◉新型コロナ治療の最前線 ②新規コロナ治療薬
川口 剛, 宮崎 泰可
感染と抗菌薬 24 ( 4 ) 238 - 241 2021.12
Publishing type：Rapid communication, short report, research note, etc. (scientific journal) Publisher：(株)ヴァンメディカル
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Ito Y., Takazono T., Koga S., Nakano Y., Ashizawa N., Hirayama T., Tashiro M., Saijo T., Yamamoto K., Imamura Y., Miyazaki T., Yanagihara K., Izumikawa K., Mukae H.
BMC Infectious Diseases 21 ( 1 ) 2021.12
Language：Japanese Publishing type：Rapid communication, short report, research note, etc. (scientific journal) Publisher：BMC Infectious Diseases
Following publication of the original article [1], the authors identified an error in Additional file 1. The correct file is given in this article. The original article has been corrected as well.
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Obata Y., Takazono T., Tashiro M., Ota Y., Wakamura T., Takahashi A., Sato K., Miyazaki T., Nishino T., Izumikawa K.
Clinical and Experimental Nephrology 25 ( 3 ) 2021.3
Language：Japanese Publishing type：Rapid communication, short report, research note, etc. (scientific journal) Publisher：Clinical and Experimental Nephrology
The article “The clinical usage of liposomal amphotericin B in patients receiving renal replacement therapy in Japan: a nationwide observational study”, written by Yoko Obata Takahiro Takazono Masato Tashiro Yuki Ota Tomotaro Wakamura Akinori Takahashi Kumiko Sato Taiga Miyazaki Tomoya Nishino, and Koichi Izumikawa, was originally published electronically on the publisher’s Internet portal on 11th November 2020 without open access. With the author(s)’ decision to opt for Open Choice, the copyright of the article changed on 7th November 2020 to © The Author(s) 2020, and the article is forthwith distributed under a Creative Commons Attribution 4.0 International License (https ://creat iveco mmons .org/licen ses/by/4.0/), which permits use, sharing, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The original article has been corrected.
Presentations 【 display / non-display 】
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カルバペネム系抗菌薬適正使用推進のための Clinical Questionと今後の取り組み
平原 康寿、森山 徳文、髙城 一郎、宮崎 泰可
第70回日本化学療法学会総会
Event date： 2022.6.3 - 2022.6.5
Presentation type：Oral presentation (general)
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マウスモデルを用いたキャンディン系抗真菌薬曝露によって生じるCandida aurisの薬剤耐性化の検討
平山達朗、宮崎泰可、芦澤信之、武田和明、岩永直樹、髙園貴弘、山本和子、泉川公一、栁原克紀、迎 寛
第70回日本化学療法学会総会
Event date： 2022.6.3 - 2022.6.5
Presentation type：Oral presentation (general)
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経口第3世代セファロスポリン系薬
宮崎泰可
第70回日本化学療法学会総会
Event date： 2022.6.3 - 2022.6.5
Presentation type：Symposium, workshop panel (nominated)
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長崎県五島市の肺炎疫学研究からみえてきたこと
宮崎泰可
第70回日本化学療法学会総会
Event date： 2022.6.3 - 2022.6.5
Presentation type：Symposium, workshop panel (nominated)
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抗真菌薬の併用療法
宮崎泰可
第70回日本化学療法学会総会
Event date： 2022.6.3 - 2022.6.5
Presentation type：Symposium, workshop panel (nominated)
Grant-in-Aid for Scientific Research 【 display / non-display 】
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尿中蛋白質断片の網羅的解析による日和見感染症の新規診断法の開発
Grant number：22K08583 2022.04 - 2025.03
独立行政法人日本学術振興会 科学研究費補助金 基盤研究(C)
Authorship：Principal investigator
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病原真菌カンジダにおける多剤耐性機序の解明とその克服
Grant number：19K07540 2019.04 - 2022.03
科学研究費補助金 基盤研究(C)
Authorship：Principal investigator
Available Technology 【 display / non-display 】
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各種感染症に対する検査法や治療法の開発を目指した臨床研究
地域医療への貢献を目指した肺炎の疫学研究
難治性真菌感染症の病態解明と創薬研究Home Page： 宮崎大学医学部内科学講座呼吸器・膠原病・感染症・脳神経内科学分野
Related fields where technical consultation is available：・ 感染症臨床研究の立案、実施
・ 病原真菌の分子生物学的解析Message：基礎と臨床の相互フィードバックで相乗効果を生み出すために、多分野連携による研究体制の構築を目指しています。