Aim: Asian patients are known to be more prone to bleeding complications than patients of other ethnicities. Therefore, there are possibilities of other risk factors that should be given special consideration for dosage adjustment in this specific ethnic group. This study aimed to investigate the risk factors for bleeding complications in Asian patients under appropriate edoxaban dosage regimens. Methods: Data on patients taking proper dosages, based on the Lixiana package insert, were analyzed. Univariate and multivariable analyses were conducted to evaluate associations between risk factors and bleeding outcomes. Subgroup analysis was performed on high-risk patients for bleeding complications whose edoxaban dose was reduced according to the package insert. Results: A total of 346 patients were included. Among them, 32 patients experienced bleeding complications. Patients with either weights of less than or equal to 60 kg and with cancer showed around 3.3- and 3.4-fold increased risk of bleeding complications compared to heavier patients ( > 60 kg) and those without cancer, respectively. In subgroup analysis with high-risk patients who took low-dose edoxaban (15 mg and 30 mg), weights of less than or equal to 60 kg remained a significant factor for bleeding outcomes. Conclusion: This study showed that weights of less than or equal to 60 kg and the presence of cancers could affect bleeding complications which occurred despite proper edoxaban treatment in Asian patients. Therefore, more strict dosage guideline could be considered in populations with high proportions of Asian ethnicities.

Aim: This study aimed to examine the effects of polymorphisms in nuclear factor of activated T cells C2 (NFATC2), a TNF-α transcription factor, on remission in RA patients receiving TNF-α inhibitors. Methods: This prospective observational study was performed in two centers. Nine single nucleotide polymorphisms (SNPs) were investigated, and haplotype analyses were performed. Logistic regression analyses were used to investigate the association between genetic polymorphisms and remission of RA. Results: This study included 88 patients, among whom 26 had remission of RA. We identified a haplotype, H2 (CCT), which carried 3 NFATC2 SNPs (rs1052649, rs1569736, and rs763944) and showed a significant relationship with remission. After adjusting for covariates, H2 carriers exhibited approximately 2.86-fold higher rates of remission than others (p=0.049). In subgroup analysis with patients with the TT genotype of rs1799964 of TNF-α, patients with the CC genotype in NFATC2 rs763944 showed an approximately 4.1-fold lower remission rate than T-allele carriers (p = 0.028), after adjusting for related covariates. In another subgroup analysis among patients with the GG genotype of TNF-α rs361525, patients with the CC genotype in NFATC2 rs763944 showed an approximately 3.2-fold lower remission rate than T-allele carriers (p = 0.04) after adjusting for covariates. Conclusion: This study suggested an association between NFATC2 polymorphisms and remission in RA patients receiving TNF-α inhibitors.