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Takahiko Sugihara has received honoraria from AbbVie GK, Asahikasei Pharmaceutical Co., Astellas Pharma Inc., AYUMI Pharmaceutical Corporation, Bristol Myers Squibb K.K., Chugai Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Mitsubishi-Tanabe Pharma Co., Ono Pharmaceutical, Pfizer Japan Inc., Takeda Pharmaceutical Co. Ltd., and UCB Japan Co. Ltd. Eiichi Tanaka has received lecture fees or consulting fees from AbbVie Japan GK, Asahi Kasei Corp., Astellas Pharma Inc., Ayumi Pharmaceutical Co., Boehringer Ingelheim Japan, Inc., Bristol Myers Squibb Co., Ltd., Chugai Pharmaceutical Co., Ltd., Daiichi-Sankyo, Inc., Eisai Co., Ltd., Eli Lilly Japan K.K., Gilead Sciences, Inc., GlaxoSmithKline K.K., Kyowa Pharma Chemical CO., Ltd., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Co., Mochida Pharmaceutical CO., Ltd., Nippon Kayaku Co., Ltd., Pfizer Japan Inc., Takeda Pharmaceutical Co., Ltd., Teijin Pharma Ltd, and Viatris Japan. Eiichi Tanaka has received research funding from Pfizer Inc. and UCB Japan Co. Ltd. Toshihiro Matsui has received research grants from AbbVie GK, AsahiKASEI Co., Ltd., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., and Mitsubishi-Tanabe Pharma Co. Toshihiro Matsui has received honoraria from AbbV GK, Astellas Pharma Inc., AYUMI Pharmaceutical Corporation, Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., Gilead Sciences, Inc., Mitsubishi-Tanabe Pharma Co., Ono Pharmaceutical, Pfizer Japan Inc., Takeda Pharmaceutical Co. Ltd., and UCB Japan Co. Ltd.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest\/competing interests"}},{"value":"The NinJa registry was established in 2002 and currently collects information annually from 49 institutions located throughout Japan. The registry, and all subsequent studies utilizing pre-existing registry data, were approved by the Sagamihara National Hospital Institutional Review Board (2014031816). The posters informing the present study were displayed in the outpatient clinic of each facility. Details about the study were disclosed on the website and the potential participants were given the opportunity to opt out. IORRA is a prospective large cohort study of RA started in 2000 at Tokyo Women\u2019s Medical University and was approved by the Tokyo Women\u2019s Medical University Review Board (#2952-R and #2922-R16).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all patients following the Declaration of Helsinki.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All of the data supporting the conclusions of this article are included within the article.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Availability of data and material"}},{"value":"Not applicable.","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code availability"}},{"value":"All authors contributed to the study conception and design, material preparation, data collection, and data analysis. The first draft of the manuscript was written by TS, and ET and TM were responsible for critical revision. All authors read and approved the final manuscript.","order":9,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 contributions"}}]}}