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Objective We compared the incidence rates of hospitalized infections (HIs) between tocilizumab (TCZ) and other biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in adults aged ≥75 years with rheumatoid arthritis (RA). Methods We used a Japanese claims database from Medical Data Vision Co., Ltd (Tokyo, Japan) to perform a retrospective longitudinal population-based study in patients with RA who were prescribed b/tsDMARDs between 2014 and 2019. We calculated adjusted risk ratios (aRRs) for HIs in three age groups ( Results Of 5506 patients, 2265 (41.1%) were Conclusion In patients with RA aged ≥75 years, b/tsDMARDs have a similar risk of HIs to tocilizumab except for etanercept.

Bisphenol A (BPA) is a well-known endocrine-disrupting chemical found in the environment. To assess the metabolic modulation of estrogenic activity of BPA after ingestion, we investigated whether the incubation of BPA with rat liver S9 fraction results in metabolic activation or inactivation of estrogenic activity using a recombinant yeast expressing human estrogen receptor and MCF-7 transfected firefly luciferase plasmid for a reporter assay. When 0.1 mM BPA was incubated with rat liver S9 for 1 h, the estrogenic activity was increased about two to five times compared with that of the control, in which the S9 was inactivated prior to incubation. This metabolic activation was inhibited by SKF 525-A, an inhibitor of cytochrome P450. With increasing incubation time, the estrogenic activity increased time-dependently. Interestingly, however, the metabolic activation did not proceed with either microsomes or cytosol alone and was restored by a recombination of both fractions. The active metabolite was eluted at later retention time than that of BPA on HPLC with a reversed-phase column. Bisphenol B and methoxychlor were also activated by incubation with rat liver S9, whereas 4-tert-octylphenol and 4-nonylphenol, as well as 17beta-estradiol, were metabolically inactivated. The present results clearly indicate that BPA is metabolically activated in terms of estrogenicity under the conditions existing only with combined rat liver microsomes and cytosol.