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Article History

Received: 12 December 2025

Accepted: 18 May 2026

First Online: 22 May 2026

Declarations

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: This study was conducted in accordance with the Ethical Guidelines for Medical and Biological Research Involving Human Subjects in Japan and the Declaration of Helsinki (1964) and its later amendments. The study protocol was reviewed and approved by the Institutional Review Board of Gifu University Graduate School of Medicine (Approval No. 2023-291).

: Because this was a retrospective study using only pre-existing data extracted from the electronic health record and involved no direct contact with patients, the requirement for written informed consent was waived by the Institutional Review Board. In accordance with institutional policy, information regarding the study and procedures for opting out was posted on the hospital website to ensure that patients had the opportunity to decline participation. All data were fully de-identified prior to analysis to protect privacy and confidentiality.

: Hirotoshi Iihara has received consulting fees from Astellas Pharma, Daiichi Sankyo, and Taiho Pharmaceutical. He has also received honoraria for lectures from Astellas Pharma, Chugai Pharmaceutical, Daiichi Sankyo, Eli Lilly, Gilead Sciences, Nippon Kayaku, Ohara Pharmaceutical, Sawai Pharmaceutical, and Taiho Pharmaceutical. Daichi Watanabe has received honoraria for lectures from Chugai Pharmaceutical. Akio Suzuki has received grants from Nippon Kayaku, Chugai Pharmaceutical, Japan Blood Products Organization, Mochida Pharmaceutical, and Asahi Kasei Pharma. He has also received honoraria for lectures from Tsumura, Daiichi Sankyo, Towa Pharmaceutical, Nippon Kayaku, Mochida Pharmaceutical, EA Pharma, Yakult Honsha, Chugai Pharmaceutical, AbbVie, Eisai, and Toa Eiyo. All other authors declare no conflicts of interest related to this work.