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Article History

Received: 12 February 2026

Revised: 16 March 2026

Accepted: 18 March 2026

First Online: 1 April 2026

Declarations

:

: The representative facility for this registry was Kyoto University. This observational study was conducted following the Declaration of Helsinki and approved by the ethics committees of the following seven institutes: Kyoto University (granted on 2016-03-24/approval No. R053), Osaka University (granted on 2015-11-04/approval No. 15300), Osaka Metropolitan University (granted on 2021-6-09/approval No. 2021-074), Osaka Medical and Pharmaceutical University (granted on 2014-07-14/approval No. 1529), Kansai Medical University (granted on 2017-11-21/approval No. 2014625), Kobe University (granted on 2015-03-20/approval No. 1738), Nara Medical University (granted on 2018-01-23/approval No. 1692), and Osaka Red Cross Hospital (granted on 2015-09-01/approval No. 644). Written informed consent was obtained from the participants. The ethics committee at Osaka University Hospital waived the requirement for patient informed consent by posting the opt-out information on the hospital’s homepage.

: Written informed consent to publish the study results was obtained from all patients.

: Y.E. and K.E. are affiliated with the Department of Sports Medical Biomechanics, The University of Osaka Graduate School of Medicine Faculty of Medicine, which is supported by Asahi-Kasei.Y.E. has received a speaker fee from Amgen, Asahi-Kasei, Ayumi, Daiichi-Sankyo, Eisai, Taisho, and UCB Japan. Y.O. has received speaker fees from Eli Lilly, Nippon Boehringer Ingelheim, Pfizer, Asahi-Kasei, Ono Pharmaceutical, Mitsubishi-Tanabe, Taisho, and Novartis Pharma. K.M. is affiliated with a department that is financially supported by two pharmaceutical companies (Asahi- Kasei and Ayumi) and the city government (Nagahama City) and received a research grant from Daiichi-Sankyo and a speaker fee from AbbVie, Asahi-Kasei, Chugai, Daiichi-Sankyo, Eisai, Mitsubishi-Tanabe, Bristol-Myers Squibb, and Pfizer. T.F. is affiliated with a department that is financially supported by two pharmaceutical companies (Asahi-Kasei and Ayumi) and the city government (Nagahama City) and has received a speaker fee from Asahi-Kasei, AbbVie, Janssen, Mitsubishi-Tanabe, and Eisai. M.H. has received research grants and/or a speaker fee from Asahi Kasei, Astellas, AstraZeneca, Ayumi Pharma, Brystol Meyers, Chugai, Eisai, Eli Lilly, Gilead Sciences Japan, Janssen pharma, Ono Pharma, Ohtsuka Pharma, Taisho Pharma, Tanabe Mitsubishi, UCB Japan. T.O. received a research grant from AbbVie, Asahi-Kasei, Chugai, Eisai, Eli Lilly and Mitsubishi-Tanabe and a speaker fee from AbbVie, Chugai, Eli Lilly, Janssen, and Novartis Pharma. T.K. is affiliated with a department that is financially supported by six pharmaceutical companies (Mitsubishi-Tanabe, Asahi-Kasei, AbbVie, Chugai, Eisai, and Takeda) and has received payments for lectures from AbbVie, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly, Pfizer, and Boehringer Ingelheim. Y.N. has received speaker fees from Astellas Pharma, Asahi Kasei Pharma, Eisai, Eli Lilly, AstraZeneca, and Tanabe Pharma. Y.S. has received speaking fees from Pfizer, Chugai., Janssen Pharmaceutical K.K., Eisai, and AbbVie. A.K. has received a research grant from Chugai and a speaker fee from Chugai, Eisai, Mitsubishi-Tanabe, AbbVie, and Ono Pharmaceutical.K. Nakata. has received a research grant from Astellas and supervises the Department of Sports Medical Biomechanics, The University of Osaka Graduate School of Medicine Faculty of Medicine, which is supported by Asahi-Kasei. K.E. has received research grants from Asahi-Kasei and Teijin Pharma. K.E. has received a speaker fee from AbbVie, Amgen, Argenx, Asahi-Kasei, Astellas, Ayumi, Bristol-Myers Squibb, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Janssen, Mitsubishi-Tanabe, Ono Pharmaceutical, Pfizer, Sanofi, Taisho, Teijin Pharma, and UCB Japan. The remaining authors have declared no conflicts of interest.