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Article History

Received: 4 July 2025

Accepted: 22 August 2025

First Online: 18 November 2025

Declarations

:

: Yoko Iwata, Manabu Saito, Ayako Fuchigami, Genki Sato, Atsuhito Saiki, Takamasa Ichijyo, Nobuyuki Sato, Tadamasa Ohashi, and Hiroshi Uchino declare that they have no competing interests. Takahisa Hirose received research funds from Nippon Boehringer Ingelheim Co., Ltd., Mitsubishi Tanabe Pharma Corporation, and Sumitomo Pharma Co., Ltd.; and lecture fees from Sanofi K.K., Eli Lilly Japan K.K., Novo Nordisk Pharma Ltd., MSD K.K., Abbott Medical Japan LLC, Mitsubishi Tanabe Pharma Corporation, Kowa Co., Ltd, and Sumitomo Pharma Co., Ltd. Atsuhito Saiki received research funds from Kowa Co., Ltd. Fukumi Yoshikawa received lecture fees from Sumitomo Pharma Co., Ltd. and Novo Nordisk Pharma Ltd.

: This study was conducted in accordance with the Declaration of Helsinki of 1964, as revised in 2013, and current legal regulations in Japan and was approved by the Ethics Committee at Toho University Graduate School of Medicine (approval #A23062_A22062). This study used non-identifiable data obtained by the training physicians, and therefore, based on the decision from our local Ethics Committee of Toho University Graduate School of Medicine (approval #A23062_#A22062), informed consent was not required. Patients had the opportunity to object to the use of their data for the retrospective scientific research; however, none of the patients objected. This study was registered in the University hospital Medical Information Network Clinical Trial Registry (UMIN000050499).