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Article History

Received: 4 February 2026

Accepted: 1 May 2026

First Online: 30 May 2026

Declarations

:

: Makoto Ohara has received lecture fees from Eli Lilly Japan K.K. Munenori Hiromura has received lecture fees from Eli Lilly Japan K.K. Yusaku Mori holds an endowed chair funded by Nippon Boehringer Ingelheim Co., Ltd. Sho-ichi Yamagishi has received lecture fees from Bayer Yakuhin, Ltd., Kowa Company, Ltd., and Novo Nordisk Pharma, Ltd. Noriyuki Takahashi, Hiroki Yokoyama, Hiroaki Seino, Shutaro Ozawa, Takemasa Omachi, Nobuaki Takehana, Tomoki Fujikawa, Ayako Ohara, Shunichiro Irie, Naoya Osaka, Michishige Terasaki, Aya Yoshihara, and Tomoyasu Fukui have nothing to disclose.

: The study protocol was approved by the Institutional Review Board (Ethics Committee) of Showa Medical University (approval No. 2024-200-B). Informed consent was waived due to the retrospective, non-interventional design. An opt-out approach was used: study information was publicly disclosed (institutional website and/or notice boards at each participating site), and patients could decline participation by requesting that their clinical information (existing medical record data) not be used for research. Upon such request, the patient’s data were excluded from the analysis. Opting out did not affect clinical care. The study was conducted in accordance with the Declaration of Helsinki and its subsequent revisions.