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Authors
Chihara, Norio https://orcid.org/0000-0003-4499-0790
Lee, Justin https://orcid.org/0009-0004-9689-5300
Yu, Jeffrey C.
Numajiri, Naoki https://orcid.org/0009-0007-9873-721X
Misu, Tatsuro https://orcid.org/0000-0002-7311-2578
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Funding
Funding for this research was provided by:
Alexion, AstraZeneca Rare Disease
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Article History
Received: 18 December 2025
Accepted: 2 April 2026
First Online: 25 April 2026
Declarations
Conflict of Interest: Norio Chihara has received funding for travel and/or speaker honoraria from AbbVie, Alexion, Biogen, Chugai, Mitsubishi Tanabe, Novartis, and Takeda. Justin Lee and Jeffrey C. Yu are employees of Alexion, AstraZeneca Rare Disease, and hold stock or stock options in AstraZeneca. Naoki Numajiri is an employee of Alexion Pharma GK. Tatsuro Misu has received speaker honoraria from Alexion, Biogen Idec Japan, Mitsubishi Tanabe, Novartis, Teijin, and Viela Bio; research support from Cosmic Corporation and Medical and Biological Laboratories Co.; and Grant-in-Aid for scientific research from Ministry of Education, Culture, Sports, Science, and Technology.
Ethical Approval: This study was conducted in accordance with the Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants and all applicable laws and regulations in Japan. It was not necessary or practical to obtain informed consent for the use of secondary data in this study; however, all data in the database were de-identified per the Act on the Protection of Personal Information, and no personal information could be restored in the database and no individual could be re-identified. Authorization to use data from the MDV database was obtained prior to conducting the analyses described in this manuscript.
