Prediction and Management for Relapse of Type 1 Autoimmune Pancreatitis After Initial Steroid Treatment: A Long-Term Follow-up From China

被引:13
作者
Xin, Lei [1 ]
Meng, Qian-Qian [1 ]
Hu, Liang-Hao [1 ]
Lin, Han [1 ]
Pan, Jun [1 ]
Hao, Lu [1 ]
Liu, Pei-Pei [1 ]
Qian, Wei [1 ]
Wang, Luo-Wei [1 ]
Li, Zhao-Shen [1 ]
机构
[1] Second Mil Med Univ, Changhai Hosp, Dept Gastroenterol, Digest Endoscopy Ctr, 168 Changhai Rd, Shanghai 200433, Peoples R China
基金
中国国家自然科学基金; 美国国家科学基金会;
关键词
autoimmune pancreatitis; IgG4; steroid; prediction; maintenance therapy; relapse; IMMUNOGLOBULIN G4-ASSOCIATED CHOLANGITIS; IGG4-RELATED SCLEROSING CHOLANGITIS; CONSENSUS DIAGNOSTIC-CRITERIA; INTERNATIONAL CONSENSUS; THERAPY; MULTICENTER; EXPERIENCE; OUTCOMES;
D O I
10.1097/MPA.0000000000001147
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objectives This study aimed to investigate the frequency, predictors, and management of relapse of type 1 autoimmune pancreatitis (AIP) after steroid treatment. Methods One hundred one patients with type 1 AIP receiving steroid as initial treatment were enrolled. Predictors were identified by multivariate analysis using Cox proportional hazards model. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated. Results Thirty-nine (41.1%) patients experienced relapse after steroid treatment during a median follow-up of 40 months. The cumulative rate of relapse reached a plateau at 57.6% (95% CI, 50.3%-64.9%) at 59 months. Without maintenance therapy (HR, 4.53; 95% CI, 1.35-15.17) and proximal bile duct involvement (HR, 2.10; 95% CI, 1.07-4.14) were identified as risk factors. Repeated steroid treatment with the same initial dose but longer induction and tapering duration was given to 87.2% patients with relapse and obtained response (97.1%) during a short-term follow-up (median, 19 months). Conclusions Relapses are common in type 1 AIP after steroid treatment. Without maintenance therapy and proximal bile duct involvement were risk factors. Repeated steroid treatment with longer duration is effective for relapse.
引用
收藏
页码:1110 / 1114
页数:5
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