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Standard steroid treatment for autoimmune pancreatitis

Kamisawa, T ; Shimosegawa, T ; Okazaki, K ; Nishino, T ; Watanabe, H ; Kanno, A ; Okumura, F ; Nishikawa, T ; Kobayashi, K ; Ichiya, T ; Takatori, H ; Yamakita, K ; Kubota, K ; Hamano, H ; Okamura, K ; Hirano, K ; Ito, T ; Ko, S B H ; Omata, M

Gut, 2009-11, Vol.58 (11), p.1504-1507 [Periódico revisado por pares]

London: BMJ Publishing Group Ltd and British Society of Gastroenterology

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Título:
Standard steroid treatment for autoimmune pancreatitis
Autor: Kamisawa, T ; Shimosegawa, T ; Okazaki, K ; Nishino, T ; Watanabe, H ; Kanno, A ; Okumura, F ; Nishikawa, T ; Kobayashi, K ; Ichiya, T ; Takatori, H ; Yamakita, K ; Kubota, K ; Hamano, H ; Okamura, K ; Hirano, K ; Ito, T ; Ko, S B H ; Omata, M
Assuntos: Abdomen ; Autoimmune Diseases - drug therapy ; Biological and medical sciences ; Biopsy ; Diabetes ; Drug Administration Schedule ; Endoscopy ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Japan ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Pain ; Pancreatic cancer ; Pancreatitis - drug therapy ; Patients ; Prednisolone - administration & dosage ; Remission Induction ; Retrospective Studies ; Secondary Prevention ; Steroids - administration & dosage ; Studies ; Treatment Outcome ; Ultrasonic imaging
É parte de: Gut, 2009-11, Vol.58 (11), p.1504-1507
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Descrição: Objective:To establish an appropriate steroid treatment regimen for autoimmune pancreatitis (AIP).Methods:A retrospective survey of AIP treatment was conducted in 17 centres in Japan. The main outcome measures were rate of remission and relapse.Results:Of 563 patients with AIP, 459 (82%) received steroid treatment. The remission rate of steroid-treated AIP was 98%, which was significantly higher than that of patients without steroid treatment (74%, 77/104; p<0.001). Steroid treatment was given for obstructive jaundice (60%), abdominal pain (11%), associated extrapancreatic lesions except the biliary duct (11%), and diffuse enlargement of the pancreas (10%). There was no relationship between the period necessary to achieve remission and the initial dose (30 mg/day vs 40 mg/day) of prednisolone. Maintenance steroid treatment was given in 377 (82%) of 459 steroid-treated patients, and steroid treatment was stopped in 104 patients. The relapse rate of patients with AIP on maintenance treatment was 23% (63/273), which was significantly lower than that of patients who stopped maintenance treatment (34%, 35/104; p = 0.048). From the start of steroid treatment, 56% (55/99) relapsed within 1 year and 92% (91/99) relapsed within 3 years. Of the 89 relapsed patients, 83 (93%) received steroid re-treatment, and steroid re-treatment was effective in 97% of them.Conclusions:The major indication for steroid treatment in AIP is the presence of symptoms. An initial prednisolone dose of 0.6 mg/kg/day, is recommend, which is then reduced to a maintenance dose over a period of 3–6 months. Maintenance treatment with low-dose steroid reduces but dose not eliminate relapses.
Editor: London: BMJ Publishing Group Ltd and British Society of Gastroenterology
Idioma: Inglês

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Standard steroid treatment for autoimmune pancreatitis

Kamisawa, T ; Shimosegawa, T ; Okazaki, K ; Nishino, T ; Watanabe, H ; Kanno, A ; Okumura, F ; Nishikawa, T ; Kobayashi, K ; Ichiya, T ; Takatori, H ; Yamakita, K ; Kubota, K ; Hamano, H ; Okamura, K ; Hirano, K ; Ito, T ; Ko, S B H ; Omata, M

London: BMJ Publishing Group Ltd and British Society of Gastroenterology

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