Type 1 Autoimmune Pancreatitis in Europe: Clinical Profile and
Response to Treatment

J 2024

Type 1 Autoimmune Pancreatitis in Europe: Clinical Profile and Response to Treatment

OVERBEEK, Kasper A, Jakob L POULSEN, Marco LANZILLOTTA, Olof VINGE-HOLMQUIST, Peter MACINGA et. al.

Basic information

Original name

Type 1 Autoimmune Pancreatitis in Europe: Clinical Profile and Response to Treatment

Authors

OVERBEEK, Kasper A, Jakob L POULSEN, Marco LANZILLOTTA, Olof VINGE-HOLMQUIST, Peter MACINGA, A Fatih DEMIRCI, Daniko P SINDHUNATA, Johanna BACKHUS, Hana ALGÜL, Jorie BUIJS, Philippe LEVY, Mariia KIRIUKOVA, Elisabetta GONI, Marcus HOLLENBACH, Rainer C MIKSCH, Lumír KUNOVSKÝ (203 Czech Republic, belonging to the institution), Miroslav VUJASINOVIC, Sara NIKOLIC, Luke DICKERSON, Michael HIRTH, Markus F NEURATH, Malte ZUMBLICK, Josephine VILA, Mustafa JALAL, Georg BEYER, Fabian FROST, Silvia CARRARA, Zdeněk KALA (203 Czech Republic, belonging to the institution), Petr JABANDŽIEV (203 Czech Republic, belonging to the institution), Gurhan SISMAN, Filiz AKYUZ, Gabriele CAPURSO, Massimo FALCONI, Alexander ARLT, Frank P VLEGGAAR, Luca BARRESI, Bill GREENHALF, László CZAKÓ, Peter HEGYI, Andrew HOPPER, Manu K NAYAR, Thomas M GRESS, Francesco VITALI, Alexander SCHNEIDER, Chris M HALLORAN, Jan TRNA (203 Czech Republic, belonging to the institution), Alexey V OKHLOBYSTIN, Lorenzo DAGNA, Djuna L CAHEN, Dmitry BORDIN, Vinciane REBOURS, Julia MAYERLE, Alisan KAHRAMAN, Sebastian RASCH, Emma CULVER, Alexander KLEGER, Emma MARTÍNEZ-MONEO, Ola RØKKE, Tomas HUCL, Søren S OLESEN, Marco J BRUNO, Emanuel DELLA-TORRE, Ulrich BEUERS, J-Matthias LÖHR and Jonas ROSENDAHL

Edition

Clinical Gastroenterology and Hepatology, New York, ELSEVIER SCIENCE INC, 2024, 1542-3565

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30219 Gastroenterology and hepatology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 12.600 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.cgh.2023.12.010

UT WoS

001241830900001

Keywords in English

Autoimmune Pancreatitis; IgG4-Related Disease; IgG4-Related Pancreatitis

Abstract

V originále

Background & Aims Autoimmune pancreatitis (AIP) is an immune-mediated disease of the pancreas with distinct pathophysiology and manifestations. Our aims were to characterize type 1 AIP in a large pan-European cohort and study the effectiveness of current treatment regimens. Methods We retrospectively analyzed adults diagnosed since 2005 with type 1 or not-otherwise-specified AIP in 42 European university hospitals. Type 1 AIP was uniformly diagnosed using specific diagnostic criteria. Patients with type 2 AIP and those who had undergone pancreatic surgery were excluded. The primary end point was complete remission, defined as the absence of clinical symptoms and resolution of the index radiologic pancreatic abnormalities attributed to AIP. Results We included 735 individuals with AIP (69% male; median age, 57 years; 85% White). Steroid treatment was started in 634 patients, of whom 9 (1%) were lost to follow-up. The remaining 625 had a 79% (496/625) complete, 18% (111/625) partial, and 97% (607/625) cumulative remission rate, whereas 3% (18/625) did not achieve remission. No treatment was given in 95 patients, who had a 61% complete (58/95), 19% partial (18/95), and 80% cumulative (76/95) spontaneous remission rate. Higher (≥0.4 mg/kg/day) corticosteroid doses were no more effective than lower (<0.4 mg/kg/day) doses (odds ratio, 0.428; 95% confidence interval, 0.054–3.387) and neither was a starting dose duration >2 weeks (odds ratio, 0.908; 95% confidence interval, 0.818–1.009). Elevated IgG4 levels were independently associated with a decreased chance of complete remission (odds ratio, 0.639; 95% confidence interval, 0.427–0.955). Relapse occurred in 30% of patients. Relapses within 6 months of remission induction were independent of the steroid-tapering duration, induction treatment duration, and total cumulative dose. Conclusions Patients with type 1 AIP and elevated IgG4 level may need closer monitoring. For remission induction, a starting dose of 0.4 mg/kg/day for 2 weeks followed by a short taper period seems effective. This study provides no evidence to support more aggressive regimens.

Citovat

OVERBEEK, Kasper A, Jakob L POULSEN, Marco LANZILLOTTA, Olof VINGE-HOLMQUIST, Peter MACINGA, A Fatih DEMIRCI, Daniko P SINDHUNATA, Johanna BACKHUS, Hana ALGÜL, Jorie BUIJS, Philippe LEVY, Mariia KIRIUKOVA, Elisabetta GONI, Marcus HOLLENBACH, Rainer C MIKSCH, Lumír KUNOVSKÝ, Miroslav VUJASINOVIC, Sara NIKOLIC, Luke DICKERSON, Michael HIRTH, Markus F NEURATH, Malte ZUMBLICK, Josephine VILA, Mustafa JALAL, Georg BEYER, Fabian FROST, Silvia CARRARA, Zdeněk KALA, Petr JABANDŽIEV, Gurhan SISMAN, Filiz AKYUZ, Gabriele CAPURSO, Massimo FALCONI, Alexander ARLT, Frank P VLEGGAAR, Luca BARRESI, Bill GREENHALF, László CZAKÓ, Peter HEGYI, Andrew HOPPER, Manu K NAYAR, Thomas M GRESS, Francesco VITALI, Alexander SCHNEIDER, Chris M HALLORAN, Jan TRNA, Alexey V OKHLOBYSTIN, Lorenzo DAGNA, Djuna L CAHEN, Dmitry BORDIN, Vinciane REBOURS, Julia MAYERLE, Alisan KAHRAMAN, Sebastian RASCH, Emma CULVER, Alexander KLEGER, Emma MARTÍNEZ-MONEO, Ola RØKKE, Tomas HUCL, Søren S OLESEN, Marco J BRUNO, Emanuel DELLA-TORRE, Ulrich BEUERS, J-Matthias LÖHR and Jonas ROSENDAHL. Type 1 Autoimmune Pancreatitis in Europe: Clinical Profile and Response to Treatment. Clinical Gastroenterology and Hepatology. New York: ELSEVIER SCIENCE INC, 2024, vol. 22, No 5, p. "994"-"1004.e10", 21 pp. ISSN 1542-3565. Available from: https://dx.doi.org/10.1016/j.cgh.2023.12.010.

@article{2379337,
   author = {Overbeek, Kasper A and Poulsen, Jakob L and Lanzillotta, Marco and VingeandHolmquist, Olof and Macinga, Peter and Demirci, A Fatih and Sindhunata, Daniko P and Backhus, Johanna and Algül, Hana and Buijs, Jorie and Levy, Philippe and Kiriukova, Mariia and Goni, Elisabetta and Hollenbach, Marcus and Miksch, Rainer C and Kunovský, Lumír and Vujasinovic, Miroslav and Nikolic, Sara and Dickerson, Luke and Hirth, Michael and Neurath, Markus F and Zumblick, Malte and Vila, Josephine and Jalal, Mustafa and Beyer, Georg and Frost, Fabian and Carrara, Silvia and Kala, Zdeněk and Jabandžiev, Petr and Sisman, Gurhan and Akyuz, Filiz and Capurso, Gabriele and Falconi, Massimo and Arlt, Alexander and Vleggaar, Frank P and Barresi, Luca and Greenhalf, Bill and Czakó, László and Hegyi, Peter and Hopper, Andrew and Nayar, Manu K and Gress, Thomas M and Vitali, Francesco and Schneider, Alexander and Halloran, Chris M and Trna, Jan and Okhlobystin, Alexey V and Dagna, Lorenzo and Cahen, Djuna L and Bordin, Dmitry and Rebours, Vinciane and Mayerle, Julia and Kahraman, Alisan and Rasch, Sebastian and Culver, Emma and Kleger, Alexander and MartínezandMoneo, Emma and Røkke, Ola and Hucl, Tomas and Olesen, Søren S and Bruno, Marco J and DellaandTorre, Emanuel and Beuers, Ulrich and Löhr, JandMatthias and Rosendahl, Jonas},
   article_location = {New York},
   article_number = {5},
   doi = {http://dx.doi.org/10.1016/j.cgh.2023.12.010},
   keywords = {Autoimmune Pancreatitis; IgG4-Related Disease; IgG4-Related Pancreatitis},
   language = {eng},
   issn = {1542-3565},
   journal = {Clinical Gastroenterology and Hepatology},
   title = {Type 1 Autoimmune Pancreatitis in Europe: Clinical Profile and Response to Treatment},
   url = {https://www.sciencedirect.com/science/article/pii/S154235652301042X?via%3Dihub},
   volume = {22},
   year = {2024}
}

TY  - JOUR
ID  - 2379337
AU  - Overbeek, Kasper A - Poulsen, Jakob L - Lanzillotta, Marco - Vinge-Holmquist, Olof - Macinga, Peter - Demirci, A Fatih - Sindhunata, Daniko P - Backhus, Johanna - Algül, Hana - Buijs, Jorie - Levy, Philippe - Kiriukova, Mariia - Goni, Elisabetta - Hollenbach, Marcus - Miksch, Rainer C - Kunovský, Lumír - Vujasinovic, Miroslav - Nikolic, Sara - Dickerson, Luke - Hirth, Michael - Neurath, Markus F - Zumblick, Malte - Vila, Josephine - Jalal, Mustafa - Beyer, Georg - Frost, Fabian - Carrara, Silvia - Kala, Zdeněk - Jabandžiev, Petr - Sisman, Gurhan - Akyuz, Filiz - Capurso, Gabriele - Falconi, Massimo - Arlt, Alexander - Vleggaar, Frank P - Barresi, Luca - Greenhalf, Bill - Czakó, László - Hegyi, Peter - Hopper, Andrew - Nayar, Manu K - Gress, Thomas M - Vitali, Francesco - Schneider, Alexander - Halloran, Chris M - Trna, Jan - Okhlobystin, Alexey V - Dagna, Lorenzo - Cahen, Djuna L - Bordin, Dmitry - Rebours, Vinciane - Mayerle, Julia - Kahraman, Alisan - Rasch, Sebastian - Culver, Emma - Kleger, Alexander - Martínez-Moneo, Emma - Røkke, Ola - Hucl, Tomas - Olesen, Søren S - Bruno, Marco J - Della-Torre, Emanuel - Beuers, Ulrich - Löhr, J-Matthias - Rosendahl, Jonas
PY  - 2024
TI  - Type 1 Autoimmune Pancreatitis in Europe: Clinical Profile and Response to Treatment
JF  - Clinical Gastroenterology and Hepatology
VL  - 22
IS  - 5
SP  - "994"-"1004.e10"
EP  - "994"-"1004.e10"
PB  - ELSEVIER SCIENCE INC
SN  - 15423565
KW  - Autoimmune Pancreatitis
KW  - IgG4-Related Disease
KW  - IgG4-Related Pancreatitis
UR  - https://www.sciencedirect.com/science/article/pii/S154235652301042X?via%3Dihub
N2  - Background & Aims Autoimmune pancreatitis (AIP) is an immune-mediated disease of the pancreas with distinct pathophysiology and manifestations. Our aims were to characterize type 1 AIP in a large pan-European cohort and study the effectiveness of current treatment regimens. Methods We retrospectively analyzed adults diagnosed since 2005 with type 1 or not-otherwise-specified AIP in 42 European university hospitals. Type 1 AIP was uniformly diagnosed using specific diagnostic criteria. Patients with type 2 AIP and those who had undergone pancreatic surgery were excluded. The primary end point was complete remission, defined as the absence of clinical symptoms and resolution of the index radiologic pancreatic abnormalities attributed to AIP. Results We included 735 individuals with AIP (69% male; median age, 57 years; 85% White). Steroid treatment was started in 634 patients, of whom 9 (1%) were lost to follow-up. The remaining 625 had a 79% (496/625) complete, 18% (111/625) partial, and 97% (607/625) cumulative remission rate, whereas 3% (18/625) did not achieve remission. No treatment was given in 95 patients, who had a 61% complete (58/95), 19% partial (18/95), and 80% cumulative (76/95) spontaneous remission rate. Higher (≥0.4 mg/kg/day) corticosteroid doses were no more effective than lower (<0.4 mg/kg/day) doses (odds ratio, 0.428; 95% confidence interval, 0.054–3.387) and neither was a starting dose duration >2 weeks (odds ratio, 0.908; 95% confidence interval, 0.818–1.009). Elevated IgG4 levels were independently associated with a decreased chance of complete remission (odds ratio, 0.639; 95% confidence interval, 0.427–0.955). Relapse occurred in 30% of patients. Relapses within 6 months of remission induction were independent of the steroid-tapering duration, induction treatment duration, and total cumulative dose. Conclusions Patients with type 1 AIP and elevated IgG4 level may need closer monitoring. For remission induction, a starting dose of 0.4 mg/kg/day for 2 weeks followed by a short taper period seems effective. This study provides no evidence to support more aggressive regimens.
ER  -

OVERBEEK, Kasper A, Jakob L POULSEN, Marco LANZILLOTTA, Olof VINGE-HOLMQUIST, Peter MACINGA, A Fatih DEMIRCI, Daniko P SINDHUNATA, Johanna BACKHUS, Hana ALGÜL, Jorie BUIJS, Philippe LEVY, Mariia KIRIUKOVA, Elisabetta GONI, Marcus HOLLENBACH, Rainer C MIKSCH, Lumír KUNOVSKÝ, Miroslav VUJASINOVIC, Sara NIKOLIC, Luke DICKERSON, Michael HIRTH, Markus F NEURATH, Malte ZUMBLICK, Josephine VILA, Mustafa JALAL, Georg BEYER, Fabian FROST, Silvia CARRARA, Zdeněk KALA, Petr JABANDŽIEV, Gurhan SISMAN, Filiz AKYUZ, Gabriele CAPURSO, Massimo FALCONI, Alexander ARLT, Frank P VLEGGAAR, Luca BARRESI, Bill GREENHALF, László CZAKÓ, Peter HEGYI, Andrew HOPPER, Manu K NAYAR, Thomas M GRESS, Francesco VITALI, Alexander SCHNEIDER, Chris M HALLORAN, Jan TRNA, Alexey V OKHLOBYSTIN, Lorenzo DAGNA, Djuna L CAHEN, Dmitry BORDIN, Vinciane REBOURS, Julia MAYERLE, Alisan KAHRAMAN, Sebastian RASCH, Emma CULVER, Alexander KLEGER, Emma MARTÍNEZ-MONEO, Ola RØKKE, Tomas HUCL, Søren S OLESEN, Marco J BRUNO, Emanuel DELLA-TORRE, Ulrich BEUERS, J-Matthias LÖHR and Jonas ROSENDAHL. Type 1 Autoimmune Pancreatitis in Europe: Clinical Profile and Response to Treatment. \textit{Clinical Gastroenterology and Hepatology}. New York: ELSEVIER SCIENCE INC, 2024, vol.~22, No~5, p.~''994''-''1004.e10'', 21 pp. ISSN~1542-3565. Available from: https://dx.doi.org/10.1016/j.cgh.2023.12.010.

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