Comparable efficacy of low- versus high-dose induction corticosteroid treatment in autoimmune pancreatitis.

Abstract

OBJECTIVE:

The objective of this study was to compare efficacy of high versus low doses of prednisone for induction of remission in autoimmune pancreatitis (AIP).

METHODS:

This is a retrospective, multicenter study including patients diagnosed with AIP between May 1992 and August 2011. Clinical, laboratory and imaging findings were assessed before treatment and at 1, 3, and 6 months after starting treatment.

RESULTS:

A total of 65 patients (57 males; median age, 63 years) were treated with an initial low dose (10-20 mg/d, n = 14), a medium dose (30 mg/d, n = 15), or a high dose (40-60 mg/d, n = 36) of prednisone. There were no significant differences in baseline characteristics between the treatment groups including age, presenting symptoms and laboratory results. During a follow-up period of 6 months, in nearly all patients, symptoms (jaundice, weight loss) resolved completely. After 6 months, treatment response with respect to symptomatic, radiological, and laboratory improvement was comparable for the different dosage groups.

CONCLUSIONS:

Response to therapy was comparable for AIP patients treated with doses of prednisone in the range of 10 to 60 mg/d. A prospective trial should be conducted to confirm efficacy of lower-dose prednisone treatment.

• Authors: Jorie Buijs, Marianne J van Heerde, Erik A J Rauws, Lucas J Maillette de Buy Wenniger, Bettina E Hansen, Katharina Biermann, Joanne Verheij, Frank P Vleggaar, Menno A Brink, Ulrich H W Beuers, Ernst J Kuipers, Marco J Bruno, Henk R van Buuren
• Journal: Pancreas (Pancreas) Vol. 43 Issue 2 Pg. 261-7 (Mar 2014) ISSN: 1536-4828 [Electronic] United States
• PMID: 24518506 (Publication Type: Comparative Study, Journal Article, Multicenter Study)

Chemical References

• Glucocorticoids
• Prednisone

Topics

• Adult
• Aged
• Autoimmune Diseases (drug therapy)
• Dose-Response Relationship, Drug
• Female
• Follow-Up Studies
• Glucocorticoids (therapeutic use)
• Humans
• Induction Chemotherapy (methods)
• Jaundice (prevention & control)
• Male
• Middle Aged
• Pancreatitis (drug therapy)
• Prednisone (therapeutic use)
• Retrospective Studies
• Time Factors
• Treatment Outcome
• Weight Loss (drug effects)