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Long-term corticosteroids may prevent relapse in autoimmune pancreatitis
Patients with autoimmune pancreatitis who received maintenance therapy with a low dose of corticosteroids for 3 years showed lower relapse rates and longer relapse-free survival compared with patients who stopped taking corticosteroids at 26 weeks, according to the results of a randomized controlled trial.
“Our results suggested that maintenance corticosteroid therapy might be effective in reducing relapses,” investigators from the Research Committee of Intractable Pancreas Diseases in Japan wrote. “Low-dose maintenance corticosteroid therapy for a long period would be an option to decrease relapses in patients with [autoimmune pancreatitis], especially those with high disease activity and risk of relapse.”
To study the efficacy of maintenance corticosteroids in autoimmune pancreatitis, the researchers recruited 49 patients from 15 tertiary care centers in Japan between April 2009 and March 2012. After the initial oral prednisolone treatment for 26 weeks (all patients achieved remission within 12 weeks), they randomly assigned 30 patients to continue long-term maintenance therapy with 5 mg to 7.5 mg oral prednisolone per day for 3 years, and the remaining 19 patients stopped treatment with prednisolone at 26 weeks.
Intention-to-treat analysis showed that within 3 years, 23.3% of the patients who received maintenance therapy relapsed compared with 57.9% of the patients who stopped corticosteroid treatment at 26 weeks, which was significantly lower (P = .011).
In addition, the maintenance therapy group had significantly longer relapse-free survival (P = .007).
Finally, the investigators observed no serious corticosteroid-related complications requiring discontinuation of therapy.
“Further studies on long-term effects of the maintenance therapy as well as identification of biomarkers predicting relapses are needed,” they concluded. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.