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Comparable efficacy of low- versus high-dose induction corticosteroid treatment in autoimmune pancreatitis
Jorie Buijs1, Marianne J van Heerde, Erik A J Rauws
1From the *Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam; †Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, Amsterdam; Departments of ‡Public Health and §Pathology, Erasmus University Medical Center, Rotterdam; ∥Department of Pathology, Academic Medical Center Amsterdam, Amsterdam; ¶Department of Gastroenterology and Hepatology, University Medical Center Utrecht; and #Department of Gastroenterology, Meander Medical Center, Amersfoort, the Netherlands.
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.
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