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Maintenance Treatment for Type 1 Autoimmune Pancreatitis: Effectiveness and Development of the PrescrAIP Relapse
Marco Lanzillotta1, Peter Macinga2, Jakob L Poulsen3
1Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy.
Maintenance therapy for type 1 autoimmune pancreatitis (AIP) reduces relapse risk, particularly in high-risk patients. The new PrescrAIP score helps personalize treatment decisions for AIP relapse prevention.
Area of Science:
- Gastroenterology
- Immunology
- Clinical Medicine
Background:
- Type 1 autoimmune pancreatitis (AIP) is a chronic relapsing-remitting inflammatory condition.
- Management of AIP often involves multiple treatment courses due to frequent relapses.
Purpose of the Study:
- To evaluate the effectiveness of maintenance treatment in preventing AIP relapse.
- To develop the PrescrAIP risk score for predicting relapse risk and maintenance treatment benefit.
Main Methods:
- Retrospective analysis of 577 patients diagnosed with type 1 AIP.
- Development of a multivariable prediction model (PrescrAIP score) using Cox regression.
- Internal and internal-external validation of the predictive model and nomogram.
Main Results:
- The 3-year relapse risk was 28%, significantly lower with maintenance treatment (22% vs. 35%).
- The PrescrAIP score incorporates factors like maintenance treatment, sex, and clinical presentation.
- Maintenance treatment benefit was observed in patients with a PrescrAIP score >155.
Conclusions:
- Maintenance therapy is effective in reducing relapse in high-risk type 1 AIP patients.
- The PrescrAIP score may guide personalized maintenance treatment strategies for AIP.
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