Factors in glucocorticoid regimens associated with treatment response and relapses of IgG4-related disease: a multicentre study

Mirei Shirakashi, Hajime Yoshifuji, Yuzo Kodama, Tsutomu Chiba, Motohisa Yamamoto, Hiroki Takahashi, Kazushige Uchida, Kazuichi Okazaki, Tetsuya Ito, Shigeyuki Kawa, Kazunori Yamada, Mitsuhiro Kawano, Shintaro Hirata, Yoshiya Tanaka, Masafumi Moriyama, Seiji Nakamura, Terumi Kamisawa, Shoko Matsui, Hiroto Tsuboi, Takayuki SumidaMotoko Shibata, Hiroshi Goto, Yasuharu Sato, Tadashi Yoshino, Tsuneyo Mimori

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    Abstract

    Glucocorticoids (GC) are effective for treating IgG4-related disease (IgG4-RD); however, relapse is often observed. We conducted a retrospective multicentre study to investigate risk factors in GC regimens associated with relapses of IgG4-RD. Data on 166 patients with definitive IgG4-RD diagnosis were collected from 12 institutions. Comprehensive surveillance of clinical backgrounds and GC regimens as well as multivariate analysis of factors associated with treatment responses and relapses was performed. To determine the initial maximal GC dose, the patients were stratified into three groups depending on the initial prednisolone (PSL) dosage: <0.39, 0.4–0.69 and >0.7 mg/kg/day. The multivariate analysis extracted the disease duration and reduction speed of initial GC dose. Patients treated with initial GC <0.39 or >0.7 mg/kg/day of PSL showed higher relapse rates than those treated with 0.4–0.69 mg/kg/day. The relapse rates were significantly higher in patients with fast reduction of the initial dose (>0.4 mg/day) than in patients with slow reduction (<0.4 mg/day). To avoid relapse, 0.4–0.69 mg/kg/day of initial PSL with slow reduction speed (<0.4 mg/day) is needed in the early treatment of IgG4-RD.

    Original languageEnglish (US)
    Article number10262
    JournalScientific reports
    Volume8
    Issue number1
    DOIs
    StatePublished - Dec 1 2018

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    ASJC Scopus subject areas

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    Shirakashi, M., Yoshifuji, H., Kodama, Y., Chiba, T., Yamamoto, M., Takahashi, H., Uchida, K., Okazaki, K., Ito, T., Kawa, S., Yamada, K., Kawano, M., Hirata, S., Tanaka, Y., Moriyama, M., Nakamura, S., Kamisawa, T., Matsui, S., Tsuboi, H., ... Mimori, T. (2018). Factors in glucocorticoid regimens associated with treatment response and relapses of IgG4-related disease: a multicentre study. Scientific reports, 8(1), [10262]. https://doi.org/10.1038/s41598-018-28405-x