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10.1186/s13075-018-1567-2

http://scihub22266oqcxt.onion/10.1186/s13075-018-1567-2
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suck abstract from ncbi


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pmid29636109
      Arthritis+Res+Ther 2018 ; 20 (1 ): 65
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  • Failure of remission induction by glucocorticoids alone or in combination with immunosuppressive agents in IgG4-related disease: a prospective study of 215 patients #MMPMID29636109
  • Wang L ; Zhang P ; Wang M ; Feng R ; Lai Y ; Peng L ; Fei Y ; Zhang X ; Zhao Y ; Zeng X ; Zhang F ; Zhang W
  • Arthritis Res Ther 2018[Apr]; 20 (1 ): 65 PMID29636109 show ga
  • BACKGROUND: The aim of this study was to assess the outcomes of remission induction in patients with IgG4-related disease (IgG4-RD) in our cohort, and to investigate the characteristics, prognosis, and risk factors in the patients failed of remission induction. METHODS: We prospectively enrolled 215 newly diagnosed patients with IgG4-RD, who were initially treated with glucocorticoid (GC) alone or in combination with immunosuppressive agents (IM), and had at least 6 months of follow up. The therapeutic goals of remission induction were defined as fulfilling each of the following after the 6-month remission induction stage: (1) ??50% decline in the IgG4-RD responder index (RI); (2) GC tapered to maintenance dose; and (3) no relapse during GC tapering. The patients not achieving the therapeutic goals were considered to have failed of remission induction. RESULTS: There were 26 patients in our cohort who failed of remission induction, including 16 (20.8%) on GC monotherapy, and 10 (7.2%) on combination therapy comprising GC and IM. The lacrimal gland and lung were most common sites of remission induction failure. Among the patients who relapsed during remission induction stage, 52.9% had secondary relapse during follow-up. Eosinophilia, higher baseline RI, more than five organs involved and dacryoadenitis were risk factors for remission induction failure with GC monotherapy, and the incidence of remission induction failure was 71.4% in the patients with more than three risk factors. After 6-month treatment, the patients who failed of remission induction had significantly higher erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and IgG4. CONCLUSION: In our cohort, 20.8% of patients failed of remission induction with GC monotherapy, while 7.2% of patients failed of remission induction with combination therapy comprising GC and IM.
  • |Adolescent [MESH]
  • |Adult [MESH]
  • |Aged [MESH]
  • |Aged, 80 and over [MESH]
  • |Azathioprine/administration & dosage [MESH]
  • |Child [MESH]
  • |Cohort Studies [MESH]
  • |Cyclophosphamide/administration & dosage [MESH]
  • |Cyclosporine/administration & dosage [MESH]
  • |Female [MESH]
  • |Glucocorticoids/*administration & dosage [MESH]
  • |Glycosides/administration & dosage [MESH]
  • |Humans [MESH]
  • |Immunoglobulin G4-Related Disease/*drug therapy [MESH]
  • |Immunosuppressive Agents/*administration & dosage [MESH]
  • |Leflunomide/administration & dosage [MESH]
  • |Male [MESH]
  • |Methotrexate/administration & dosage [MESH]
  • |Middle Aged [MESH]
  • |Mycophenolic Acid/administration & dosage [MESH]
  • |Prednisone/*administration & dosage [MESH]
  • |Prospective Studies [MESH]
  • |Remission Induction [MESH]
  • |Treatment Outcome [MESH]


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