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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Arthritis+Res+Ther
2018 ; 20
(1
): 65
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gab.com Text
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English Wikipedia
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.