title: Comparable efficacy of low- versus high-dose induction corticosteroid treatment in autoimmune pancreatitis.
abstract: 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.
authors: From 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.
authors: Jorie
authors: J
authors: Buijs
authors: Marianne J
authors: MJ
authors: van Heerde
authors: Erik A J
authors: EA
authors: Rauws
authors: Lucas J Maillette
authors: LJ
authors: de Buy Wenniger
authors: Bettina E
authors: BE
authors: Hansen
authors: Katharina
authors: K
authors: Biermann
authors: Joanne
authors: J
authors: Verheij
authors: Frank P
authors: FP
authors: Vleggaar
authors: Menno A
authors: MA
authors: Brink
authors: Ulrich H W
authors: UH
authors: Beuers
authors: Ernst J
authors: EJ
authors: Kuipers
authors: Marco J
authors: MJ
authors: Bruno
authors: Henk R
authors: HR
authors: van Buuren
mesh_terms: D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods; D007565:Jaundice / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000188:drug therapy*; D011241:Prednisone / Q000627:therapeutic use*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects
chemical_list: D005938:Glucocorticoids; D011241:Prednisone