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Treatment

 

Risk factors of relapse following glucocorticoid tapering in IgG4-related disease

1, 2, 3, 4, 5, 6, 7

 

  1. Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
  2. Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
  3. Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan. ykaneko.z6@keio.jp
  4. Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
  5. Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
  6. Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
  7. Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.

CER10929
2018 Vol.36, N°3 ,Suppl.112
PI 0186, PF 0189
Treatment

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PMID: 29846165 [PubMed]

Received: 31/10/2017
Accepted : 12/03/2018
In Press: 24/05/2018
Published: 14/08/2018

Abstract

OBJECTIVES:
To identify risk factors of relapse in IgG4-related disease (IgG4-RD) during glucocorticoid (GC) tapering.
METHODS:
A total of 27 consecutive patients with IgG4-RD (7 with and 20 without relapse) treated with GC for more than 6 months were enrolled. Baseline characteristics were compared in patients with and without relapse. Longitudinal analysis was also performed.
RESULTS:
Patients with relapse had significantly higher levels of serum IgG4 (816.0 vs. 346.5 mg/dL, p=0.048) and number of organs involved (5 vs. 3, p=0.008) and lower levels of serum IgA (82 vs. 176 mg/dL, p=0.002) at baseline, compared to patients without relapse. The most useful cut-off value of baseline serum IgG4 to predictive relapse was 813 mg/dl with a sensitivity of 57.1% and a specificity of 95.0%. In longitudinal analysis, serum IgG4 decreased at 6 months after treatment in both groups, but was elevated at relapse in patients with relapse, while remaining low in those without relapse.
CONCLUSIONS:
Higher levels of serum IgG4 at baseline were associated with relapse in IgG4-RD. Re-elevation of serum IgG4 levels during GC treatment reflected disease relapse.

Rheumatology Article

Rheumatology Addendum