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Prognostic factors in IgG4-related disease: a long-term monocentric Chinese cohort study

Objectives Patients with IgG4-related disease (IgG4-RD) suffer high relapse rates during long-term treatment, but factors that predict relapse outcomes are not well established. In the present study, we aimed to identify predictive factors for treatment resistance and disease relapse in a Chinese Ig... Full description

Journal Title: Clinical rheumatology 2020-11-05, Vol.40 (6), p.2293-2300
Main Author: Zongfei, Ji
Other Authors: Lingying, Ma , Lijuan, Zhang , Ying, Sun , Rongyi, Chen , Dongmei, Liu , Xiufang, Kong , Xiaomin, Dai , Lili, Ma , Huiyong, Chen , Lindi, Jiang
Format: Electronic Article Electronic Article
Language: English
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Publisher: Cham: Springer International Publishing
ID: ISSN: 0770-3198
Link: https://www.ncbi.nlm.nih.gov/pubmed/33151477
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recordid: cdi_proquest_miscellaneous_2457971945
title: Prognostic factors in IgG4-related disease: a long-term monocentric Chinese cohort study
format: Article
creator:
  • Zongfei, Ji
  • Lingying, Ma
  • Lijuan, Zhang
  • Ying, Sun
  • Rongyi, Chen
  • Dongmei, Liu
  • Xiufang, Kong
  • Xiaomin, Dai
  • Lili, Ma
  • Huiyong, Chen
  • Lindi, Jiang
subjects:
  • Analysis
  • China
  • Cholesterol
  • Cohort Studies
  • Corticosteroids
  • Disease resistance
  • Dosage
  • Glucocorticoids
  • Humans
  • Immunoglobulin G
  • Immunoglobulin G4-Related Disease - drug therapy
  • Low density lipoproteins
  • Medical prognosis
  • Medical research
  • Medical treatment
  • Medicine
  • Medicine & Public Health
  • Medicine, Experimental
  • Original Article
  • Patients
  • Prognosis
  • Remission
  • Rheumatology
  • Risk factors
  • Serum levels
  • Treatment Outcome
  • Tumor necrosis factor-α
ispartof: Clinical rheumatology, 2020-11-05, Vol.40 (6), p.2293-2300
description: Objectives Patients with IgG4-related disease (IgG4-RD) suffer high relapse rates during long-term treatment, but factors that predict relapse outcomes are not well established. In the present study, we aimed to identify predictive factors for treatment resistance and disease relapse in a Chinese IgG4-RD cohort. Methods This study enrolled 102 patients newly diagnosed with IgG4-RD. Disease prognosis was determined by evaluating disease activity and dosage of glucocorticoids. Predictive factors for refractory and relapsed disease were identified by univariate analysis and Cox regression. Results Among the 102 patients, 78 cases received medical treatment with regular follow-up (21 [6-111] months). During the follow-up period, 55 (70.5%) patients sustained clinical remission, and 23 (29.5%) patients suffered refractory or relapsed disease. The relapse rate of the patients with IgG4-RD was significantly higher among patients who stopped taking medicine than among those who continued treatment with glucocorticoids (GC) + immunosuppressor (IM). Serum TNF-α ≥ 13 pg/mL, sIL-2R ≥ 1010 U/mL, total cholesterol < 3.55 mmol/L, low-density lipoprotein < 2.0 mmol/L, IgG ≥ 20.2 g/L, and drug withdrawal were predictive factors for refractory and relapsed IgG4-RD. Multivariate Cox regression revealed that both sIL-2R and TNF-α were independent risk factors for refractory and relapsed disease. The combination of GC and IM treatment was an independent protective factor against refractory and relapsed IgG4-RD. Conclusions High serum levels of sIL-2R and TNF-α may be informative risk factors for refractory and relapsed IgG4-RD. Our data suggest that a combination treatment of GC along with IM may be protective against refractory and relapsed IgG4-RD. Key Points • High sIL-2R and TNF-α levels are informative risk factors for refractory and relapsed IgG4-related disease. • Combination treatment of GC with IM protects against refractory and relapsed IgG4-related disease
language: eng
source:
identifier: ISSN: 0770-3198
fulltext: no_fulltext
issn:
  • 0770-3198
  • 1434-9949
url: Link


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titlePrognostic factors in IgG4-related disease: a long-term monocentric Chinese cohort study
creatorZongfei, Ji ; Lingying, Ma ; Lijuan, Zhang ; Ying, Sun ; Rongyi, Chen ; Dongmei, Liu ; Xiufang, Kong ; Xiaomin, Dai ; Lili, Ma ; Huiyong, Chen ; Lindi, Jiang
creatorcontribZongfei, Ji ; Lingying, Ma ; Lijuan, Zhang ; Ying, Sun ; Rongyi, Chen ; Dongmei, Liu ; Xiufang, Kong ; Xiaomin, Dai ; Lili, Ma ; Huiyong, Chen ; Lindi, Jiang
descriptionObjectives Patients with IgG4-related disease (IgG4-RD) suffer high relapse rates during long-term treatment, but factors that predict relapse outcomes are not well established. In the present study, we aimed to identify predictive factors for treatment resistance and disease relapse in a Chinese IgG4-RD cohort. Methods This study enrolled 102 patients newly diagnosed with IgG4-RD. Disease prognosis was determined by evaluating disease activity and dosage of glucocorticoids. Predictive factors for refractory and relapsed disease were identified by univariate analysis and Cox regression. Results Among the 102 patients, 78 cases received medical treatment with regular follow-up (21 [6-111] months). During the follow-up period, 55 (70.5%) patients sustained clinical remission, and 23 (29.5%) patients suffered refractory or relapsed disease. The relapse rate of the patients with IgG4-RD was significantly higher among patients who stopped taking medicine than among those who continued treatment with glucocorticoids (GC) + immunosuppressor (IM). Serum TNF-α ≥ 13 pg/mL, sIL-2R ≥ 1010 U/mL, total cholesterol < 3.55 mmol/L, low-density lipoprotein < 2.0 mmol/L, IgG ≥ 20.2 g/L, and drug withdrawal were predictive factors for refractory and relapsed IgG4-RD. Multivariate Cox regression revealed that both sIL-2R and TNF-α were independent risk factors for refractory and relapsed disease. The combination of GC and IM treatment was an independent protective factor against refractory and relapsed IgG4-RD. Conclusions High serum levels of sIL-2R and TNF-α may be informative risk factors for refractory and relapsed IgG4-RD. Our data suggest that a combination treatment of GC along with IM may be protective against refractory and relapsed IgG4-RD. Key Points • High sIL-2R and TNF-α levels are informative risk factors for refractory and relapsed IgG4-related disease. • Combination treatment of GC with IM protects against refractory and relapsed IgG4-related disease
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subjectAnalysis ; China ; Cholesterol ; Cohort Studies ; Corticosteroids ; Disease resistance ; Dosage ; Glucocorticoids ; Humans ; Immunoglobulin G ; Immunoglobulin G4-Related Disease - drug therapy ; Low density lipoproteins ; Medical prognosis ; Medical research ; Medical treatment ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Original Article ; Patients ; Prognosis ; Remission ; Rheumatology ; Risk factors ; Serum levels ; Treatment Outcome ; Tumor necrosis factor-α
ispartofClinical rheumatology, 2020-11-05, Vol.40 (6), p.2293-2300
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descriptionObjectives Patients with IgG4-related disease (IgG4-RD) suffer high relapse rates during long-term treatment, but factors that predict relapse outcomes are not well established. In the present study, we aimed to identify predictive factors for treatment resistance and disease relapse in a Chinese IgG4-RD cohort. Methods This study enrolled 102 patients newly diagnosed with IgG4-RD. Disease prognosis was determined by evaluating disease activity and dosage of glucocorticoids. Predictive factors for refractory and relapsed disease were identified by univariate analysis and Cox regression. Results Among the 102 patients, 78 cases received medical treatment with regular follow-up (21 [6-111] months). During the follow-up period, 55 (70.5%) patients sustained clinical remission, and 23 (29.5%) patients suffered refractory or relapsed disease. The relapse rate of the patients with IgG4-RD was significantly higher among patients who stopped taking medicine than among those who continued treatment with glucocorticoids (GC) + immunosuppressor (IM). Serum TNF-α ≥ 13 pg/mL, sIL-2R ≥ 1010 U/mL, total cholesterol < 3.55 mmol/L, low-density lipoprotein < 2.0 mmol/L, IgG ≥ 20.2 g/L, and drug withdrawal were predictive factors for refractory and relapsed IgG4-RD. Multivariate Cox regression revealed that both sIL-2R and TNF-α were independent risk factors for refractory and relapsed disease. The combination of GC and IM treatment was an independent protective factor against refractory and relapsed IgG4-RD. Conclusions High serum levels of sIL-2R and TNF-α may be informative risk factors for refractory and relapsed IgG4-RD. Our data suggest that a combination treatment of GC along with IM may be protective against refractory and relapsed IgG4-RD. Key Points • High sIL-2R and TNF-α levels are informative risk factors for refractory and relapsed IgG4-related disease. • Combination treatment of GC with IM protects against refractory and relapsed IgG4-related disease
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abstractObjectives Patients with IgG4-related disease (IgG4-RD) suffer high relapse rates during long-term treatment, but factors that predict relapse outcomes are not well established. In the present study, we aimed to identify predictive factors for treatment resistance and disease relapse in a Chinese IgG4-RD cohort. Methods This study enrolled 102 patients newly diagnosed with IgG4-RD. Disease prognosis was determined by evaluating disease activity and dosage of glucocorticoids. Predictive factors for refractory and relapsed disease were identified by univariate analysis and Cox regression. Results Among the 102 patients, 78 cases received medical treatment with regular follow-up (21 [6-111] months). During the follow-up period, 55 (70.5%) patients sustained clinical remission, and 23 (29.5%) patients suffered refractory or relapsed disease. The relapse rate of the patients with IgG4-RD was significantly higher among patients who stopped taking medicine than among those who continued treatment with glucocorticoids (GC) + immunosuppressor (IM). Serum TNF-α ≥ 13 pg/mL, sIL-2R ≥ 1010 U/mL, total cholesterol < 3.55 mmol/L, low-density lipoprotein < 2.0 mmol/L, IgG ≥ 20.2 g/L, and drug withdrawal were predictive factors for refractory and relapsed IgG4-RD. Multivariate Cox regression revealed that both sIL-2R and TNF-α were independent risk factors for refractory and relapsed disease. The combination of GC and IM treatment was an independent protective factor against refractory and relapsed IgG4-RD. Conclusions High serum levels of sIL-2R and TNF-α may be informative risk factors for refractory and relapsed IgG4-RD. Our data suggest that a combination treatment of GC along with IM may be protective against refractory and relapsed IgG4-RD. Key Points • High sIL-2R and TNF-α levels are informative risk factors for refractory and relapsed IgG4-related disease. • Combination treatment of GC with IM protects against refractory and relapsed IgG4-related disease
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pmid33151477
doi10.1007/s10067-020-05484-8
orcididhttps://orcid.org/0000-0001-5125-6178