The clinical efficacy of azathioprine as maintenance treatment for autoimmune pancreatitis: a systematic review and meta-analysis.
The clinical efficacy of azathioprine as maintenance treatment for autoimmune pancreatitis: a systematic review and meta-analysis.
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DOI：
10.1007/s00535-021-01817-9
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发表时间：
2021-10
影响因子：
6.3
通讯作者：
Masamune A
中科院分区：
文献类型：
--
作者：
Masaki Y;Nakase H;Tsuji Y;Nojima M;Shimizu K;Mizuno N;Ikeura T;Uchida K;Ido A;Kodama Y;Seno H;Okazaki K;Nakamura S;Masamune A
硫唑嘌呤（AZA）在预防复发和维持自身免疫性胰腺炎（AIP）缓解方面的有效性已有报道;然而，这些研究大多数是病例系列研究，文献中没有随机对照试验。因此，本研究对现有文献进行了系统回顾和荟萃分析，以确定AZA作为AIP患者维持治疗的临床疗效。进行了系统检索，以确定AZA作为AIP患者维持治疗的临床疗效研究。估计粗多次复发率以评估AZA控制AIP复发的能力。使用随机效应模型和DerSimonian-Laird方法获得汇总估计值。我们确定了对初始类固醇治疗无反应的AIP患者，经历了类固醇撤机失败，或那些在缓解期间复发的难治性病例。在审查研究后，10篇文章符合纳入标准，并被选为荟萃分析。在所有4504例患者中，3534例患者接受类固醇治疗，346例患者接受AZA治疗复发性AIP。在这项荟萃分析中，14/73例（19.2%）接受AZA治疗难治性AIP的患者复发。同时，14/47例（29.8%）无AZA的患者复发。接受AZA治疗的患者复发风险的综合比值比估计为0.52（p = 0.15）。这项系统性综述和荟萃分析证明了AZA在预防AIP复发方面的疗效，这支持AZA作为AIP患者的维持治疗，这些患者在停用类固醇治疗后复发。在线版本包含补充材料，可通过10.1007/s 00535 -021-01817-9获得。
The effectiveness of azathioprine (AZA) in preventing relapse and maintaining autoimmune pancreatitis (AIP) remission has been reported; however, most of these studies are case series with no randomized control trials available in the literature. Therefore, this study performed a systematic review and meta-analysis of the existing literature on this subject to determine the clinical efficacy of AZA as maintenance therapy for AIP patients. A systematic search was performed to identify studies on the clinical efficacy of AZA as maintenance therapy in AIP patients. The crude multiple relapse rate was estimated to assess the ability of AZA to control relapses in AIP. Pooled estimates were obtained using a random-effects model with the DerSimonian-Laird method. We identified AIP patients who did not respond to initial steroid treatment, experienced steroid weaning failure, or those who relapsed during remission as refractory cases. After reviewing the studies, ten articles fulfilled the inclusion criteria and were selected for meta-analysis. Of all 4504 patients, 3534 patients were treated with steroids, and 346 patients were treated with AZA for relapsed AIP. In this meta-analysis, 14/73 (19.2%) patients receiving AZA for refractory AIP relapsed. Meanwhile, 14/47 (29.8%) patients without AZA experienced relapse. The integrated odds ratio for relapse risk in patients receiving AZA was estimated to be 0.52 (p = 0.15). This systematic review and meta-analysis demonstrated the efficacy of AZA in preventing relapse of AIP, which supports the use of AZA as a maintenance treatment in patients with AIP who relapse upon withdrawal of steroid therapy. The online version contains supplementary material available at 10.1007/s00535-021-01817-9.
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DOI：
10.1038/ajg.2014.223
发表时间：
2014-10
期刊：
The American journal of gastroenterology
影响因子：
--
作者：
Huggett MT;Culver EL;Kumar M;Hurst JM;Rodriguez-Justo M;Chapman MH;Johnson GJ;Pereira SP;Chapman RW;Webster GJM;Barnes E
通讯作者：
Barnes E
影响因子：
6.3
作者：
Kakuta Y;Kawai Y;Okamoto D;Takagawa T;Ikeya K;Sakuraba H;Nishida A;Nakagawa S;Miura M;Toyonaga T;Onodera K;Shinozaki M;Ishiguro Y;Mizuno S;Takahara M;Yanai S;Hokari R;Nakagawa T;Araki H;Motoya S;Naito T;Moroi R;Shiga H;Endo K;Kobayashi T;Naganuma M;Hiraoka S;Matsumoto T;Nakamura S;Nakase H;Hisamatsu T;Sasaki M;Hanai H;Andoh A;Nagasaki M;Kinouchi Y;Shimosegawa T;Masamune A;Suzuki Y;MENDEL study group
通讯作者：
MENDEL study group
影响因子：
2.9
作者：
Buijs, Jorie;Cahen, Djuna L.;Bruno, Marco J.
通讯作者：
Bruno, Marco J.
影响因子：
9.8
作者：
Church, Nicholas I.;Pereira, Stephen P.;Webster, George J. M.
通讯作者：
Webster, George J. M.
影响因子：
9.8
作者：
Maire, Frederique;Le Baleur, Yann;Hammel, Pascal
通讯作者：
Hammel, Pascal