Informace o publikaci

Maintenance Treatment for Type 1 Autoimmune Pancreatitis: Effectiveness and Development of the PrescrAIP Relapse Prediction Model

Autoři	LANZILLOTTA Marco MACINGA Peter POULSEN Jakob L VINGE-HOLMQUIST Olof DEMIRCI A Fatih TACELLI Matteo BACKHUS Johanna ALGÜL Hana DESCOURVIERES Clémence KIRIUKOVA Mariia GONI Elisabetta HOLLENBACH Marcus MIKSCH Rainer C KUNOVSKÝ Lumír VUJASINOVIC Miroslav NIKOLIC Sara DICKERSON Luke HIRTH Michael NEURATH Markus F ZUMBLICK Malte VILA Josephine JALAL Mustafa BEYER Georg FROST Fabian CARRARA Silvia KALA Zdeněk JABANDŽIEV Petr SISMAN Gurhan AKYUZ Filiz CAPURSO Gabriele FALCONI Massimo ARLT Alexander VLEGGAAR Frank P BARRESI Luca GREENHALF Bill CZAKÓ László HEGYI Peter HOPPER Andrew NAYAR Manu K GRESS Thomas M VITALI Francesco SCHNEIDER Alexander HALLORAN Chris M TRNA Jan OKHLOBYSTIN Alexey V DAGNA Lorenzo CAHEN Djuna L BORDIN Dmitry REBOURS Vinciane MAYERLE Julia KAHRAMAN Alisan RASCH Sebastian CULVER Emma KLEGER Alexander MARTÍNEZ-MONEO Emma HUCL Tomas OLESEN Soren S BRUNO Marco J BEUERS Ulrich DELLA-TORRE Emanuel LÖHR J Matthias ROSENDAHL Jonas OVERBEEK Kasper A
Rok publikování	2026
Druh	Recenzovaný odborný článek
Časopis / Zdroj	Clinical Gastroenterology and Hepatology
Fakulta / Pracoviště MU	Lékařská fakulta
Citace
www	https://www.sciencedirect.com/science/article/abs/pii/S1542356525007955
Doi	https://doi.org/10.1016/j.cgh.2025.09.005
Klíčová slova	type 1 autoimmune pancreatitis; maintenance therapy; relapse prediction; PrescrAIP model; treatment effectiveness
Popis	Background & Aims Type 1 autoimmune pancreatitis (AIP) is a relapsing remitting disorder that often requires multiple treatment courses. Our aims were to assess the efficacy of maintenance treatment in preventing relapse and to develop the PrescrAIP risk score predicting relapse risk and the benefit of maintenance treatment. Methods We retrospectively analyzed patients meeting international diagnostic criteria for type 1 AIP who reached partial or complete remission after initial treatment. The primary outcome was disease relapse, defined as recurrence of symptoms and/or radiologic findings. We developed a multivariable prediction model using Cox proportional hazards regression, performed internal and internal-external validation, and built a predictive nomogram. Results We included 577 patients (68% male). During a median follow-up of 34 months (interquartile range, 13–69 months), we observed 154 relapses. The overall 3-year relapse risk was 28% (95% confidence interval [CI], 24%–32%), lower in patients receiving maintenance treatment than in those without (22% vs 35%; P < .001). The final PrescrAIP model incorporated protective factors (maintenance treatment, prior surgery, focal mass, female sex) and risk factors (biliary involvement, other organ involvement, IgG4 elevation, allergy, jaundice, acute pancreatitis). The model showed moderate discrimination (Concordance index, 0.69) and good calibration. Internal-external validation yielded Concordance index values ranging from 0.64 to 0.71. Maintenance treatment significantly reduced relapse in patients with a PrescrAIP score >155, but not in those with lower scores. Conclusion Maintenance therapy reduced relapse only in patients at high relapse risk. Once externally validated, the PrescrAIP score may guide personalized maintenance treatment decisions.