|
シミズ キヨウコ
SHIMIZU Kyoko
清水 京子 所属 その他 その他 職種 非常勤嘱託 |
|
| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | The clinical efficacy of azathioprine as maintenance treatment for autoimmune pancreatitis: a systematic review and meta-analysis. |
| 掲載誌名 | 正式名：Journal of gastroenterology 略 称：J Gastroenterol ISSNコード：14355922/09441174 |
| 掲載区分 | 国内 |
| 巻・号・頁 | 56(10),pp.869-880 |
| 著者・共著者 | Masaki Yoshiharu, Nakase Hiroshi, Tsuji Yoshihisa, Nojima Masanori, Shimizu Kyoko, Mizuno Nobumasa, Ikeura Tsukasa, Uchida Kazushige, Ido Akio, Kodama Yuzo, Seno Hiroshi, Okazaki Kazuichi, Nakamura Seiji, Masamune Atsushi |
| 発行年月 | 2021/10 |
| 概要 | 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. |
| DOI | 10.1007/s00535-021-01817-9 |
| PMID | 34426870 |