Lanzillotta Marco, Vinge-Holmquist Olof, Overbeek Kasper A, Poulsen Jakob L, Demirci A Fatih, Macinga Peter, Löhr Matthias, Rosendahl Jonas
Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), San Raffaele Scientific Institute, Milan, Italy.
Department of Gastroenterological Surgery, Akershus University Hospital, Loerenskog, Norway.
Front Med (Lausanne). 2020 Aug 5;7:408. doi: 10.3389/fmed.2020.00408. eCollection 2020.
Treatment of autoimmune pancreatitis (AIP) is based solely on consensus and has yet to become standardized. Consequently, therapeutic regimens vary greatly between countries and centers, and largely depend on the experience of the physician. At this moment, the optimal regimen for inducing disease remission and preventing relapse is unknown. The primary objective of this study is to describe current treatment regimens used in Europe, and to compare their effectiveness in inducing remission and preventing and treating relapse. The secondary objectives are: to identify risk factors for relapse; to assess the diagnostic accuracy of the Unified-AIP criteria; to assess the performance of the M-ANNHEIM score for predicting relapse; and to assess long-term outcomes including pancreatic exocrine insufficiency and pancreatic cancer. This is an international, retrospective, observational cohort study, performed in over 40 centers from 16 European countries. Eligible are all patients diagnosed with AIP from 2005 onwards, regardless of the used diagnostic criteria. Data on study subjects will be retrieved from the hospital's electronic medical records and registered with a standardized, web-based, electronic case report form (eCRF). To compare the effectiveness of treatment regimens in inducing remission, preventing relapse, and treating relapse, subjects will be stratified in groups based on: type of therapy; initial therapy dose; cumulative therapy dose; therapy tapering speed and duration; and having received maintenance therapy or not. Ethical and/or institutional review board approvals are obtained by all participating centers according to local regulations. The study complies with the General Data Protection Regulation (GDPR). All manuscripts resulting from the study will be submitted to peer-reviewed journals. This is the first pan-European retrospective registry for AIP. It will produce the first large-scale data on treatment of European patients with AIP, providing answers on the use and effectiveness of treatment regimens. In the future, this collaboration may provide a network for continuation into a prospective European registry.
自身免疫性胰腺炎(AIP)的治疗仅基于共识,尚未实现标准化。因此,各国和各中心的治疗方案差异很大,并且在很大程度上取决于医生的经验。目前,诱导疾病缓解和预防复发的最佳方案尚不清楚。本研究的主要目的是描述欧洲目前使用的治疗方案,并比较它们在诱导缓解、预防和治疗复发方面的有效性。次要目的包括:确定复发的危险因素;评估统一AIP标准的诊断准确性;评估M-ANNHEIM评分预测复发的性能;以及评估包括胰腺外分泌功能不全和胰腺癌在内的长期结局。这是一项国际、回顾性、观察性队列研究,在来自16个欧洲国家的40多个中心进行。符合条件的是2005年以后诊断为AIP的所有患者,无论使用何种诊断标准。研究对象的数据将从医院的电子病历中获取,并通过标准化的基于网络的电子病例报告表(eCRF)进行登记。为了比较治疗方案在诱导缓解、预防复发和治疗复发方面的有效性,将根据以下因素将受试者分层分组:治疗类型;初始治疗剂量;累积治疗剂量;治疗减量速度和持续时间;以及是否接受维持治疗。所有参与中心均根据当地法规获得伦理和/或机构审查委员会的批准。本研究符合《通用数据保护条例》(GDPR)。该研究产生的所有手稿都将提交给同行评审期刊。这是首个针对AIP的泛欧洲回顾性登记研究。它将产生关于欧洲AIP患者治疗的首批大规模数据,为治疗方案的使用和有效性提供答案。未来,这种合作可能会提供一个网络,以便延续为前瞻性的欧洲登记研究。