Autoimmune pancreatitis: rituximab tops azathioprine and methotrexate for preventing relapse

  • Soliman H & al.
  • United European Gastroenterol J
  • 1 Oct 2019

  • International Clinical Digest
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Takeaway

  • Rituximab is more efficient and better tolerated than the immunomodulatory drugs (IMs), azathioprine and methotrexate, for treating relapsing autoimmune pancreatitis (AIP).

Why this matters

  • AIP patients who have frequent relapses, cannot tolerate high-dose steroids, or cannot wean from steroids without disease recurrence are likely to benefit from rituximab or IM treatment.

Study design

  • Researchers analysed the health records of patients treated for AIP (type 1: n=92; men, 76.4%; median age at diagnosis, 58 years; type 2: n=70; men, 50.7%; median age at diagnosis, 32 years).
  • Funding: None.

Key results

  • Relapse rate was 46.5% for type 1 patients and 12.5% for type 2 patients.
  • Treatment with IM prevented relapse in 67% (14) of 21 patients (median follow-up, 17 [range, 3-66] months).
  • Treatment with rituximab prevented relapse in 94.1% (16) of 17 patients (P=.03; median follow-up, 20 [range, 11-44] months).

Limitations

  • The study was retrospective with small sample size and long recruitment period.

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