{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T15:46:54Z","timestamp":1782748014111,"version":"3.54.5"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005089","name":"Natural Science Foundation of Beijing Municipality","doi-asserted-by":"publisher","award":["7232113"],"award-info":[{"award-number":["7232113"]}],"id":[{"id":"10.13039\/501100005089","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2703104"],"award-info":[{"award-number":["2022YFC2703104"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82071839"],"award-info":[{"award-number":["82071839"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271848"],"award-info":[{"award-number":["82271848"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp;amp; Rheumatology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate longitudinal serum IgG dynamics in IgG4\u2010related disease (IgG4\u2010RD) after treatment and assess their prognostic value for relapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort of 274 newly treated patients with IgG4\u2010RD was stratified into elevated IgG (n\u00a0=\u00a0186) and normal IgG (n\u00a0=\u00a088) groups. Treatment responses were evaluated by covariance analysis adjusted for baseline IgG. Longitudinal IgG trends and relapse risk were analyzed using Kaplan\u2013Meier curves and Cox regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Elevated baseline IgG level was associated with more severe phenotypes, including male predominance, older age, higher responder index scores, more internal organ involvement, hypocomplementemia, and elevated erythrocyte sedimentation rate\/C\u2010reactive protein level. IgG1 and IgG4 mainly contributed to IgG elevation. After treatment, 79.6% of patients with elevated IgG levels achieved normalization, with the greatest decline in the first year. Glucocorticoid (GC)\u2013based regimens reduced IgG levels more effectively than GC\u2010sparing therapies and achieved higher normalization rates (85.2% vs 66.7%). Twelve\u2010month IgG normalization strongly predicted reduced relapse risk. Patients achieving IgG normalization had lower relapse rates (17.9% vs 44.1%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.001) and superior relapse\u2010free survival (mean 33.20 [95% CI 32.21\u201334.19] vs 27.71 [95% CI 24.29\u201331.13] months; log\u2010rank\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multivariate Cox regression confirmed failure of 12\u2010month IgG normalization (hazard ratio [HR] 2.67 [95% CI 1.43\u20134.99],\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.002) and treatment intensity (GCs\u2009+\u2009weak immunosuppressants [IMs]: HR 0.36,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.012; GCs\u2009+\u2009potent IMs: HR 0.40,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.020, vs GC\u2010sparing) as independent relapse determinants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Baseline IgG elevation marks more severe IgG4\u2010RD phenotypes. The first treatment year achieving IgG normalization represents a critical prognostic biomarker. Failure to normalize IgG within 12 months markedly increases relapse risk. Longitudinal IgG monitoring supports risk stratification and treatment optimization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.70056","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T14:26:52Z","timestamp":1768228012000},"page":"1500-1511","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["First\u2010Year\n                    <scp>IgG<\/scp>\n                    Dynamics in\n                    <scp>IgG4<\/scp>\n                    \u2010Related Disease: A Critical Window for Predicting Long\u2010Term Outcomes"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8470-0076","authenticated-orcid":false,"given":"Xin","family":"He","sequence":"first","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Chinese Academy of Medical Science &amp; Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases  Beijing China"},{"name":"Department of Medical Oncology National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Chinese Academy of Medical Science &amp; Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6595-0803","authenticated-orcid":false,"given":"Yuxue","family":"Nie","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Chinese Academy of Medical Science &amp; Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6712-0378","authenticated-orcid":false,"given":"Jingna","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Chinese Academy of Medical Science &amp; Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyuan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Chinese Academy of Medical Science &amp; Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nianyi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Chinese Academy of Medical Science &amp; Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Chinese Academy of Medical Science &amp; Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinli","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Chinese Academy of Medical Science &amp; Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jialei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Chinese Academy of Medical Science &amp; Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Chinese Academy of Medical Science &amp; Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Chinese Academy of Medical Science &amp; Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases  Beijing China"},{"name":"Department of Rheumatology Xuzhou Central Hospital  Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1728-2342","authenticated-orcid":false,"given":"Yunyun","family":"Fei","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Chinese Academy of Medical Science &amp; 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