{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T09:54:28Z","timestamp":1767866068051,"version":"3.49.0"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T00:00:00Z","timestamp":1653436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The acceptable duration of steroid therapy for patients with IgG4\u2010sclerosing cholangitis (SC) has been under debate. Our aim is to clarify the feasible duration of steroid treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We retrospectively reviewed the data of patients with IgG4\u2010SC and analyzed the following: biliary status during the steroid therapy, incidence of remission, relapse, relapse\u2010free survival rate, and steroid\u2010related complications (SRCs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Remission was achieved in 99.5% (763\/767) of patients who received steroid therapy, while the remission rate dropped to 63.6% (78\/129) of patients who did not receive it. Relapse was noted in 19.7% (151\/763) of the patients who received steroid. Besides, relapse rate went up 38.4% (30\/78) of the counterpart. Normalization of the serum total bilirubin and serum alkaline phosphatase levels were achieved at 2\u2009weeks regardless of biliary drainage. Multivariate analysis identified younger onset, MST less than 3\u2009years, immunosuppressant, and steroid cessation as independent risk factors for relapse. Steroid\u2010free was achieved in the patients underwent MST only 3.4% over 54\u2009months. SRCs were recorded in a total of 99 patients (12.9%) despite sufficient preemptive medications. Multivariate analysis identified history of malignancy and immunosuppressant as independent risk factors for SRCs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Steroid therapy should be continued for no &lt;3\u2009years to reduce the risk of relapse, with use of preemptive measures taken around 5\u2009years. The biliary drainage might not be mandatory. Steroid as 1st line therapy could serve as a bridge to further promising treatments.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.1157","type":"journal-article","created":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T23:52:55Z","timestamp":1650671575000},"page":"884-897","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Steroid therapy still plays a crucial role and could serve as a bridge to the next promising treatments in patients with <scp>IgG4<\/scp>\u2010related sclerosing cholangitis: Results of a Japanese nationwide study"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6767-0410","authenticated-orcid":false,"given":"Kensuke","family":"Kubota","sequence":"first","affiliation":[{"name":"Endoscopic Unit Yokohama City University Hospital  Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terumi","family":"Kamisawa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Tokyo Metropolitan, Komagome Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6321-5995","authenticated-orcid":false,"given":"Takahiro","family":"Nakazawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6358-5283","authenticated-orcid":false,"given":"Atsushi","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Medicine Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8342-886X","authenticated-orcid":false,"given":"Itaru","family":"Naitoh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajime","family":"Takikawa","sequence":"additional","affiliation":[{"name":"Faculty of Medical Technology Teikyo University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2145-6416","authenticated-orcid":false,"given":"Michiaki","family":"Unno","sequence":"additional","affiliation":[{"name":"Department of Surgery Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeyuki","family":"Kawa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Matsumoto Dental University  Shiojiri Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Masamune","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seiji","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Section of Oral and Maxillofacial Oncology Division of Maxillofacial Diagnostic and Surgical Sciences Faculty of Dental Science, Kyushu University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuichi","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kansai Medical University Kori Hospital  Neyagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Collaborators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e328341a240"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2008.172908"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-303617"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201657"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640620934911"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1012926"},{"key":"e_1_2_7_8_1","first-page":"9","article-title":"Clinical practice guidelines for IgG4\u2010related sclerosing cholangitis","volume":"26","author":"Kamisawa T","year":"2019","journal-title":"JHBPS"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2016.03.017"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302886"},{"key":"e_1_2_7_11_1","first-page":"598","article-title":"Epidemiological features of immunoglobulin G4\u2010related sclerosing cholangitis in Japan","volume":"27","author":"Tanaka A","year":"2020","journal-title":"JHBPS"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2021.02.009"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010018\u201028405\u2010x"},{"key":"e_1_2_7_14_1","first-page":"536","article-title":"Clinical diagnostic criteria of IgG4\u2010related sclerosing cholangitis 2012","volume":"19","author":"Ohara H","year":"2012","journal-title":"JHBPS"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpa.0000202941.85955.07"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001347.pub2"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312049"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu228"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.09.051"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39132"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.03.034"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kez380"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-206605"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.02.049"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000000440"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-016-1302-1"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2015.1054424"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e3182433d77"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.12.009"}],"container-title":["Journal of Hepato-Biliary-Pancreatic Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhbp.1157","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jhbp.1157","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhbp.1157","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T07:13:08Z","timestamp":1756883588000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jhbp.1157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,25]]},"references-count":28,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1002\/jhbp.1157"],"URL":"https:\/\/doi.org\/10.1002\/jhbp.1157","archive":["Portico"],"relation":{},"ISSN":["1868-6974","1868-6982"],"issn-type":[{"value":"1868-6974","type":"print"},{"value":"1868-6982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,25]]},"assertion":[{"value":"2022-01-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}