{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T19:51:49Z","timestamp":1779220309498,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,3,23]],"date-time":"2018-03-23T00:00:00Z","timestamp":1521763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sporadic autoimmune pancreatitis (AIP) cases showing remission without steroid treatment have been reported, however, the clinical course of these patients has not been clarified. This study sought to clarify the clinical course in AIP patients with hesitation for steroid treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected clinical data for AIP patients from high\u2010volume centers in Japan. Data for AIP patients with and those without steroid treatment (steroid treatment vs. wait and see policy or W&amp;S) were then compared. The primary point was the relapse\u2010free survival rate (RFS) in patients with and those without steroid treatment, as determined using Kaplan\u2013Meier curve. The secondary point was the identification of predictors of remission and risks of relapse in AIP patients without steroid treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 510 AIP patients in the steroid treatment group and 97 patients in the W&amp;S group. Overall, 55.7% (54\/97) of type 1 AIP patients in the W&amp;S group experienced transient remission without steroid treatment. The W&amp;S group had a significantly higher patient age and significantly lower incidences of jaundice, diffuse pancreas swelling, proximal\u2010type sclerosing cholangitis, and stent placement and a lower remission rate than the steroid treatment group (each <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05). The RFS reached a plateau at 10\u00a0years in both the W&amp;S group (50%) and steroid treatment group (52.9%). As for the RFS (W&amp;S vs. group with steroid), 89.4% vs. 74.4% within 3\u00a0years, 81.8% vs. 65.3% within 5\u00a0years, and 50% vs. 52.9% within 10\u00a0years (log\u2010rank, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.064). Female gender (OR 0.340, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.027) and stent placement for jaundice (OR\u00a04.552, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.008) were identified as predictors of transient remission in the W&amp;S group. New\u2010onset diabetes mellitus (OR\u00a08.333, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.012) and the presence of extensive multi\u2010organ involvement (OR\u00a035, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.006) were identified as risks of relapse in the W&amp;S group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Some type 1 AIP patients without steroid treatment experience transient remission. These cases tend to have lower disease activities than AIP patients receiving steroids. Female gender and stent placement for jaundice may be predictors of transient remission among patients not receiving steroid treatment, however, relapses can occur in these patients with new\u2010onset diabetes mellitus and the presence of extensive multi\u2010organ involvement. Therefore, steroid treatment is still imperative for these patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.541","type":"journal-article","created":{"date-parts":[[2018,2,12]],"date-time":"2018-02-12T06:42:41Z","timestamp":1518417761000},"page":"223-230","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Clinical course of type 1 autoimmune pancreatitis patients without steroid treatment: a Japanese multicenter study of 97 patients"],"prefix":"10.1002","volume":"25","author":[{"given":"Kensuke","family":"Kubota","sequence":"first","affiliation":[{"name":"Department of Endoscopy Yokohama City University Hospital Yokohama Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terumi","family":"Kamisawa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Tokyo Komagome Metropolitan Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Hirano","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiki","family":"Hirooka","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Nagoya University Hospital Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazushige","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Hirakata Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsukasa","family":"Ikeura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Hirakata Osaka 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retroperitoneal fibrosis and sclerosing cholangitis independent of autoimmune pancreatitis. A recurrent case after a 5\u2010year history of spontaneous remission","volume":"10","author":"Miura H","year":"2009","journal-title":"JOP"}],"container-title":["Journal of Hepato-Biliary-Pancreatic Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjhbp.541","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhbp.541","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T15:44:32Z","timestamp":1695570272000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jhbp.541"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,23]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1002\/jhbp.541"],"URL":"https:\/\/doi.org\/10.1002\/jhbp.541","archive":["Portico"],"relation":{},"ISSN":["1868-6974","1868-6982"],"issn-type":[{"value":"1868-6974","type":"print"},{"value":"1868-6982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,23]]},"assertion":[{"value":"2018-03-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}