{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T06:36:47Z","timestamp":1778567807090,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"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 of Gastro and Hepatol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Type 1 autoimmune pancreatitis (AIP) is a form of pancreatitis that responds well to glucocorticoid therapy and often results in clinical and radiological remission. However, AIP frequently relapses during long\u2010term follow\u2010up. While initial relapse is well described, repeated relapses are poorly understood. This study aimed to clarify their clinical features and predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 270 patients diagnosed with type 1 AIP between 2004 and 2022 across 12 institutions. Clinical characteristics were compared among the non\u2010relapse, single\u2010relapse, and multiple\u2010relapse groups. Predictors of a second relapse were assessed in patients who experienced at least one relapse using Kaplan\u2013Meier and Cox regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During a median follow\u2010up of 65\u2009months, 107 patients (40%) experienced at least one relapse, and 32 (12%) had multiple relapses. The median time to second relapse was 49\u2009months, and the cumulative second relapse rate reached 47.4% at 7\u2009years. Multivariable analysis identified extra\u2010pancreatic sclerosing cholangitis at first relapse as an independent predictor of a second relapse (hazard ratio, 2.773; 95% confidence interval, 1.294\u20135.941;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). Furthermore, 61% of patients whose first relapse involved the extra\u2010pancreatic bile duct experienced multiple relapses, often at the same site, and 73% of them were still on glucocorticoid therapy at the second relapse.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Second and subsequent relapses are common in type 1 AIP, and are particularly likely when the first relapse involves extra\u2010pancreatic sclerosing cholangitis. These patients may require more intensive monitoring and treatment beyond glucocorticoid monotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.70125","type":"journal-article","created":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T13:54:43Z","timestamp":1760795683000},"page":"3030-3038","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Profile and Predictors of Repeated Relapse in Type 1 Autoimmune Pancreatitis: A Multicenter Observational Study"],"prefix":"10.1111","volume":"40","author":[{"given":"Sho","family":"Saeki","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Biomedical &amp; Health Sciences Hiroshima University  Hiroshima Japan"},{"name":"Department of Gastroenterology National Hospital Organization Higashihiroshima Medical Center  Higashihiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3545-8743","authenticated-orcid":false,"given":"Yasutaka","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Biomedical &amp; Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiji","family":"Hanada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Onomichi General Hospital  Onomichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamito","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Hiroshima Prefectural Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshifumi","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Hiroshima General Hospital  Hatsukaichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6916-4108","authenticated-orcid":false,"given":"Atsushi","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saiseikai Hiroshima Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Hirao","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hiroshima City Hiroshima Citizens Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bunjiro","family":"Noma","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kure Kyosai Hospital  Kure Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Minami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Hiroshima Red Cross &amp; Atomic\u2010bomb Survivors Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihito","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer Center  Kure Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanobu","family":"Yukutake","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Hiroshima City North Medical Center Asa Citizens Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teruo","family":"Mouri","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Chugoku Rosai Hospital  Kure Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryota","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology National Hospital Organization Higashihiroshima Medical Center  Higashihiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Biomedical &amp; Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juri","family":"Ikemoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Biomedical &amp; Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaru","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Biomedical &amp; Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1652-0743","authenticated-orcid":false,"given":"Shiro","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Biomedical &amp; Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34593"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60720-0"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-303617"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-016-1302-1"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312049"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-022-01857-9"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-023-02939-5"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2008.172908"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.12.009"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000000440"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.325"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-011-0393-y"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000001007"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.541"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000001173"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2019.1577489"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640620934911"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2024.01.006"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e3182142fd2"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.913"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.12147"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2015.1054424"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27435"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302886"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0183844"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640619862459"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/272595"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.223"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.12.038"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.70125","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T09:24:35Z","timestamp":1764581075000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.70125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,18]]},"references-count":29,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/jgh.70125"],"URL":"https:\/\/doi.org\/10.1111\/jgh.70125","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,18]]},"assertion":[{"value":"2025-08-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}