{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:50:08Z","timestamp":1791283808181,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"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 Intern Med"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>In retroperitoneal fibrosis (RPF), glucocorticoids (GC), alone or in combination with immunosuppressive agents, induce remission in 80%\u201390% of patients but up to two thirds of them relapse. There is limited knowledge on outcome predictors in RPF. We aimed to identify clinical, laboratory and imaging predictors of remission and relapse in RPF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included consecutive RPF patients treated with 6\u20139\u2010month courses of GC with\/without immunosuppressive agents. Baseline and post\u2010treatment computed tomography, magnetic resonance imaging and <jats:sup>18<\/jats:sup>F\u2010fluorodeoxyglucose (<jats:sup>18<\/jats:sup>F\u2010FDG) positron emission tomography (PET) were assessed. The potential predictive value of the examined parameters as predictors of remission and time\u2010to\u2010relapse was analysed using logistic and Cox regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 152 patients screened, 115 were included. Of them, 101 (87.8%) achieved remission a median of 4 months (interquartile range 3\u20135) after starting treatment. At multivariable analysis, smoking (odds ratio [OR] 0.34, 95% confidence interval [CI] 0.11\u20130.99) and atypical RPF localization (e.g., pelvic) (OR 0.11, 95% CI 0.02\u20130.52) were negatively associated with remission, whereas pre\u2010treatment <jats:sup>18<\/jats:sup>F\u2010FDG\u2010PET activity was positively associated (OR 11.51, 95% CI 1.35\u201398.20). A median of 33 months (17\u201357) after treatment initiation, 42% patients relapsed (median time from remission to relapse, 14 months [8\u201326]). Thoracic vessel involvement and positive <jats:sup>18<\/jats:sup>F\u2010FDG\u2010PET at the end of treatment independently predicted relapse (hazard ratio [HR] 2.61, 95% CI 1.19\u20135.68 and HR 3.47, 95% CI 1.54\u20137.82, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Metabolic activity of RPF at <jats:sup>18<\/jats:sup>F\u2010FDG\u2010PET is an important predictor of remission and relapse. Smoking and atypical localization are negatively associated with remission, whereas thoracic aorta involvement is associated with relapse risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joim.70017","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:43:44Z","timestamp":1756277024000},"page":"438-449","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Predictors of remission and relapse in retroperitoneal fibrosis"],"prefix":"10.1111","volume":"298","author":[{"given":"Milena","family":"Bond","sequence":"first","affiliation":[{"name":"Department of Rheumatology Hospital of Bruneck (ASAA\u2010SABES) Teaching Hospital of the Paracelsius Medical University  Brunico Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Bettiol","sequence":"additional","affiliation":[{"name":"Department of Biomedical Experimental and Clinical Sciences \u2018Mario Serio\u2019 University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenia Accorsi","family":"Buttini","sequence":"additional","affiliation":[{"name":"Unit of Blood Diseases and Bone Marrow Transplantation Cell Therapies and Haematology Research Program Department of Clinical and Experimental Science ASST Spedali Civili di Brescia University of Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Trivioli","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Palazzini","sequence":"additional","affiliation":[{"name":"Department of Biomedical Experimental and Clinical Sciences \u2018Mario Serio\u2019 University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Fibbi","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit Meyer Children's Hospital IRCCS  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelangelo","family":"Tesi","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit Meyer Children's Hospital IRCCS  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Biancalana","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Dejaco","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Hospital of Bruneck (ASAA\u2010SABES) Teaching Hospital of the Paracelsius Medical University  Brunico Italy"},{"name":"Division of Rheumatology and Clinical Immunology Department of Internal Medicine Medical University of Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Emmi","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical and Health Sciences University of Trieste  Trieste Italy"},{"name":"Clinical Medicine and Rheumatology Unit Cattinara University Hospital  Trieste Italy"},{"name":"Centre for Inflammatory Diseases Monash Medical Centre Monash University Department of Medicine  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto","family":"Vaglio","sequence":"additional","affiliation":[{"name":"Department of Biomedical Experimental and Clinical Sciences \u2018Mario Serio\u2019 University of Florence  Florence Italy"},{"name":"Nephrology and Dialysis Unit Meyer Children's Hospital IRCCS  Florence 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