European Journal of Biomedical and Pharmaceutical Sciences

MAINTENANCE CORTICOSTEROIDS THERAPY REDUCING THE RISK OF RELAPSE FOR IGG4-RELATED DISEASE: SYSTEMATIC REVIEW AND META-ANALYSIS

Dina Omar, Yishu Huang, Hasan A. M. M. Almansoub and Lingli Dong*

ABSTRACT

Objectives: To estimate the efficacy of maintenance corticosteroids therapy in patients with IgG4- related disease (IgG4-RD). Methods: Medical databases of MEDLINE/PubMed, EMBASE and Web of Science were systematically searching by using "IgG4 related disease" or "IgG4 related diseases" or "Autoimmune pancreatitis" or "Immunoglobulin G4 related disease" AND "Glucocorticoids" or "adrenal cortex hormones " or prednisone " or "methylprednisolone" or "Hydrocortisone " or " Dexamethasone used Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines during the preparation of this review. Results:11 studies 907 IgG4 -RD patients were included in our studies. The overall effect estimates favored maintenance therapy in term of relapse episodes (RR 1.92, 95% CI [1.63, 2.26]; p <0.001;). The pooled effect estimate was homogenous (p >0.1). Similarly, the overall effect estimates favored maintenance therapy in term of improvement rate (RR 0.75, 95% CI [0.70, 0.80]; p <0.001;). The pooled analyses were highly heterogeneous (p <0.1). However, no significant difference was detected between both groups in terms of number of organs with relapse episodes (RR 1.10 [0.71, 1.70]; p =0.066;) and IgG4 elevation levels (SMD 0.01, 95% CI [-0.77, 0.79]; p =0.99;). The pooled analyses were highly heterogeneous (p <0.1). Conclusion: Maintenance corticosteroid therapy plays an essential role in reducing the risk of relapse in IgG4-RD. The heterogeneity of the studies published until now means that more studies are needed to evaluate its necessity better.

Keywords: IgG4 related disease, corticosteroids, maintenance therapy, induction therapy, Relapse.