Actualización en el uso de corticoides como terapia de mantenimiento en pacientes con pancreatitis autoinmune

Abstract

Background: autoimmune pancreatitis (AIP) has a prevalence of 4.6/100,000 and an incidence of 1.4/100,000 in Japan. Type 1 predominates in the East, with 96% of cases in Japan and 80% in Europe and the USA. Objective: to describe the use of corticosteroids as maintenance therapy in patients with autoimmune pancreatitis. Methodology: a narrative literature review was carried out, including 11 scientific articles collected from different databases such as Medline, Lilacs, TripDataBase, Cochrane Library, Epistemonikos, Scopus, by means of identification-typing-eligibility-selection. Results: the studies reveal the efficacy of corticosteroids in maintenance therapy of IAP, achieving up to 92.6% of remission. They are associated with a significant decrease in pancreatic cyst diameter, higher response rates and greater cyst disappearance within one year. Relapse rates vary with treatment duration, being lower with prolonged treatment and routine use of glucocorticoid maintenance therapy. They are associated with a lower incidence of severe calcification in the pancreatic head. In addition, predictors of relapse are identified, such as high autotaxin levels, involvement of other organs, multiple involvement, high IgG levels and lack of maintenance therapy, providing vital information for the management of IAP.