Monitoring and predicting disease activity in autoimmune pancreatitis with the M-ANNHEIM-AiP-Activity-Score

• Verfasst von: Hirth, Michael [VerfasserIn]
• Verfasst von: Vujasinovic, Miroslav [VerfasserIn]
• Verfasst von: Münch, Markus [VerfasserIn]
• Verfasst von: Weiß, Christel [VerfasserIn]
• Verfasst von: Ebert, Matthias [VerfasserIn]
• Verfasst von: Schneider, Alexander [VerfasserIn]
• Titel: Monitoring and predicting disease activity in autoimmune pancreatitis with the M-ANNHEIM-AiP-Activity-Score
• Verf.angabe: Michael Hirth, Miroslav Vujasinovic, Markus Münch, Christel Weiss, Matthias Löhr, Matthias P. Ebert, Alexander Schneider
• Jahr: 2018
• Jahr des Originals: 2017
• Umfang: 10 S.
• Fussnoten: Available online 25 October 2017 ; Gesehen am 12.07.2018
• Titel Quelle: Enthalten in: Pancreatology
• Ort Quelle: Amsterdam : Elsevier, 2001
• Jahr Quelle: 2018
• Band/Heft Quelle: 18(2018), 1, Seite 29-38
• ISSN Quelle: 1424-3911
• DOI: doi:10.1016/j.pan.2017.10.005
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Autoimmune pancreatitis
• Sach-SW: Disease activity
• Sach-SW: Disease monitoring
• Sach-SW: Score
• K10plus-PPN: 1577548388

Abstract

Background & objectives: Autoimmune pancreatitis (AiP) is treated by immunosuppressive therapy. Exact description of disease activity of AiP is essential in clinical practice and research, but a score to describe the disease activity is missing. Thus, we aimed to establish an activity score of AiP. Methods: We retrospectively studied long-term disease courses of 29 patients with AiP (Mannheim, Germany), receiving corticosteroid treatment (CST) by analyzing 613 treatment appointments. Two assumptions were made: First, disease activity is higher at emergency treatments; second, disease activity drops under CST. In all patients, we evaluated established activity- and classification-systems of chronic pancreatitis (cP). Based on the most suitable system, we established an activity score of AiP by including AiP-specific parameters identified from our long-term disease courses and the literature. The new AiP-specific activity score was validated in an external cohort of 14 patients with AiP (Stockholm, Sweden). Results: Within published activity indexes of cP, the M-ANNHEIM-classification most significantly correlated with emergency- and treatment-dependent disease activities (p < 0.001 and p < 0.01, conditional-logistic-regression-analysis). Significant correlations of disease activity were found for several clinical parameters (biliary involvement, extrapancreatic lesions, acute pancreatitis, focal pancreatic mass, pancreatic sausage/mass, focal enlargement, ascites; p < 0.05, Wilcoxon-signed-rank-test). Based on these data and disease features from the literature, the M-ANNHEIM-AiP-Activity-Score (MAAS) was established. CST-induced reduction of MAAS disease activity of more than 60% was associated with lower relapse rates (p < 0.05; Chi-Square-test). The results were validated in the external patient cohort. Conclusion: The MAAS might represent a useful tool to monitor AiP.