Risk factors for IgG4‐related disease relapse: A systematic review and meta‐analysis

Abstract

AbstractIgG4‐related disease (IgG4‐RD) is an autoimmune disease involving multiple organs with unique pathological features and has high relapse rates after treatment. Identifying patients at high risk of disease relapse for targeted treatment with long‐term and low‐dose glucocorticoid maintenance therapy is crucial for formulating rational treatment strategies. In this study, we conducted a meta‐analysis of relevant articles to explore the risk factors for IgG4‐RD relapse. We searched the Medline (via PubMed), EMBASE, Web of Science and Cochrane Library databases and extracted the mean and standard deviation of continuous variables and true‐positive (TP), false‐positive (FP), false‐negative (FN) and true‐negative (TN) rates to construct a 2 × 2 contingency table from dichotomous variables, and hazard ratios (HRs) were calculated from univariate and multivariate analyses. Finally, we identified five indicators (elevated baseline serum IgG4 level, eosinophil count, increased multiple organ involvement, history of allergy and proximal bile duct stenosis) as risk factors for IgG4‐RD relapse. These results provide new ideas and directions for more researchers to study the relapse of IgG4‐RD and offer reasonable suggestions for clinicians to select IgG4‐RD patients for low‐dose glucocorticoid maintenance therapy to reduce their relapse rates.