The long-term impact of autoimmune pancreatitis on pancreatic function, quality of life, and life expectancy

Abstract

Objective: To evaluate the long-termoutcome of autoimmune pancreatitis. Methods: Patients with at least 2 years of follow-up were included. Information was collected regarding disease characteristics, treatment outcome, diagnosedmalignancies, andmortality. In addition, pancreatic function and quality of life were assessed prospectively. Results: 107 patients were included (87% men, 90% with type 1), with a median follow-up of 74 (interquartile range, 49-108) months. One third was operated for suspected pancreatic cancer (32%). Most patients were (successfully) treated with steroids (83%), but relapses were common (52%), for which no risk factors could be identified. Pancreatic carcinoma was not observed. Prospective data were obtained from 64%, as 17% had died, 7% were lost to follow-up, and 13% refused to participate. After a median of 75 (interquartile range, 50-106) months, 46% still used active treatment. Exocrine and endocrine insufficiencieswere highly prevalent (82%and 57%, respectively). Quality of life and survival were not impaired, as compared with a reference population. Conclusions: Despite an excellent initial treatment response, relapses are common, even in type 2, and almost half of the patients require maintenance therapy. Pancreatic insufficiency is highly prevalent, which calls for active screening. Pancreatic cancer was not observed, and quality of life and survival are not impaired.