LAUSR

OBJECTIVES Few studies have examined factors affecting steroid-free remission (SFR) in those with immunoglobulin G4-related disease (IgG4-RD). The aim of this study was to investigate clinical factors affecting SFR in IgG4-RD. METHODS The medical records of 68 patients who met the 2020 revised comprehensive diagnostic criteria for IgG4-RD were reviewed retrospectively. SFR was defined as remission maintained for at least six months without corticosteroids. Cox regression analysis was performed to examine the associations between SFR and various clinical factors. The relapse rate after SFR was examined using the log-rank test. RESULTS After a median follow-up of 36 months, 30.9% (21/68) patients with IgG4-RD achieved SFR. Multivariate Cox regression analysis revealed that IgG4-RD diagnosed by complete resection rather than by common diagnostic procedures was the only factor positively associated with SFR (HR, 7.41; 95% CI, 2.23-24.60; p = 0.001). Furthermore, relapse after attainment of SFR was significantly less common in the group that underwent complete resection than in the group that did not undergo complete resection (log-rank p = 0.006). CONCLUSIONS Patients with IgG4-RD diagnosed by complete resection had a higher likelihood of achieving SFR, and a lower rate of relapse after attaining SFR.