Randomised controlled trial of long-term maintenance corticosteroid therapy in patients with autoimmune pancreatitis

We read with great interest the article by Masamune et al1 regarding the role of long-term maintenance corticosteroids in patients with autoimmune pancreatitis (AIP).1 AIP is a steroid responsive disorder, which has two distinct entities with overlapping features, classified as type I and type II AIP. While type I AIP is a part of a spectrum of IgG4-related disease with extrapancreatic manifestations, type II is a pancreas-specific disease. The diagnostic criteria, treatment approach and prognosis are different between the two types. Masamune et al demonstrated that corticosteroid treatment for a prolonged period of 3 years reduces rates of relapse when compared with patients who discontinued steroid treatment at 26 weeks. The authors have showed that the two treatment groups are comparable at baseline with regard to clinical, radiological and serological characteristics. However, the authors do not reveal the distribution of the two different types of...