| Title |
IgG4-Related Disease: Beyond Glucocorticoids
|
|---|---|
| Published in |
Drugs & Aging, March 2018
|
| DOI | 10.1007/s40266-018-0534-6 |
| Pubmed ID | |
| Authors |
Mitsuhiro Akiyama, Tsutomu Takeuchi |
| Abstract |
IgG4-related disease is a heterogeneous immune-mediated fibroinflammatory condition that can affect every single organ. This disease is more prevalent in the elderly (the mean age of patients is above 60 years) and the prevalence rate is estimated to be over 4.6 per 100,000 population. Before making a diagnosis, the exclusion of malignancies, lymphoma, anti-neutrophil cytoplasmic antibody-associated vasculitis, multicentric Castleman disease, and other mimickers is crucial for appropriate treatment. Broad management guidelines have been published emphasizing the need for prompt treatment and the use of glucocorticoids as first-line drug therapy for induction of remission. However, the toxic effects of glucocorticoids are problematic because IgG4-related disease is more prevalent in patients above 60 years of age, a population with frequent comorbid conditions and polypharmacy. Immunosuppressants (cyclophosphamide, methotrexate, leflunomide, and tacrolimus) and targeted immunomodulators (rituximab, XmAb5871, and abatacept) are appealing to overcome potential toxic effects of glucocorticoids and as emerging glucocorticoid-sparing and/or maintenance treatments. In this review, we provide an overview of our understanding of the pathophysiology of the disease (T follicular helper cells, CD4+cytotoxic T cells, plasmablasts, and alternatively activated M2 macrophages) and clinical characteristics, and highlight the potential targets for treatment intervention. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 27 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 5 | 19% |
| Student > Ph. D. Student | 3 | 11% |
| Professor | 2 | 7% |
| Librarian | 2 | 7% |
| Student > Master | 2 | 7% |
| Other | 5 | 19% |
| Unknown | 8 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 14 | 52% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 11% |
| Immunology and Microbiology | 1 | 4% |
| Agricultural and Biological Sciences | 1 | 4% |
| Unknown | 8 | 30% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 March 2018.
All research outputs
#15,495,840
of 23,028,364 outputs
Outputs from Drugs & Aging
#976
of 1,215 outputs
Outputs of similar age
#213,390
of 333,790 outputs
Outputs of similar age from Drugs & Aging
#18
of 23 outputs
Altmetric has tracked 23,028,364 research outputs across all sources so far. This one is in the 22nd percentile – i.e., 22% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,215 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.7. This one is in the 14th percentile – i.e., 14% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 333,790 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 23 others from the same source and published within six weeks on either side of this one. This one is in the 17th percentile – i.e., 17% of its contemporaries scored the same or lower than it.