This protocol applies to patients with a confirmed diagnosis of type 2 autoimmune pancreatitis (AIP) — also termed idiopathic duct-centric pancreatitis (IDCP) — which is a distinct entity from type 1 AIP. International consensus diagnostic criteria (ICDC) separate the two subtypes on the basis of differing natural history, diagnostic criteria, and management approach; the term IDCP is used specifically for type 2 AIP.
First-line therapy with prednisone was used as induction. The goal of that line was complete remission at 4 weeks. This protocol addresses the situation in which that endpoint was not met — providing the next structured step after steroid induction failure in IDCP.
After failure of prednisone induction to achieve complete remission, escalation involves a rituximab-based induction approach. The full regimen, sequencing, and decision criteria are contained in the structured protocol below.