An Unmet Need for Oral Ulcer Activity in Patients with Behcet’s Disease: A Multi-National Study

Gonca Mumcu¹, Adebowale Adesanya², Aysun Aksoy³, Joice Moraes Faria M Belem⁴, Natalia Borges Cardin⁴, Fatma Alibaz-Oner⁵, Tulin Ergun⁶, Nevsun Inanc⁷, Alexandre W.S. Souza⁸, Wafa Madanat⁹, Farida Fortune¹⁰ and Haner Direskeneli⁷, ¹Department of Health Management, Marmara University, Faculty of Health Sciences, Istanbul, Turkey, ²Barts and The London, School of Medicine and Dentistry, Institute of Dentistry, Clinical and Diagnostic Oral Sciences, London, UK, London, United Kingdom, ³Rheumatology, Marmara University School of Medicine, Istanbul, Turkey, ⁴Rheumatology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil, ⁵Şerifali mahallesi İbrahim Hakkı sokak. Lavella 4 sitesi. B blok, D:22 Umraniye, Şerifali mahallesi İbrahim Hakkı sokak. Lavella 4 sitesi. B blok, D:22 Umraniye, Istanbul, Turkey, ⁶Department of Dermatology, Faculty of Medicine, Marmara University, Istanbul, Turkey, ⁷Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey, ⁸Rheumatology Division, Universidade Federal de São Paulo, Sao Paulo, Brazil, ⁹Jordan’s Friends of Behcet’s disease Patients Society, Medical department, Amman, Jordan, Amman, Jordan, ¹⁰Dental Institute, Barts and The London NHS Trust, London, United Kingdom

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Behcet's syndrome

Session Information

Date: Monday, October 22, 2018

Session Title: Vasculitis Poster II: Behҫet’s Disease and IgG4-Related Disease

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Efficacy of current management approaches for oral ulcer treatment in routine clinical practice is insufficiently explored in Behcet’s disease (BD) patients. The aim of this multi-national study was to assess whether an unmet need for oral ulcer activity is present in patients with Behçet’s disease.

Methods: Behçet’s disease (n=197) patients from Jordan (n=50), Brazil (n=46), United Kingdom (n=41) and Turkey (60)(F/M: 100/97, mean age: 40,7±11,6 years) were included in this cross-sectional study. Data were collected by a questionnaire regarding oral ulcer activity during the previous month, treatment protocols and smoking patterns. Transformed BDCAF score was used to evaluate the general disease activity during the last month.

Results: In the whole BD group, 41,1% (n=81) of patients were treated with non-immunosuppresive medications (non-IS) and 53,3% (n=105) by ISs, irregular medication use/no medication was observed in 5,6% (n=11). The number and healing time of oral ulcers were 3,3±3,2 and 6,5±4,6 days, respectively in patients with active oral ulcers (n=114, 57,9%). The number of oral ulcers were significantly higher in patients treated with non-IS medications (4,04±3,9) and non-smoker patients (3,6±3,4) than those treated with ISs (2,5±2,1) and current smokers (2,3±2,1)(p<0.0001 and p=0.021, respectively). In binary logistic regression, non-IS medication use was found to be a predictive factor for oral ulcer activity (OR:2,3; p=0.011). Transformed BDCAF score was also lower in patients treated with ISs (4,02±3.5) than those using a non-IS treatment protocol (6,6±3,1)(p=0.009).

Conclusion: Since oral ulcer activity and global activity assessed by BDCAF were higher in patients treated with non-IS medications, an ‘unmet need’ was observed with milder, non-IS-based treatment protocols in a multi-national setting of clinical practice in BD patients.

Disclosure: G. Mumcu, None; A. Adesanya, None; A. Aksoy, None; J. M. F. M. Belem, None; N. Borges Cardin, None; F. Alibaz-Oner, None; T. Ergun, None; N. Inanc, None; A. W. S. Souza, None; W. Madanat, None; F. Fortune, None; H. Direskeneli, None.

To cite this abstract in AMA style:

Mumcu G, Adesanya A, Aksoy A, Belem JMFM, Borges Cardin N, Alibaz-Oner F, Ergun T, Inanc N, Souza AWS, Madanat W, Fortune F, Direskeneli H. An Unmet Need for Oral Ulcer Activity in Patients with Behcet’s Disease: A Multi-National Study [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/an-unmet-need-for-oral-ulcer-activity-in-patients-with-behcets-disease-a-multi-national-study/. Accessed December 2, 2020.

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