Clinical Characteristics and the Level Disease Activity of Behcet´s Disease in China: A Study Based on Smart System of Disease Management (SSDM)

Lingli Dong¹, Shouxin Li ¹, Fen Wang ², Zhenbiao Wu ³, Shengtao Zhang ¹, Qin Li ⁴, Henglian Wu ⁵, Zhengang Wang ⁶, Huifang Guo ⁷, Yikai Yu ¹, LingXun Shen ⁸, Yasong Li ⁹, Yang Liu ¹⁰, Tian Wang ¹¹, Peng Ji ¹², Zongwen Shuai ², Hongbin Li ¹³, Li Luo ¹², Hui Xiao ¹⁴, Yuhua Jia ¹⁵, Bing Wu ¹⁶, Shengsong Jia ¹⁵, Fei Xiao ¹⁷ and Lijun Wu ¹⁸, ¹Tongji Hospital，Tongji Medical Colllege，Huazhong University of Science and Technology, Wuhan, Hubei, China (People's Republic), ²First Affiliated Hospital of Medical University Of Anhui, Hefei, Anhui, China (People's Republic), ³The First Affiliated Hospital of The Fourth Military Medical University, Xian, Shanxi, China (People's Republic), ⁴The First People's Hospital of Yunnan Province, Kunming, Yunnan, China (People's Republic), ⁵Dongguan donghua hospital, Dongguan, Guangdong, China (People's Republic), ⁶TongRen hospital,Capital University, Bei Jing, China (People's Republic), ⁷The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (People's Republic), ⁸Union Hospital Affiliated Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China (People's Republic), ⁹Zhejiang provincial people's hospital, Hangzhou, Zhejiang, China (People's Republic), ¹⁰Affiliated Hospital of Inner Mongolia Medical University, Huhehaote, Nei Mongol, China (People's Republic), ¹¹Beijing Anzhen Hospital, Capital Medical University, Beijing, Beijing, China (People's Republic), ¹²The first affiliated hospital of xinjiang medical university, Urumchi, China (People's Republic), ¹³The Affiliated Hospital of Inner Mongolia Medical University, Huhhot, Nei Mongol, China (People's Republic), ¹⁴Shanghai Gothic Internet Technology Co., Ltd, shanghai, Shanghai, China (People's Republic), ¹⁵Shanghai Gothic Internet Technology Co., Ltd., Shanghai, Shanghai, China (People's Republic), ¹⁶Shanghai Gothic Internet Technology Co., Ltd, Shanghai, China (People's Republic), ¹⁷Shanghai Gothic Internet Technology Co., Ltd., shanghai, China (People's Republic), ¹⁸People's Hospital of Xinjiang Uygur Autonomous region, Wulumuqi, Xinjiang, China (People's Republic)

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: BDCAF, Behcet's syndrome, EMRAI and Clinical Characteristics, Self-management

Session Information

Date: Monday, November 11, 2019

Title: Vasculitis – Non-ANCA-Associated & Related Disorders Poster III: Behçet’s Disease & Other Vasculitides

Session Type: Poster Session (Monday)

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

Background/Purpose: Behcet´s disease (BD) is a systemic autoimmune disease that affects multiple organ systems with recurrent oral ulcers, genital ulcers and skin lesions, which might be accompanied by psychological abnormalities such as anxiety or depression. Behcet´s Disease Current Activity Form (BDCAF) and Electronic Medical Record-based Activity Index (EMRAI) are commonly used internationally to evaluate the disease activity of BD; Hospital Anxiety & Depression Scale (HADS) is commonly used to evaluate patients’ mental health.
This study aimed to analyze the clinical characteristics, the level of disease activity, and the incidence of anxiety and depression for Chinese BD patients. Patients can perform self-management of disease with Smart System of Disease Management (SSDM).

Methods: SSDM is a series of doctor-patient interactive applications for self-management of patients with chronic diseases. Patients can perform BDCAF, EMRAI and HADS self-assessment with SSDM and upload the self-assessment data to their authorized doctors. The SSDM patients’ application system integrates the BDCAF and EMRAI into one scoring system. Patients could obtain scores of BDCAF and EMRAI by responding to one questionnaire through SSDM. Patients with a score ≥4, will be diagnosed as BD. HADS is divided into two sub-tables of HADS-Anxiety (HADS-A) and HADS- Depression (HADS-D). A patient’s HADS score >10, will be diagnosed with anxiety or depression.

Results: From April 2017 to May 2019, 1,072 BD patients from 225 hospitals used SSDM, with a mean age of 38.78±12.23 (14~78) years old, and median disease duration of 21.77 months. 513 patients performed BDCAF and EMRAI self-assessment 873 times, 130 patients repeat assessments for 360 times. The mean score of BDCAF and EMRAI are 3.69±2.25 and 3.60±2.03, respectively. The matching degree of the two score was 0.8818.
The most common clinical characteristics were oral ulcers (76.9%), joint pain (43.87%) and genital ulcer (40.21%). The comparative study between males and females revealed significant difference in the aspects of epididymitis (10.03% vs 0, p< 0.001), genital ulcer (32.11% vs 44.43%, p< 0.001), headache (21.74% vs 33.10%, p< 0.001), superficial thrombophlebitis (21.74% vs 33.10%, p< 0.001) and red eye (29.77% vs 18.47%, p< 0.001). Please see details in Table 1.
The incidence of anxiety and depression was 15% and 16%, among 134 patients assessed for HADS.

Conclusion: Chinese BD patients can effectively perform BDCAF and EMRAI self-assessment with SSDM. The results of the assessment conducted by the two scoring systems are similar. The clinical characteristics of Chinese BD were different depending on gender.

BD-Table 1

Table 1. Clinical Characteristics of different systems in Chinese BD patients.

Disclosure: L. Dong, None; S. Li, None; F. Wang, None; Z. Wu, None; S. Zhang, None; Q. Li, None; H. Wu, None; Z. Wang, None; H. Guo, None; Y. Yu, None; L. Shen, None; Y. Li, None; Y. Liu, None; T. Wang, None; P. Ji, None; Z. Shuai, None; H. Li, None; L. Luo, None; H. Xiao, None; Y. Jia, None; B. Wu, None; S. Jia, None; F. Xiao, None; L. Wu, None.

To cite this abstract in AMA style:

Dong L, Li S, Wang F, Wu Z, Zhang S, Li Q, Wu H, Wang Z, Guo H, Yu Y, Shen L, Li Y, Liu Y, Wang T, Ji P, Shuai Z, Li H, Luo L, Xiao H, Jia Y, Wu B, Jia S, Xiao F, Wu L. Clinical Characteristics and the Level Disease Activity of Behcet´s Disease in China: A Study Based on Smart System of Disease Management (SSDM) [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/clinical-characteristics-and-the-level-disease-activity-of-behcets-disease-in-china-a-study-based-on-smart-system-of-disease-management-ssdm/. Accessed .

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