Background/Purpose: Organ-specific patient-reported outcome (PRO) measures may help management decisions of Behcet’s disease (BD). The aim of this prospective study was to evaluate the factors associated with the score of mucocutaneous activity index (MI), a validated patient-reported outcome tool, for Behçet’s Disease (BD).

Methods: In this study, 834 BD patients (F/M: 441/393, mean age: 38,4±10,9 years) followed in twelve tertiary centres from Turkey were included. Validated mucocutaneous activity index (MI) and its subgroup activity indices regarding oral ulcer (CI), genital ulcer (GI) and erythema nodosum (EI) were assessed. Scores of each subgroup were between 0=inactive and 10=very active. Total MI score composed of these subgroups (0-30 points). Transformed Behcet’s disease current activity form (BDCAF) was used to evaluate global activity.

Results: Active BD patients (n=567, 67,9%) were mainly in the mild group with mucocutaneous involvement (n=420). Disease duration was lower (9,7±6,9 vs 11,1±8,1 years, p=0.001) and patients were younger (36,4±10,2 vs 41,9±11,2 years, p=0.001) in the active group. The ratio of non-smokers was also higher in active patients (76,1% vs 67,6%, p=0.011). A higher MI score was observed in females (8,2±4,6) compared to males (7,3±3,9) among active patients (p=0.023). It was higher in females (8,1±4,3) than males (6,7±3,.6) in non-smokers (n=419)(p=0.002), whereas a significant relationship was not present in current smokers (n=132, p=0.85) with gender. MI score was also higher in patients whose disease durations were less than 5 years (6,5±2,6) than the others (4,7±4,7)(p=0.001).

Being a non-smoker (OR:1,7), disease duration less than 5 years (OR:2,4) and female sex (OR:1,5) were found as predictive factors for mucocutaneous activity according to binary logistic regression analysis (p<0.05). Increases in both MI score and BDCAF score were observed in immunosuppressive (IS) medication group (n=86; 9,6±5,3; 6,6±2,9) compared to non-IS group (n=316; 7,7±4,1; 5,5±2,5) in active patients with mucocutaneous involvement (p=0.001 and p=0.008).

Conclusion: Female gender, smoking and disease duration were associated with higher MI scores in our study. An organ-specific and reliable PRO measure such as mucocutaneous index might be a candidate scale for future clinical studies and clinical follow-up of mucocutaneous manifestations in BD patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/mucocutaneous-activity-index-as-a-patient-reported-outcome-measure-in-behcets-disease-a-multi-center-study-from-turkey/