ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2749

The Clinical Course of Acute Deep Vein Thrombosis of the Legs in Behçet’s Syndrome

Melike Melikoglu1, Yesim Ozguler2, Serdal Ugurlu3, Firat Cetinkaya4, Koray Tascilar2, Emire Seyahi3, Vedat Hamuryudan3 and Hasan Yazici1, 1Istanbul University, Cerrahpasa Medical Faculty, Rheumatology, Istanbul, Turkey, 2University of Istanbul, Cerrahpasa Medical Faculty, Rheumatology, Istanbul, Turkey, 3Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey, 4Radiology, Colormed Radiology Center, Istanbul, Turkey

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Title: Vasculitis

Session Type: Abstract Submissions (ACR)

Background/Purpose To determine the prospective clinical course of lower extremity deep vein thrombosis (LEDVT) in patients with Behçet’s syndrome (BS). 

Methods Consecutive BS patients with an acute episode of LEDVT were prospectively studied.  Clinical examination and lower extremity Doppler ultrasonography (US) were done at 1, 3, 6, 18 and 24 months after the index event. A relapse was defined as a new episode of LEDTV and/or a superficial vein thrombosis (SVT). 

Results

40 patients (6F, 34M) with LEDVT were followed for a mean= 33.2±10.8 months.  The mean age was 30.2±7.3, and the median disease duration since disease onset was 33.3 months (IQR=8.0-60.8). A total of 50 relapses were observed in 27 patients. This was in the form of solo SVT in 8 patients, solo LEDVT in 10 and LEDV+SVT in 9 patients. Cox regression analysis revealed that a recanalization rate of ≥ 50% in LEDVT observed by US at month 3 was significantly associated with a lower relapse rate (HR= 0.23; 95% CI =0.092-0.59). 

The first line treatment had been with azathioprine (AZA) with moderate doses of glucocorticoids (0.5 mg/kg/d) in 34 (85%) patients, interferon-alpha (IFN-alpha) in 4 and cyclophosphamide in 2 patients (also with pulmonary vasculitis). 19 out of 34 (55%) remained on AZA, 10 were switched to IFN-alpha for resistant or recurrent disease during  follow up. 8 of these 10 patients did not experience relapses after switching to IFN-alpha. 16 patients treated with IFN-alpha (including 3/4 initially treated with IFN-alpha) during follow-up and 12 of 16 (75%) patients were still on IFN-alpha therapy without relapses. 

Conclusion Relapses and resistant disease are frequent 27/40 (67.5%) in LEDTV in BS and is significantly associated with a failure to recanalize at 3 months.  IFN-alpha can justifiably be tried in the treatment of LEDVT, refractory to AZA and glucocorticoid use.

Disclosure:

M. Melikoglu,
None;

Y. Ozguler,
None;

S. Ugurlu,
None;

F. Cetinkaya,
None;

K. Tascilar,
None;

E. Seyahi,
None;

V. Hamuryudan,
None;

H. Yazici,
None.

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