Background/Purpose: Behçet’s disease (BD) is characterized by recurrent aphthous stomatitis, eye lesions, skin lesions, and genital ulcer. In addition to these symptoms, Behçet’s disease is frequently complicated by joint symptoms, usually affecting large joints. Although glucocorticoid and NSAIDs are effective in subsiding each arthritis attack, they are unable to prevent recurrence of attacks. In 2018 EULAR recommendations, colchicine as well as other drugs, such as TNF inhibitors, IFN-alpha and azathioprine are recommended to control arthritis in BD. However, long-term outcome of patients with arthritis has not been determined. In fact, bone deformity and bone destruction are considered rare in BD in contrast with rheumatoid arthritis. In this study, we investigated the long-term outcome of joint symptoms in patients with BD.

Methods: Retrospective analysis of the clinical charts of 107 patients with BD was carried out, who visited the clinic of our hospital between 2017 and 2018. All the patients met the International Study Group for BD criteria. The presence and clinical course of joint symptoms were surveyed in these patients. The status of activity of daily living was evaluated using Steinbrocker’s functional grade (Class I–IV) at the most recent visit.

Results: Of the 107 patients, 36 (15 men and 21 women) were treated for joint symptoms associated with BD. Arthritis attacks in most patients were successfully treated with glucocorticoid and/or NSAIDs. After the initial attacks, colchicine, methotrexate and infliximab were given to 18 patients, 10 patients and 2 patients, respectively, to prevent the relapse of arthritis attacks. The mean (± SD) duration from the onset of joint symptoms to the most recent check-up was 21.2±14.6 years (mean ± SD). The functional stages at the time of the most recent check-up were Class I in 30 patients and Class II in 6 patients, whereas there were no patients in Class III or IV. The functional stages at the evaluation were not significantly correlated with the duration of the disease or treatment with colchicine, methotrexate or infliximab. Thus, no major impairment in active daily living was noted throughout the long-term course in all the patients. Consistently, no patients showed bone erosion or destructive arthritis on radiography.

Conclusion: The results in the present study have disclosed that the long-term outcome of arthritis in BD is much better that that of RA, resulting in no patients with serious disability over Class III even after a long time of disease duration of 21.2 years in average. Although the final functional stages were not correlated with their use, further studies with a larger number of patients are needed to confirm whether colchicine, methotrexate and infliximab might have beneficial effects for arthritis in BD.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-long-term-outcome-of-patients-with-arthritis-of-behcets-disease/