Session Title: Vasculitis
Session Type: Abstract Submissions (ACR)
Background/Purpose: The nature of Behcet’s disease (BD) as a multi-systemic disorder with a remitting-relapsing course is unsufficiently explored. As complete remission should be aimed in all inflammatory diseases, we investigated the frequency of complete remission in routine practice in BD.
Methods: In this retrospective study, 130 patients with BD (F/M: 67/63, mean age: 43.23±11,7 years) classified according to ISG criteria were included. The demographic and clinical data for active organ manifestations and treatment protocols were evaluated, both for the current visit and in the last month. Patients having at least one of any disease manifestations were categorized as active.
Results: A total of 857 visits of 130 patients were overviewed. Mean visit number was 6,5± 2,7 (range:1-10) and mean follow-up duration was 53,54±41,79 months (3-162). Sixty-one patients (46,9%) were of mucocutaneus type, whereas 69 patients (53,1%) had major organ involvement. When all visits combined, 16-49% of the patients were using immunosuppressives (IS), whereas 30-62,3% was under non-IS therapies such as colchicine or NSAIDs. There was also a group of noncompliant patients (6-53,8%) without any treatment. Patients were clinically active in 67% (n=575) of the total visits (n=857). Mean frequency of clinical activity was 61,9% (53,7-87,7), which increased to 77,2% (64,2- 90) when the month before the visit was also included. The major cause of the activity was aphthous ulcers (44,1-74,6%) with other mucocutaneous manifestations also commonly present (Genital ulcer: 4,5-33,8 %, erythema nodosum: 7,5-30%, papulopustular lesions: 16,3-39,2%, arthritis: 19,9-33,3%, uveitis: 0-7,7% and vascular involvement: 2,3-12,3%). No difference was observed between the frequency of activity of patients having ISs or non-IS therapies.
Conclusion: Although complete remission is the current, primary target in inflammatory rheumatological diseases such as rheumatoid arthritis or vasculitides, it is fairly difficult to achieve complete remission in BD with current therapeutic regimens. The reluctance of the clinician to be aggressive for some manifestations with low morbidity, such as mucocutaneous lesions, might be influencing the continuous, low-disease activity state in BD patients.
S. Yýlmaz Oner,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-unmet-need-in-behcets-disease-most-patients-are-not-in-complete-remission-in-the-long-term-follow-up/