Earlier and more aggressive treatment with biologics may prevent relapses and further new organ involvement in Behçet's disease

Immunosuppressives (IS) are the choice of treatment for major organ involvement in Behçet's disease (BD). In this study, we aimed to investigate the relapse rate and new major organ development in BD under ISs during long-term follow-up. The files of 1114 BD patients followed in Marmara Univers...

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Veröffentlicht in:Clinical immunology (Orlando, Fla.) Fla.), 2023-03, Vol.248, p.109263-109263, Article 109263
Hauptverfasser: Bozkurt, Tugce, Karabacak, Murat, Karatas, Hakan, Kutluğ Ağaçkıran, Seda, Ergun, Tulin, Direskeneli, Haner, Alibaz-Oner, Fatma
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Sprache:eng
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Zusammenfassung:Immunosuppressives (IS) are the choice of treatment for major organ involvement in Behçet's disease (BD). In this study, we aimed to investigate the relapse rate and new major organ development in BD under ISs during long-term follow-up. The files of 1114 BD patients followed in Marmara University Behçet's Clinic were analyzed retrospectively. Patients with a follow-up less than 6 months were excluded. Conventional IS and biologic treatment courses were compared. ‘Events under IS’ were defined as a relapse of the same organ and/or new major organ development in patients receiving ISs. Among 806 patients included in the final analysis (male: 56%, age at diagnosis: 29 (23–35) years, median follow-up time: 68 (33–106) months). Major organ involvement was present in 232 (50.5%) patients at diagnosis, and 227 (49.5%) developed new major organ involvement during follow-up. Major organ involvement developed earlier in males (p = 0.012) and in patients with a first-degree relative history of BD (p = 0.066). ISs were given mostly for major organ involvement (86.8%, n = 440). Overall, 36% of the patients had a relapse or new major organ involvement under ISs (relapse: 30.9%, new major organ involvement: 11.6%.) ‘Events under IS’ (35.5% vs 20.8%, p = 0.004), and relapses (29.3% vs 13.9%, p = 0.001) were more common with conventional ISs compared to biologics. Any major event under ISs was less common with biologics compared to conventional ISs in patients with BD. These results suggest that earlier and more aggressive treatment may be an option in BD patients who had the highest risk for severe disease course. •Major organ involvement developed in half of Behçet patients during the follow-up period.•New major organ involvement or/and relapses developed in one third of the patients under immunosuppressive treatments.•New major organ involvement or/and relapses were less common with biologics compared to conventional immunosuppressives.
ISSN:1521-6616
1521-7035
DOI:10.1016/j.clim.2023.109263