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Unmet need in Behcet’s disease: most patients in routine follow-up continue to have oral ulcers

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Abstract

The clinical course of Behcet’s disease (BD) as a multisystemic disorder with a remitting-relapsing nature is insufficiently explored. As complete remission should be aimed in all inflammatory diseases, we investigated the frequency of complete remission in patients with BD followed in long-term, routine practice. In this retrospective study, 258 patients with BD who were regularly followed in outpatient clinics were assessed. The demographic and clinical data for active organ manifestations and treatment protocols were evaluated, and “complete remission” for this study was defined as no sign of any disease manifestation in the current visit and the preceding month. Two hundred fifty-eight patients with BD (F/M 130/128, mean age 41.1 ± 11.5 years) were included to the study. Mucocutaneous disease was present in 48.4 % (n = 125). Mean visit number was 6.8 ± 2.7, and mean follow-up duration was 45.8 ± 36.5 months. Patients were clinically active in 67.2 % (n = 1,182) of the total visits (n = 1,757), which increased to 75.6 % (68.1–90.3) when the month preceding the visit was also included. The most common active manifestation was oral ulcers (39.4–63.2 %) followed by other mucocutaneous manifestations and musculoskeletal involvement. When multivariate analysis was performed, oral ulcers, which are the main cause of the clinical activity, negatively correlated with immunosuppressive treatments (β = −0.356, p < 0.000) and age (β = −0.183, p = 0.04). It is fairly difficult to achieve complete remission in BD with current therapeutic regimens. The reluctance of the clinician to be aggressive for some BD manifestations with low morbidity, such as mucocutaneous lesions and arthritis, might be influencing the continuous, low-disease activity state, especially due to oral ulcers, in BD patients.

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Abbreviations

BD:

Behcet’s disease

CR:

complete remission

OU:

oral ulcers

IS:

immunosuppressive

OI:

ocular involvement

VI:

vascular involvement

NI:

neurological involvement

MI:

musculoskeletal involvement

V:

visit

CA:

clinical activity

GU:

genital ulcer

EN:

erythema nodosum

PPL:

papulopustular lesion

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Authors and Affiliations

  1. Division of Rheumatology, School of Medicine, Marmara University, Istanbul, Turkey

    Fatma Alibaz-Oner, Gulsen Ozen, Meryem Can, Sibel Yilmaz Oner, Nevsun Inanc, Pamir Atagunduz & Haner Direskeneli

  2. Faculty of Health Sciences, Department of Health Informatics and Technologies, Marmara University, Istanbul, Turkey

    Gonca Mumcu

  3. Department of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey

    Zeynep Kubilay, Gulce Celik & Aslı Karadeniz

  4. Department of Dermatology, School of Medicine, Marmara University, Istanbul, Turkey

    Tulin Ergun

  5. Fevzi Çakmak Mahallesi 1121. sokak No: 14 34200, Esenler, Istanbul, Turkey

    Fatma Alibaz-Oner

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  1. Fatma Alibaz-Oner
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  2. Gonca Mumcu
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  3. Zeynep Kubilay
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  4. Gulsen Ozen
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  8. Sibel Yilmaz Oner
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  11. Tulin Ergun
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Correspondence to Fatma Alibaz-Oner.

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Alibaz-Oner, F., Mumcu, G., Kubilay, Z. et al. Unmet need in Behcet’s disease: most patients in routine follow-up continue to have oral ulcers. Clin Rheumatol 33, 1773–1776 (2014). https://doi.org/10.1007/s10067-014-2585-3

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  • DOI: https://doi.org/10.1007/s10067-014-2585-3

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