Please use this identifier to cite or link to this item: https://hdl.handle.net/11499/10527
Title: Behçet disease with vascular involvement: Effects of different therapeutic regimens on the incidence of new relapses
Authors: Alibaz-Oner, F.
Karadeniz, A.
Yilmaz, S.
Balkarli, A.
Kimyon, G.
Yazici, A.
Çinar, M.
Keywords: alpha interferon
anticoagulant agent
azathioprine
corticosteroid
cyclophosphamide
immunosuppressive agent
infliximab
low molecular weight heparin
methotrexate
warfarin
adult
anticoagulant therapy
Article
Behcet disease
bleeding
clinical feature
demography
epistaxis
female
follow up
gastrointestinal hemorrhage
hematoma
human
immunosuppressive treatment
major clinical study
male
physician
priority journal
recurrence risk
relapse
retrospective study
treatment duration
vascular Behcet disease
vascular disease
Behcet Syndrome
pathology
recurrent disease
vasculitis
Adult
Female
Follow-Up Studies
Humans
Male
Recurrence
Retrospective Studies
Vasculitis
Publisher: Lippincott Williams and Wilkins
Abstract: Vascular involvement is one of the major causes of mortality and morbidity in Behcet disease (BD). There are no controlled studies for the management of vascular BD (VBD), and according to the EULAR recommendations, only immunosuppressive (IS) agents are recommended. In this study, we aimed to investigate the therapeutic approaches chosen by Turkish physicians during the initial event and relapses of VBD and the association of different treatment options with the relapses retrospectively. Patients with BD (n-936, female/male: 347/589, mean age: 37.6 ± 10.8) classified according to ISG criteria from 15 rheumatology centers in Turkey were included. The demographic data, clinical characteristics of the first vascular event and relapses, treatment protocols, and data about complications were acquired. VBD was observed in 27.7% (n - 260) of the patients during followup. In 57.3% of the VBD patients, vascular involvement was the presenting sign of the disease. After the first vascular event, ISs were given to 88.8% and AC treatment to 59.8% of the patients. Median duration of AC treatment was 13 months (1-204) and ISs, 22 months (1-204). Minor hemorrhage related to AC treatment was observed in 7 (4.7%) patients. Asecond vascular event developed in 32.9% (n=86) of the patients. The vascular relapse rate was similar between patients taking only ISs and AC plus IS treatments after the first vascular event (29.1% vs 22.4%, P=0.28) and was significantly higher in group taking only ACs than taking only ISs (91.6% vs 29.1%, P<0.001). During follow-up, a third vascular event developed in 17 (n = 6.5%) patients. The relapse rate was also similar between the patients taking only ISs and AC plus IS treatments after second vascular event (25.3% vs 20.8%, P=0.93). When multivariate analysis was performed, development of vascular relapse negatively correlated with only IS treatments. We did not find any additional positive effect of AC treatment used in combination with ISs in the course of vascular involvement in patients with BD. Severe complications related to AC treatment were also not detected. Our results suggest that short duration of IS treatments and compliance issues of treatment are the major problems in VBD associated with vascular relapses during follow-up. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
URI: https://hdl.handle.net/11499/10527
https://doi.org/10.1097/MD.0000000000000494
ISSN: 0025-7974
Appears in Collections:PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
Tıp Fakültesi Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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