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2015 ; 94
(6
): e494
Nephropedia Template TP
gab.com Text
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English Wikipedia
Behçet disease with vascular involvement: effects of different therapeutic
regimens on the incidence of new relapses
#MMPMID25674739
Alibaz-Oner F
; Karadeniz A
; Ylmaz S
; Balkarl A
; Kimyon G
; Yazc A
; Çnar M
; Ylmaz S
; Yldz F
; Bilge ?Y
; Bilgin E
; Coskun BN
; Omma A
; Çetin GY
; Ça?atay Y
; Karaaslan Y
; Sayarlo?lu M
; Pehlivan Y
; Kalyoncu U
; Karada? Ö
; Ka?ifo?lu T
; Erken E
; Pay S
; Çefle A
; Ksack B
; Onat AM
; Çobankara V
; Direskeneli H
Medicine (Baltimore)
2015[Feb]; 94
(6
): e494
PMID25674739
show ga
Vascular involvement is one of the major causes of mortality and morbidity in
Behçet 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 follow-up. 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. A second 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.