Prognosis of Behcet's syndrome among men with mucocutaneous involvement at disease onset: long-term outcome of patients enrolled in a controlled trial.
OBJECTIVE
To assess the influence of being free of major organ involvement during the early years of the disease on the prognosis of men with Behçet's syndrome (BS).


METHODS
Ninety-six men with BS, who had only active mucocutaneous manifestations when entering a controlled trial of thalidomide mean (s.d.) 11.7 (0.8) years ago, were re-evaluated for the use of immunosuppressives as an indication of major organ involvement during the post-trial period.


RESULTS
Outcome information was obtained in 91 (95%) patients. Thirty-nine (43%) patients had to use immunosuppressives during the post-trial period. Immunosuppressive use was significantly more frequent among patients developing BS at younger age (76%; <or=24 years) than older age (30%; >or=25 years). Developing BS at young age (OR = 6.3; 95% CI 2.09, 19.04) and not using colchicine during the post-trial period (OR = 3.860; 95% CI 1.484, 10.034) were risk factors for immunosuppressive use. However, 82% of the patients using colchicine had onset during old age. Colchicine showed a significant effect in decreasing the use of immunosuppressives only among patients of old age at onset (Fisher's exact test = 5.026; P = 0.031) in the subgroup analysis. Eye disease (18 patients) and vascular involvement (14 patients) were the most frequent indications for immunosuppressive use.


CONCLUSIONS
Being free of major organ involvement during the early years of BS does not indicate a mild prognosis for men developing BS at young age. Whether colchicine will reduce the need for immunosuppressive use among men developing BS at old age awaits formal studies.
Hamuryudan
Vedat
V
Department of Internal Medicine, Division of Rheumatology, Cerrahpasa Medical School, Istanbul University, Aksaray, 34365, Istanbul, Turkey. vhamuryudan@yahoo.com
Hatemi
Gulen
G
Tascilar
Koray
K
Sut
Necdet
N
Ozyazgan
Yilmaz
Y
Seyahi
Emire
E
Mat
Cem
C
Yurdakul
Sebahattin
S
Yazici
Hasan
H
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D001528:Behcet Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D003078:Colchicine / Q000627:therapeutic use; D004363:Drug Utilization / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D019226:Oral Ulcer / Q000188:drug therapy; D011379:Prognosis; D013792:Thalidomide / Q000627:therapeutic use; D016896:Treatment Outcome; D014605:Uveitis / Q000188:drug therapy; D055815:Young Adult
D007166:Immunosuppressive Agents; D013792:Thalidomide; D003078:Colchicine