Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Mod Rheumatol. 2021 Nov;31(6):1148-1157. doi: 10.1080/14397595.2021.1886623. Epub 2021 Feb 25.
Many factors can influence the response to treatment and prognosis of Behçet's disease (BD). Identifying the predictors of response to treatment can improve the quality and decrease the cost of medical care. This analytical study was performed to identify factors affecting the remission and outcome in BD patients with long-term follow-up.
A total of 245 BD patients aged over 16 years were followed for at least 12 months and visited at least three times a year were included. The outcome was assessed by the number of patients who were in sustained and long-term remission, had lost the primary criteria of BD for at least 12 months, were asymptomatic, and developed the sequela of disease or deceased. Sustained remission was defined as being in remission for at least six months. Long-term remission was defined as remission for ≥ 5 years.
Mean age and mean duration of follow-up were 35.1 ± 10.7 years and 92.3 months, respectively. At the end of follow-up, 63.2% of the patients lost the criteria of BD, 51.8% of the cases were in sustained remission, and 36.2% of them were asymptomatic. Predictors of sustained remission were adherence to therapy and treatment for more than six years. Having genital ulcers and treatment with methotrexate were associated with non-remission. Predictor of long-term remission was remission induction in the first two years of the treatment. Treatment with methotrexate was associated with non-remission. Poor outcome was observed in 31.8% of patients. Male sex, obesity, and having severe disease were the risk factors of poor outcome.
Achieving remission in BD is not inaccessible. Treatment with conventional and biologic disease-modifying antirheumatic drugs may cause sustained and long-term remission. Adherence to treatment, remission induction during the two years after the diagnosis and treatment for at least six years have significant role.
许多因素会影响白塞病（BD）的治疗反应和预后。识别治疗反应的预测因素可以提高医疗质量并降低医疗成本。本分析性研究旨在确定长期随访的 BD 患者缓解和结局的影响因素。
共纳入 245 名年龄超过 16 岁的 BD 患者，随访时间至少 12 个月，每年至少就诊 3 次。通过以下患者数量评估结局：持续和长期缓解的患者、BD 主要标准至少缓解 12 个月、无症状、发生疾病后遗症或死亡的患者。持续缓解定义为缓解至少 6 个月，长期缓解定义为缓解≥5 年。
平均年龄和平均随访时间分别为 35.1±10.7 岁和 92.3 个月。随访结束时，63.2%的患者失去 BD 标准，51.8%的患者持续缓解，36.2%的患者无症状。持续缓解的预测因素是治疗依从性和治疗超过 6 年。存在生殖器溃疡和使用甲氨蝶呤治疗与未缓解相关。缓解诱导治疗的前两年是长期缓解的预测因素。使用甲氨蝶呤与未缓解相关。31.8%的患者预后不良。男性、肥胖和严重疾病是预后不良的危险因素。
实现 BD 的缓解并非遥不可及。使用传统和生物疾病修饰抗风湿药物治疗可能会导致持续和长期缓解。治疗依从性、诊断后两年内缓解诱导和治疗至少 6 年与缓解密切相关。
