Impact of age at diagnosis on long‐term prognosis in patients with intestinal Behçet's disease

Abstract

Background and AimAlthough age at disease onset is considered to be a significant factor in the prognosis of Crohn's disease, little is known about its influence on the long‐term prognosis of those with intestinal Behçet's disease (BD). This study aimed to evaluate the long‐term clinical outcomes of patients with intestinal BD according to age of disease onset.MethodsPatients diagnosed with intestinal BD at < 18, 18–60, and > 60 years of age were classified into early‐onset, adult‐onset, and late‐onset groups, respectively. The influence of disease onset time on clinical prognosis, including specific medical requirements, BD‐related intestinal surgery, hospitalization, and emergency room visits, was compared using the log–rank test in a large cohort of patients with intestinal BD.ResultsAmong 780 patients, 21 (2.7%), 672 (86.2%), and 87 (11.1%) comprised the early‐onset, adult‐onset, and late‐onset groups, respectively. Patients in the early‐onset group were more likely to require immunosuppressants than those in the adult‐onset group (P = 0.048). Nine (42.9%), 158 (23.5%), and 18 (20.7%) patients in the early‐onset, adult‐onset, and late‐onset groups, respectively, underwent intestinal resection. The early‐onset group exhibited a higher risk for intestinal resection than the late‐onset (P = 0.043) and adult‐onset (P = 0.030) groups. The late‐onset group exhibited a higher risk for BD‐related hospitalization than the adult‐onset group (P = 0.023).ConclusionsAge at diagnosis affected the clinical course of intestinal BD, including intestinal surgery, hospitalization, and specific medical requirements. Different treatment strategies should be established according to age at diagnosis.

Intestinal Behçet's disease: A review of clinical diagnosis and treatment

“…Especially in younger patients, greater attention should be paid to disease progression, as multiple clinical evidences suggested that they often exhibit more severe clinical symptoms and poorer prognoses[ 74 - 76 ]. Patients with severe courses tend to be younger than those with mild courses[ 45 ], resulting in higher demand for outpatient, inpatient treatment, and intestinal surgery[ 75 ]. They are also more prone to postoperative recurrence[ 76 ].…”

“…They are also more prone to postoperative recurrence[ 76 ]. Therefore, it is essential to develop targeted treatment strategies for younger patients with intestinal BD, and to initiate immunosuppressant therapy early in the course of the disease[ 75 ].…”