Long‐term clinical outcomes of intestinal Behçet's disease: A 30‐year cohort study at a tertiary hospital in South Korea

Abstract

Background and Aim:We aimed to identify the long-term clinical outcomes of and prognostic factors for intestinal Behçet's disease (BD). Methods: A cohort of 780 patients with intestinal BD between 1997 and 2021 was investigated to determine long-term clinical outcomes and prognostic factors at an inflammatory bowel disease clinic at Severance Hospital, Seoul, Korea. Results: During the median follow-up period of 12.7 ± 7.2 years, 5-aminosalicylic acids, corticosteroids, immunomodulators, and anti-tumor necrosis factor-alpha (TNF-α) agents were required in 94.9%, 67.2%, 43.8%, and 14.6% of the patients, respectively. The cumulative rates of anti-TNF-α use were 3.

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

“…4 Consistent with previous studies, most patients in our study were in the adult-onset group; the mean age of this group was 39.5 ± 10.6 years. The frequency of factors previously known to effect poor prognosis of intestinal BD, such as history of appendectomy, 28 DAIBD score, 3,28 EIMs, 29 multiple intestinal ulcers, 28 and volcano-type ulcers, 27,30 was not significantly different among the three groups in the present study.…”

“…4 According to a recent long-term follow-up study published by our institution, the cumulative rates at 1, 5, 10, and 20 years were 5.7%, 12.6%, 16.5%, and 21.6%, respectively. 28 In our study, patients in the early-onset group were approximately twice as likely to undergo intestinal surgery as those in the other two groups. The cumulative rates of intestinal surgery at 1, 5, and 10 years after the initial diagnosis of intestinal BD in the early-onset group were 28.6%, 38.1%, and 44.3%, respectively.…”

“…In a Korean population‐based study, the cumulative rates of surgery at 1 and 4 years after diagnosis were 5.0% and 10.9%, respectively, and there was no difference in the risk for surgery according to age group (at reference ages 30 and 40 years) in the short‐term follow‐up of intestinal BD 4 . According to a recent long‐term follow‐up study published by our institution, the cumulative rates at 1, 5, 10, and 20 years were 5.7%, 12.6%, 16.5%, and 21.6%, respectively 28 . In our study, patients in the early‐onset group were approximately twice as likely to undergo intestinal surgery as those in the other two groups.…”

“…24 Clinical disease activity was assessed according to the DAIBD, which consists of eight items: general well-being, fever, EIM, abdominal pain, abdominal mass, abdominal tenderness, intestinal complications, and number of liquid stools, with scores ranging from 0 to 325. Based on calculated DAIBD score, disease severity was classified into four disease groups: quiescent (≤ 19); mild (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39); moderate ; and severe (≥ 75). 25 Typical ulcers were defined as large, oval-shaped, and deep-penetrating ulcers with discrete borders in the ileocecal area.…”

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

“…Notably, the onset of intestinal BD symptoms typically lags behind those of extragastrointestinal manifestations[ 20 ]. Approximately 5-10% of patients with systemic BD develop intestinal BD approximately 7.35 years after initial disease onset[ 13 ], and approximately 75% patients require hospitalization[ 21 ].…”