Effect of Immunosuppressive Agents on Recurrence of Cardiovascular Involvement of Behcet's Disease / 대한류마티스학회지

ABSTRACT

OBJECTIVE: Despite the high risk for disease-related morbidity and mortality in Behcet's disease (BD) with cardiovascular (CV) manifestations, only a few studies concerning BD with CV involvements are available. We conducted study to evaluate the clinical manifestations of CV BD (cardiovascular Behcet's disease) and the clinical outcome according to the different treatment modalities, especially focusing on the immunosuppressive agents. METHODS: We retrospectively reviewed 1,812 patients diagnosed with BD at tertiary hospital. All patients with vascular involvements were classified into three groups by lesion site. We assessed clinical characteristics, treatments, outcome and recurrence in each group. RESULTS: Of 1,812 patients, 79 patients showed CV involvements. Male to female ratio was 65 (82.3%) to 14 (17.7%). Venous involvements occurred in 57 cases (72.2%), arterial lesions in 22 (27.8%), cardiac involvements 16 (20.3%). In clinical manifestation, only hypertension and arthritis were more frequently found in cardiac lesion than in venous lesion (p=0.01, p=0.01, respectively). CV lesions recurred in 16 patients (20.3%), mostly at the same sites as previous involvements. There was no association of recurrence with site of lesion (p=0.49). Recurrent rate was significant different in three medication group (p=0.028). Recurrences were more frequent in patients treated with no immunosuppressive agent and colchicines only or colchicines with prednisolone than in patients treated with additional immunosuppressive agent (p=0.024, R.R, 7.16 (95% CI, 1.55 to 32.99)). CONCLUSION: Recurrence rate was lower in patients with aggressive immunosuppressive treatment. Although most of patients improved, more efforts to decrease the relatively high rate of the recurrence (20.3%) would be needed.