Gonca Mumcu1, Ümit Karacayli2, Meral Yay3, Aysun Aksoy4, Mehmet Nedim Taş5, Berkan Armağan6, Alper Sari6, Burçin Cansu Bozca7, Emre Tekgöz8, Duygu Temiz Karadağ9, Suade Özlem Badak10, Duygu Tecer11, Cemal Bes12, Ali Şahin13, Eren Erken10, Ayse Cefle9, Muhammet Çinar8, Sedat Yilmaz8, Erkan Alpsoy6, Soner Şenel14, Şule Yaşar Bilge15, Timuçin Kaşifoğlu15, Ömer Karadağ6, Kenan Aksu5, Gökhan Keser5, Fatma Alibaz-Öner4, Nevsun Inanç4, Tülin Ergun16, Haner Direskeneli4. 1. Marmara University, Faculty of Health Sciences, Istanbul, Turkey. 2. Gulhane Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, University of Health Sciences, Ankara, Turkey. ukaracayli@gmail.com. 3. Department of Statistics, Mimar Sinan Fine Arts University, Istanbul, Turkey. 4. Marmara University, Medical School, Division of Rheumatology, Istanbul, Turkey. 5. Ege University, Medical School, Division of Rheumatology, Izmir, Turkey. 6. Hacettepe University, Medical School, Division of Rheumatology, Ankara, Turkey. 7. Akdeniz University, Medical School, Dermatology Department, Antalya, Turkey. 8. Gulhane Medical Faculty, Gulhane Education and Research Hospital, Division of Rheumatology, Gulhane, Turkey. 9. Kocaeli University, Medical School, Division of Rheumatology, Kocaeli, Turkey. 10. Cukurova University, Medical School, Division of Rheumatology, Adana, Turkey. 11. Şanlıurfa Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey. 12. Istanbul Bakırköy Dr.Sadi Konuk Education and Research Hospital, Rheumatology Clinic, Istanbul, Turkey. 13. Cumhuriyet University, Medical School, Division of Rheumatology, Sivas, Turkey. 14. Erciyes University, Medical School, Division of Rheumatology, Kayseri, Turkey. 15. Eskisehir, Osmangazi University, Medical School, Division of Rheumatology, Eskisehir, Turkey. 16. Marmara University, Medical School, Dermatology Department, Istanbul, Turkey.
Abstract
OBJECTIVES: The aim of this multicentre study was to understand patients' needs and to evaluate the oral ulcer activity with the Composite Index (CI), according to different treatment modalities in Behçet's syndrome (BS). METHODS: BS patients (n=834) from 12 centres participated in this cross-sectional study. Oral ulcer activity (active vs. inactive) and the CI (0: inactive vs. 1-10 points: active) were evaluated during the previous month. The effects of treatment protocols [non-immunosuppressive: non-IS vs. immunosuppressive: (ISs)], severity (mild vs. severe), disease duration (<5 years vs. ≥5 years) and smoking pattern (non-smoker vs. current smoker) were analysed for oral ulcer activity. RESULTS: Oral ulcer activity was observed in 65.1% of the group (n=543). In both genders, the activity was higher in mild disease course with non-IS treatment group compared to severe course with ISs (p<0.05). As a resistant group, patients with mild disease course whose mucocutaneous symptoms were unresponsive to non-IS medications were treated with ISs in a limited period and achieved the highest CI scores in females. Oral ulcer activity and poor CI score were associated with disease duration less than 5 years compared to others in male patients (p<0.05). CONCLUSIONS: Oral ulcer activity pattern is affected by both the combination of disease course, treatment protocols and disease duration. CI scores reflected the oral clinical activity and CI might be a candidate scale to evaluate the efficacy of treatments during the follow-up of oral ulcer activity in BS.
OBJECTIVES: The aim of this multicentre study was to understand patients' needs and to evaluate the oral ulcer activity with the Composite Index (CI), according to different treatment modalities in Behçet's syndrome (BS). METHODS:BSpatients (n=834) from 12 centres participated in this cross-sectional study. Oral ulcer activity (active vs. inactive) and the CI (0: inactive vs. 1-10 points: active) were evaluated during the previous month. The effects of treatment protocols [non-immunosuppressive: non-IS vs. immunosuppressive: (ISs)], severity (mild vs. severe), disease duration (<5 years vs. ≥5 years) and smoking pattern (non-smoker vs. current smoker) were analysed for oral ulcer activity. RESULTS:Oral ulcer activity was observed in 65.1% of the group (n=543). In both genders, the activity was higher in mild disease course with non-IS treatment group compared to severe course with ISs (p<0.05). As a resistant group, patients with mild disease course whose mucocutaneous symptoms were unresponsive to non-IS medications were treated with ISs in a limited period and achieved the highest CI scores in females. Oral ulcer activity and poor CI score were associated with disease duration less than 5 years compared to others in male patients (p<0.05). CONCLUSIONS:Oral ulcer activity pattern is affected by both the combination of disease course, treatment protocols and disease duration. CI scores reflected the oral clinical activity and CI might be a candidate scale to evaluate the efficacy of treatments during the follow-up of oral ulcer activity in BS.
Authors: Tamer A Gheita; Hanan M Fathi; Nahla N Eesa; Emad El-Shebini; Samar Tharwat; Nevin Hammam; Rasha M Fawzy; Rawhya R El-Shereef; Mona H Abd El-Samea; Rasha A Abdel Noor; Mohamed N Salem Journal: Clin Rheumatol Date: 2021-06-25 Impact factor: 2.980