Background Diagnosis of Behcet's syndrome (BS) is based on clinical signs and symptoms, without the use laboratory or imaging tests and the most commonly used diagnostic criteria are the International Study Group (ISG) criteria. Patients have also been diagnosed with BS not meeting ISG criteria based on the clinical impression of the treating physicians.
Objectives To determine differences in disease activity among BS patients meeting and not meeting the ISG criteria.
Methods Behcet's patients seen at the NYU Behcet's Center had their demographic, clinical features and outcomes data abstracted. Confirmed BS diagnosis was determined if ISG criteria were met at any time during the course of observation. Multiple linear regression estimated any association between meeting ISG criteria and gender with the patient-reported outcomes Behcet's Syndrome Activity Scale (BSAS), Pain Visual Analog Scale (VAS), Fatigue VAS, Patient Global Assessment VAS, and RAPID3 as well as Physician Global Assessment VAS.
Results First observation data on 832 subjects were abstracted for this analysis. 504 (63%) met ISG criteria for Behcet's, 616 (74%) were female with an average age of 35 years (±13.8). Mean scores for BSAS, pain, fatigue, patient global, RAPID3 and physician global were uniformly higher in those meeting criteria vs not meeting criteria. Meeting ISG criteria was significantly associated with increases in all clinical outcomes independently of gender, ranging from 5 points on the Physician Global VAS to 13 points on the Fatigue VAS (Table). Conversely, gender was only associated with significant increases in BSAS, Fatigue and RAPID3 independent of meeting ISG criteria.
Conclusions Behcet's patients who fulfill ISG criteria have more active disease, based on all measures of disease activity, including patient and physician based outcomes. Interestingly, females were also at risk for more active disease as measured by composite patient reported outcome measures, reflecting possibly the different character of Behcet's in non-endemic areas, such as the US.
Disclosure of Interest Y. Yazici Grant/research support from: BMS, Celgene, Genentech, Consultant for: BMS, Celgene, H. Bernstein: None declared, C. Swearingen: None declared