Behçet's Disease Current Therapies: MTX- Imuran and Long-term Effect of VIT D and Colchicine (Multi Centric Cohort Study from Aseer Region, Saudi Arabia)
Nouf A Alhammadi
Suliman Alhabib Medical Center, Saudi Arabia.
Mushary S. Alqahtani *
Internal Medicin Department, Armed Forces Hospitals, Southern Region, Saudi Arabia.
Khaled A. Amer
Internal Medicin Department, Aseer Central Hospital, Saudi Arabia.
Abdullah AL Thawwab
Internal Medicin Department, King Abdullah Medical City, Saudi Arabia.
Ahmed Saad Al Zomia
College of Medicin, King Khalid University, Abha, Saudi Arabia.
Hanan Alqahtani
University of Toronto, Aseer Central Hospital, Saudi Arabia.
Fares Ayed Alshahrani
Internal Medicin Department, Armed Forces Hospitals, Southern Region, Saudi Arabia.
Mohammed Abdullah Alshehri
Internal Medicin Department, Armed Forces Hospitals, Southern Region, Saudi Arabia.
Nasser Saidan Alaslai
Internal Medicin Department, Armed Forces Hospitals, Southern Region, Saudi Arabia.
Maram Ali AlShahrani
Internal Medicin Department, Armed Forces Hospitals, Southern Region, Saudi Arabia. c Internal Medicin Department, Aseer Central Hospital, Saudi Arabia.
Raghad Saad Alshahrani
Internal Medicin Department, Armed Forces Hospitals, Southern Region, Saudi Arabia. c Internal Medicin Department, Aseer Central Hospital, Saudi Arabia.
Arwa Ayed Alshahrani
Internal Medicin Department, Armed Forces Hospitals, Southern Region, Saudi Arabia.
Batool Abdullah Alahmary
King Faisal University, Saudi Arabia.
Fahad Abdulruhman Alazragi
Internal Medicin Department, Aseer Central Hospital, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Background: Behçet's disease (BD) is a rare, chronic inflammatory disorder that recurs over time, impacting multiple systems, positioning it at the intersection of autoimmune and auto-inflammatory syndromes. BD is a unique clinical entity known for its diverse manifestations with recurring oral ulcers are the most common, followed by genital ulcers. This article aims to explore and emphasize the diverse medication approaches for treating our patients with Behçet's disease.
Methods: A comprehensive retrospective analysis was conducted on medical records and data of patients under active care in rheumatology clinics, all of whom had a confirmed diagnosis of Behçet's disease looking for their different treatment options. We defined organ involvement severity to Mild (one organ), Moderate (2 organs) and sever is 3 and more organ involvement.
Results: 111 patients, evenly distributed by gender, we analyzed therapy effects on Behçet's disease. Azathioprine and methotrexate users (54 and 13 patients, respectively) were typically aged 21-60. Colchicine use (78 patients) showed consistent results, with similar organ involvement severity. Comparatively, Vitamin D use (55 patients) showed similar age and gender distribution, with a quarter exhibiting severe organ involvement. However, neurological, gastrointestinal, and pulmonary symptoms showed no significant differences across these groups.
Conclusion: In our study, we observed more sever disease in people taking MTX compared to Imuran. We also observed no morbidity or mortality benefit of vitamin D. Collaboration across disciplines is crucial for personalized treatment, considering organ involvement, age, gender, symptom intensity, and disease duration. Larger, prospective studies are needed to compare different Conventional Disease modifying agent and to consider mortality benefits of Colchicine in BD.
Keywords: Behcet disease, Vitamin D, methotrexate, azathioprine