Risk factors of disease activity in patients with Behçet's syndrome

Objectives: To investigate the clinical characteristics and laboratory data in Behçet's syndrome (BS) patients in China and analyze the risk factors of disease activity.

Method: A retrospective analysis method was used and the demographic data and laboratory results were collected from 174 BS patients. Univariate and multivariate logistic regression analyses were used to analyze the demographic data and laboratory indexes whether that are risk factors or not of disease activity.

Results: The most common clinical manifestations of BS patients enrolled were mouth ulceration (48.85%), followed by erythema nodosum (20.69%), and eye involvement (13.75%), while the least common was headache (0%). Most active BS patients (96.55%) used 2 or ≥ 3 immunosuppressants to control disease, while most inactive patients (75%) used 0 or 1 immunosuppressant. The associated risk factors of disease activity consisted of disease duration, neutrophil-to-lymphocyte ratio (NLR), white blood cells, red blood cells, hemoglobin, platelets, fibrin degradation products, IgG, IgM, complement 3, complement 4, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin, albumin-to-globulin ratio (AGR), and high-density lipoprotein (HDL) (P < 0.05 or P = 0.00). Disease duration (≤ 60 months) (OR 8.49, 95% CI 2.09-34.49, P = 0.003), NLR (≥ 2) (OR 8.68, 95% CI 2.12-35.49, P = 0.003), CRP (≥ 10 mg/L) (OR 41.12, 95% CI 8.43-200.70, P = 0.000), ESR (≥ 20 mm/H) (OR 9.60, 95% CI 2.41-38.18, P = 0.001), and AGR (< 1.5) (OR 12.42, 95% CI 2.92-52.80, P = 0.001) were the independent risk factors of disease activity in BS patients.

Conclusions: Attention should be paid to the risk factors of disease activity and the medicine should be adjusted correspondingly. Key Points • The current diagnosis and efficacy evaluation of Behçet's syndrome (BS) mainly relied on clinical symptoms, while there are no specific laboratory biomarkers for reference. • In this study, we found that disease duration (≤ 60 months), neutrophil-to-lymphocyte ratio (≥ 2), C-reactive protein (≥ 10 mg/L), erythrocyte sedimentation rate (≥ 20 mm/H), and albumin-to-globulin ratio (< 1.5) were the independent risk factors of disease activity in BS patients. • In the ROC curve analysis, we found that erythrocyte sedimentation rate, C-reactive protein, and neutrophil-to-lymphocyte ratio could predict whether BS patients were active.

Keywords: Behçet’s syndrome; Risk factors.