2394 - Long-Term Outcome of Arterial Lesions in Behçet’s Disease: A Series of 101 Patients

Tuesday, November 8, 2011: 9:00 AM-6:00 PM
Hall F2 - Poster Hall (McCormick Place West)
David Saadoun1, B. Asli2, Bertrand Wechsler2, Habib Houman3, Guillaume Geri2, Jean-Charles Piette2, Zahir Amoura2, Mathieu Resche Rigon1 and Patrice Cacoub2, 1Department of Internal Medicine and Laboratory I3 “Immunology, Immunopathology, Immunotherapy”, UMR CNRS 7211, INSERM U959, Groupe Hospitalier Pitié-Salpetrière, Université Pierre et Marie Curie, Paris 6, Paris, France, Paris, France, 2CHU Pitié-Salpêtrière, Paris, France, 3department of internal medicine hôpital la rabta Tunis Tunisie, France
Presentation Number: 2394

Background/Purpose: The vasculitis of Behçet’s disease (BD) is distinctive because of involvement of both arteries and veins of all sizes. The concept of vasculo-Behçet has been adopted for cases in which vascular manifestations are present and often dominate the clinical features. While venous manifestations are frequent and have been reported in many publications, data regarding arterial lesions in BD are rare and often isolated.

Method: We reported the main characteristics, treatment and long-term outcome of 101 (12.3%) patients with arterial lesions among a cohort of 820 BD patients. Factors that affect prognosis were assessed by multivariate analysis.

Result: There was 93 (91.2%) male with a median age at diagnosis of BD of 33 [27-41] years. Arterial lesions included aneurysms (47.3%), occlusions (36.5%), stenosis (13.5%) and aortitis (2.7%). Lesions mainly involved aorta (n=25), femoral (n=23) and pulmonary (n=21) arteries. Patients with arterial lesions were more frequently of male gender (91.2% versus 62.4%, respectively, p=0.017) and had higher rate of venous involvement (80.4% versus 29.8%, respectively, p<0.001) compared to those without arterial manifestations. Thirty nine (38.6%) patients achieved a complete remission. In multivariate analysis, the presence of venous involvement [odds ratio (95% CI), 0.29 (0.08-1.11)] and arterial occlusive lesions [0.13 (0.01-1.25)] were negatively associated with complete remission. The use of immunosuppressants [3.38 (0.87-13.23)] was associated with the occurrence of complete remission. The 20-years survival rate was signicantly lower in BD patients with arterial involvement compared to those without arterial lesions (73% vs 89%, p<0.0001, respectively).

Conclusion: In conclusion, the long-term outcome of arterial lesions in BD is poor, especially in case of occlusive lesions and associated venous involvement. The use of immunosuppressants improved the prognosis.

Keywords: vasculitis

Disclosure: D. Saadoun, None; B. Asli, None; B. Wechsler, None; H. Houman, None; G. Geri, None; J. C. Piette, None; Z. Amoura, None; M. Resche Rigon, None; P. Cacoub, None.