Association of high disease activity and serum IL-6 levels with the incidence of inflammatory major organ events in...

Area of Science:

• Rheumatology
• Immunology
• Clinical Medicine

Background:

• The relationship between Behçet disease (BD) activity and major organ events remains poorly understood.
• Inflammatory major organ events in BD affect the eyes, central nervous system, intestines, and vasculature.

Purpose of the Study:

• To investigate the association between Behçet Disease Current Activity Form (BDCAF) scores and the incidence of inflammatory major organ events in BD patients.
• To identify predictors of inflammatory major organ events through clustering analysis of clinical data, treatments, and serum cytokines.

Main Methods:

• Prospective registry study involving Japanese multicenter cohorts.
• Annual evaluation of BDCAF scores and monitoring of BD-related symptoms, including major organ events.
• Time-to-event analysis and unsupervised clustering of BDCAF, therapies, and serum cytokines.

Main Results:

• A total of 260 patients were analyzed, with a median BDCAF score of 2 at enrollment, indicating persistent disease activity.
• Patients with a BDCAF score of 0 showed significantly longer inflammatory major organ event-free survival compared to those with scores ≥1 (p=2.2 x 10^-4).
• Clustering identified patients refractory to TNF inhibitors with high serum inflammatory cytokines, including IL-6, and increased major organ events.

Conclusions:

• Treatment strategies should focus on overall disease activity in Behçet disease.
• Monitoring residual serum IL-6 levels may aid in preventing inflammatory major organ events.