Comorbid Inflammatory Diseases in Behçet's Disease: A Multicenter Large Cohort Study

Behçet's disease (BD) is a chronic, multisystem immune-mediated vasculitis. A significant number of patients with BD have inflammatory comorbid (IC) disease that can affect the clinical course of the disease. In the current literature, there is no study which investigated IC disease in BD. It was aimed to show the prevalence and clinical spectrum of IC disease in patients with BD.

A total of 1591 patients diagnosed with BD and followed at five tertiary healthcare facilities were enrolled in the study. Patients were divided according to the presence of IC disease. Demographic characteristics, clinical manifestations, and laboratory parameters were systematically noted from medical records. The activity of the disease was evaluated by Behçet's Disease Current Activity Form (BDCAF).

Inflammatory comorbid diseases were identified in 246 (15.3%) patients. The most common comorbidities were axial spondyloarthritis (n = 115, 7.2%), familial Mediterranean fever (FMF) (n = 38, 2.4%), and hidradenitis suppurativa (n = 37, 2.3%). Patients with IC disease had a greater use of anti-TNF treatment (p = 0.03). In the multivariate analysis, older age, and longer disease duration were found to be significantly associated with IC disease in BD (p < 0.05).

BD can be associated with other inflammatory conditions. Furthermore, patients with inflammatory comorbidities were more likely to receive anti-TNF therapy, although this may partly reflect treatment indications for the comorbid conditions themselves. Therefore, clinicians should remain vigilant for inflammatory comorbidities, as their recognition may have implications for therapeutic decision-making.