Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;64(2):111-116.
doi: 10.3349/ymj.2022.0264.

Risk Factors for Surgery in Patients with Intestinal Behçet's Disease During Anti-Tumor Necrosis Factor-Alpha Therapy

So Jung Han  1 , Eun Ae Kang  1 , Jihye Park  1 , Soo Jung Park  1 , Jae Jun Park  1 , Tae Il Kim  1 , Won Ho Kim  1 , Jae Hee Cheon  2
Affiliations

Risk Factors for Surgery in Patients with Intestinal Behçet's Disease During Anti-Tumor Necrosis Factor-Alpha Therapy

So Jung Han et al. Yonsei Med J. 2023 Feb.

Abstract

Purpose: Behçet's disease (BD) is a chronic inflammatory immune-mediated disease involving multiorgan systems. Gastrointestinal (GI) manifestations of BD include abdominal pain, vomiting, GI bleeding, fistula formation, obstruction, and perforation that might require surgery. Recently, anti-tumor necrosis factor-alpha (anti-TNF-α) therapy has been shown to have favorable outcomes in patients with intestinal BD who are refractory to conventional therapy. This study sought to figure out the risk factors for undergoing surgery during anti-TNF-α therapy in patients with intestinal BD.

Materials and methods: In this retrospective analysis of intestinal BD patients who were treated with anti-TNF-α, we collected the baseline patient data including comorbidities, clinical, endoscopic, and radiologic characteristics, and the Disease Activity Index for Intestinal Behçet's Disease at the time of anti-TNF-α initiation. Each potential risk factor was compared. For multivariate analysis, Cox regression was used.

Results: A total of 62 patients were considered eligible for analysis, and 15 of them (24.1%) underwent surgery. In univariate analysis, the presence of extraintestinal manifestation, such as joint symptoms and erythrocyte sedimentation rate (ESR), were significantly associated with surgery during therapy. In multivariate analysis, drug response within 4 weeks [hazard ratio (HR), 64.59], skin and joint manifestation (HR, 10.23 and HR, 6.22), geographic ulcer (HR, 743.97), and ESR >42.5 mm/h (HR, 9.16) were found to be factors predictive of undergoing surgery during anti-TNF-α therapy.

Conclusion: We found five risk factors predictive of surgery in patients with intestinal BD receiving anti-TNF-α therapy, which can guide physicians in selecting appropriate patients between anti-TNF-α therapy and early surgery.

Keywords: Intestinal Behçet's disease; risk factors; surgery; tumor necrosis factor-alpha.

PubMed Disclaimer

Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

References

    1. Skef W, Hamilton MJ, Arayssi T. Gastrointestinal Behçet’s disease: a review. World J Gastroenterol. 2015;21:3801–3812. - PMC - PubMed
    1. Sakane T, Takeno M, Suzuki N, Inaba G. Behçet’s disease. N Engl J Med. 1999;341:1284–1291. - PubMed
    1. Jung HC, Rhee PL, Song IS, Choi KW, Kim CY. Temporal changes in the clinical type or diagnosis of Behçet’s colitis in patients with aphthoid or punched-out colonic ulcerations. J Korean Med Sci. 1991;6:313–318. - PMC - PubMed
    1. Cha HJ, Kim K, Kim M, Choi H, Kim YM, Suh JH. Concurrent gastric adenocarcinoma of fundic gland type and carcinoma with lymphoid stroma: a rare case report. Case Rep Gastroenterol. 2016;10:292–301. - PMC - PubMed
    1. Watanabe K, Tanida S, Inoue N, Kunisaki R, Kobayashi K, Nagahori M, et al. Evidence-based diagnosis and clinical practice guidelines for intestinal Behçet’s disease 2020 edited by Intractable Diseases, the Health and Labour Sciences Research Grants. J Gastroenterol. 2020;55:679–700. - PMC - PubMed

MeSH terms

Substances