Full Papers
Adherence to guidelines for the treatment of Behçet's syndrome in New York and Amsterdam
F.G. Kerstens1, F. Turkstra2, S. Atalay3, R.M. Van Vugt4, C.J. Swearingen5, Y. Yazici6
- NYU Hospital for Joint Disease, New York, NY, USA; and Amsterdam Rheumatology & immunology Center | Reade, Amsterdam, The Netherlands. F.Kerstens@reade.nl
- Amsterdam Rheumatology & Immunology Center | Reade, Amsterdam, The Netherlands.
- Amsterdam Rheumatology & Immunology Center | Reade, Amsterdam, The Netherlands.
- Amsterdam Rheumatology & Immunology Center | VU University Medical Centre, Amsterdam, The Netherlands.
- NYU Hospital for Joint Disease, New York, NY, USA.
- NYU Hospital for Joint Disease, New York, NY, USA.
CER9998
2017 Vol.35, N°6 ,Suppl.108
PI 0055, PF 0059
Full Papers
Free to view
(click on article PDF icon to read the article)
PMID: 28406760 [PubMed]
Received: 08/10/2016
Accepted : 23/02/2017
In Press: 13/04/2017
Published: 27/11/2017
Abstract
OBJECTIVES:
To assess adherence to published guidelines for the treatment of Behçet’s syndrome (BS) in two geographic areas.
METHODS:
We extracted guideline statements from the 2008 EULAR recommendations. Adherence to these statements was evaluated retrospectively in both New York (USA) and Amsterdam (The Netherlands), by reviewing records from patients fulfilling the ISG criteria. We analysed data per statement and event, and divided data according to the year in which an event occurred. We compared events prior to 2009 to those after publication of the EULAR recommendations (2009 and later).
RESULTS:
474 patients were evaluated, 24 of whom were from Amsterdam. Treatment adherence varied substantially across various Behçet’s manifestations, ranging from 21% vs. 31% in posterior uveitis, 50% vs. 25% in arterial disease, 29% vs. 29% in arthritis and 38% vs. 55% in erythema nodosum to 65% vs. 67% in deep venous thrombosis (DVT), before and after publication of the guidelines respectively. Topical treatment of mucocutaneous disease was only 2% vs. 8%, whereas adherence in neuro-Behçet was ≥ 94% and 100% in gastrointestinal disease.
CONCLUSIONS:
Adherence to treatment guidelines varies substantially by Behçet’s manifestation. Lack of adherence in manifestations such as eye disease and arthritis suggests that current recommendations are not sufficient or other concurrent manifestations require more aggressive treatment. The extensive use of anti-TNF agents might indicate a shift towards more aggressive treatment. Thus, our results suggest the 2008 guidelines were not in line with treatment in clinical practice over the past years and the recent revision of the recommendations was indeed needed.
