Impact of age at diagnosis on long-term prognosis in patients with intestinal Behçet's disease

J Gastroenterol Hepatol. 2024 Mar;39(3):519-526. doi: 10.1111/jgh.16449. Epub 2023 Dec 27.

Abstract

Background and aim: Although age at disease onset is considered to be a significant factor in the prognosis of Crohn's disease, little is known about its influence on the long-term prognosis of those with intestinal Behçet's disease (BD). This study aimed to evaluate the long-term clinical outcomes of patients with intestinal BD according to age of disease onset.

Methods: Patients diagnosed with intestinal BD at < 18, 18-60, and > 60 years of age were classified into early-onset, adult-onset, and late-onset groups, respectively. The influence of disease onset time on clinical prognosis, including specific medical requirements, BD-related intestinal surgery, hospitalization, and emergency room visits, was compared using the log-rank test in a large cohort of patients with intestinal BD.

Results: Among 780 patients, 21 (2.7%), 672 (86.2%), and 87 (11.1%) comprised the early-onset, adult-onset, and late-onset groups, respectively. Patients in the early-onset group were more likely to require immunosuppressants than those in the adult-onset group (P = 0.048). Nine (42.9%), 158 (23.5%), and 18 (20.7%) patients in the early-onset, adult-onset, and late-onset groups, respectively, underwent intestinal resection. The early-onset group exhibited a higher risk for intestinal resection than the late-onset (P = 0.043) and adult-onset (P = 0.030) groups. The late-onset group exhibited a higher risk for BD-related hospitalization than the adult-onset group (P = 0.023).

Conclusions: Age at diagnosis affected the clinical course of intestinal BD, including intestinal surgery, hospitalization, and specific medical requirements. Different treatment strategies should be established according to age at diagnosis.

Keywords: Behçet's syndrome; age of onset; immunosuppressive agents; intestines; surgery.

MeSH terms

  • Adult
  • Behcet Syndrome* / complications
  • Behcet Syndrome* / diagnosis
  • Behcet Syndrome* / therapy
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Intestinal Diseases* / diagnosis
  • Intestinal Diseases* / etiology
  • Intestinal Diseases* / therapy
  • Intestines
  • Prognosis

Substances

  • Immunosuppressive Agents