P0234 Predicting factors for long-term outcomes of intestinal Behçet's disease in Japan
K Murakami, S Ihara, M FujishiroAbstract
Background
This study aimed to investigate long-term prognosis and predictive factors for relapse in patients with intestinal Behçet's disease (BD) who initiated conventional therapy (5-ASA, oral steroids, and azathioprine) in Japan.
Methods
Sixty-three patients with intestinal BD treated at Tokyo University Hospital in Japan from 2005 to 2024 were included. Patients who required anti-TNFα agents were classified as the Advanced Therapy (AT) group, while those controlled with conventional therapy were classified as the Conventional Therapy (CT) group. Cumulative relapse rates and risk factors for relapse were analyzed by Kaplan-Meier method and Cox proportional hazards Regression.
Results
The median follow-up was 93 months (range, 4-231), with 28 patients (44%) in the AT group and 35 patients (56%) in the CT group. At the time of diagnosis of intestinal BD, there were no significant differences between the two groups in terms of sex, age, and BD subtypes. The cumulative relapse rates at 1, 3, 5, and 10 years were 22.6%, 35.9%, 40.0%, and 50.8%, respectively. Univariate and multivariate analyses identified concomitant use of PPIs (HR: 2.65, 95% CI: 1.06-6.58, p=0.036), the presence of bloody stool (HR: 2.40, 95% CI: 1.05-5.46, p=0.037), CRP ≥ 4 mg/dL (HR: 2.56, 95% CI: 1.04-6.31, p=0.042), and maximum ulcer size ≥ 3 cm (HR: 2.68, 95% CI: 1.05-6.84, p=0.039) as independent risk factors for transitioning to AT. A predictive model incorporating these factors demonstrated good diagnostic ability (AUC = 0.847).
Conclusion
PPI use, bloody stool, high CRP, and large ulcer size were considered risk factors for resistance to conventional therapy and the need for anti-TNFα agents in patients with intestinal BD.