scholarly journals Retinal microvasculature features in patients with Behcet’s disease: a systematic review and meta-analysis

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Kai-bao Ji ◽  
Zhe Hu ◽  
Qing-lin Zhang ◽  
Hai-feng Mei ◽  
Yi-qiao Xing
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Continuous Variables ◽  
Behcet's Disease ◽  
Retinal Microvasculature ◽  
The Status

AbstractThis meta-analysis aimed to analyze retinal microvasculature features in eyes with Behçet’s disease (BD) using optical coherence tomography angiography (OCTA). Electronic databases, including PubMed, Web of Science, Embase, and Cochrane Library, were comprehensively searched for published studies comparing retinal microvasculature characteristics between eyes with BD and controls. Continuous variables were calculated using the mean difference (MD) with 95% confidence interval (CI). Review Manager software (version 5.30) was used to conduct statistical analysis. A total of 13 eligible studies involving 599 eyes with BD and 622 control eyes were included in the meta-analysis. The pooled results showed that the macular whole enface superficial and deep vessel density (VD) values measured by OCTA were significantly lower in eyes with BD than in control eyes (superficial VD: MD = − 3.05, P < 0.00001; deep VD: MD = − 4.05, P = 0.0004). The foveal superficial and deep VD values were also significantly lower in the BD group than in the control group (superficial VD: MD = − 1.50, P = 0.009; deep VD: MD = − 4.25, −  = 0.03). Similarly, the analysis revealed a significant reduction in the parafoveal superficial and deep VD in eyes with BD than in control eyes (superficial VD: MD =  − 3.68, P < 0.00001; deep VD: MD = − 4.95, P = 0.0007). In addition, the superficial and deep foveal avascular zones (FAZs) were significantly larger in patients with BD than in controls (superficial FAZ: MD = 0.06, P = 0.02; deep FAZ: MD = 0.12, P = 0.03). The present meta-analysis found that macular whole enface VD, foveal VD, and parafoveal VD were lower in eyes with BD, and the FAZ was larger in patients with BD. The findings suggest that OCTA can assist clinicians in diagnosing and monitoring the status of patients with BD.

scholarly journals The Use of Biologic Agents in the Treatment of Oral Lesions due to Pemphigus and Behcet's Disease: A Systematic Review

2020 ◽  
Vol 1 (1) ◽  
pp. 14-23
Author(s):  
Gerald E. Davis II ◽  
George Sarandev ◽  
Alexander T. Vaughan ◽  
Kamal Al-Eryani ◽  
Reyes Enciso
Keyword(s):  
Systematic Review ◽  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Meta Analysis ◽  
Biologic Agents ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Behcet's Disease ◽  
Randomized Controlled

Background: Current treatments for pemphigus and Behcet's disease, such as corticosteroids, have long-term serious adverse effects. Objective: The objective of this systematic review was to evaluate the efficacy of biologic agents (biopharmaceuticals manufactured via a biological source) on the treatment of intraoral lesions associated with pemphigus and Behcet's disease compared to glucocorticoids or placebo. Methods: PubMed, Web of Science, Cochrane Library, and EMBASE were searched for randomized controlled studies up to January 2019. Bias was assessed with the risk of bias tool. Results: Out of 740 references retrieved, only four randomized controlled trials (RCTs) were included, comprised of a total of 158 subjects (138 pemphigus and 20 Behcet's disease). All studies were assessed at high risk of bias. Heterogeneity of data prevented the authors from performing a meta-analysis. Infliximab or rituximab with short-term prednisone showed higher safety and lowered cumulative prednisone dose than prednisone alone in the treatment of pemphigus. Subcutaneous injection of etanercept provided 45% of patients free of ulcers compared to 5% in the placebo group in one study with Behcet's disease; however, no difference was found in pemphigus patients. Conclusion: Though biological agents alone or in combination with prednisone showed favorable results in three RCTs compared to prednisone alone or placebo, a meta-analysis could not be undertaken due to high heterogeneity. Results are inconclusive, and larger, well-designed RCTs are needed.

scholarly journals Beneficial Effects of Apremilast on Genital Ulcers, Skin Lesions, and Arthritis in Patients With Behçet’s Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Yuki Iizuka ◽  
Kaoru Takase-Minegishi ◽  
Lisa Hirahara ◽  
Yohei Kirino ◽  
Yutaro Soejima ◽  
...  
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Meta Analysis ◽  
Skin Lesions ◽  
Cochrane Library ◽  
Behcet's Disease ◽  
Beneficial Effects ◽  
Oral Ulcers ◽  
Genital Ulcers

Abstract Objective This study aimed to determine the clinical efficacy of apremilast for oral ulcers, extra-oral manifestations, and overall disease activity in patients with Behçet’s disease (BD). Methods A systematic literature search was performed in PubMed, EMBASE, Cochrane Library, and Web of Science Core Collection. Studies assessing the treatment effects of apremilast in BD were included. The odds ratios (ORs) of being symptom free for individual manifestations and mean difference (MD) of Behçet’s Disease Current Activity Form (BDCAF) scores were calculated with 95% confidence intervals (CIs) at 12 and 24 weeks using a random-model meta-analysis. Results Of 259 screened articles, eight were included. After 12 weeks of apremilast treatment the OR of symptom-free was as followings: oral ulcers, 45.76 (95% CI, 13.23–158.31); genital ulcers, 4.56 (95% CI, 2.47–8.44); erythema nodosum, 3.59 (95% CI, 1.11–11.61); pseudofolliculitis, 2.81 (95% CI, 1.29–6.15); and arthritis, 3.55 (95% CI, 1.71–7.40). Furthermore, BDCAF scores at 12 weeks were significantly reduced (MD=−1.38; −1.78 to −0.99). However, the proportion of oral-ulcer free patients increased at 24 weeks (OR=14.88; 4.81 to 46.07). Conclusion The currently accumulated data indicates an improvement in mucocutaneous and articular symptoms by short-term apremilast treatment in patients with BD.

scholarly journals Association between IL1B −511C/T polymorphism and Behçet’s disease: a meta-analysis

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052097986
Author(s):  
Baogang Wang ◽  
Yihang Gao ◽  
Yuying Tan ◽  
Xiaolin Yang ◽  
Xiaxia Man
Keyword(s):  
Behçet’S Disease ◽  
Large Scale ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Meta Analysis ◽  
Recessive Model ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Behcet's Disease ◽  
Hardy Weinberg Equilibrium

Background Many studies have investigated the relationship between the interleukin-1β gene ( IL1B) −511C/T polymorphism and the risk of Behçet’s disease (BD); however, the conclusions remain controversial. Methods In this study, we systemically retrieved relevant studies from the Chinese Biomedicine Database, China National Knowledge Infrastructure, Embase, Cochrane Library, and PubMed databases. We then calculated the odds ratios (ORs) and 95% confidence intervals (CIs) using the meta-package Stata version 12.0. Results The IL1B −511C/T polymorphism was not related to BD susceptibility using any of the tested models (C vs T: OR = 1.20, 95% CI = 0.97–1.49; CC vs TT: OR = 1.27, 95% CI = 0.95–1.70; CT vs TT: OR = 1.03, 95% CI = 0.781.36; dominant model: OR = 1.12, 95% CI = 0.87–1.46; recessive model: OR = 1.27, 95% CI = 0.89–1.82). Similarly, subgroup analysis including studies consistent with the Hardy–Weinberg equilibrium revealed no association between the IL1B polymorphism and BD susceptibility. Conclusion This meta-analysis indicates that the IL1B −511C/T polymorphism is unlikely to affect the risk of BD; however, further large-scale, carefully designed studies are needed to verify these results.

scholarly journals Hyperhomocysteinaemia in Behçet's Disease

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Amira Hamzaoui ◽  
Olfa Harzallah ◽  
Rim Klii ◽  
Silvia Mahjoub
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Homocysteine Level ◽  
Behçet's Disease ◽  
Negative Control Group ◽  
Negative Control ◽  
Control Group ◽  
Behcet's Disease ◽  
Homocysteine Concentration ◽  
Significant Difference

Objectives. The aim of this study was to investigate if hyperhomocysteinaemia is a contributive risk factor for the pathogenesis and the activity of Behçet's disease (BD).Design and Methods. Fifty four patients fullfiling the criteria of the International Study Group for BD were enrolled. Fifty healthy volunteers matched for age and sex with the BD group were included as a negative control group. Patients, with any condition that might affect plasma homocysteine concentration, were excluded.Results. Mean serum homocysteine concentration was significantly higher in patients with BD than in the healthy controls (), in patients with active disease (), and in masculine gender (). There was no significant difference between homocysteine level and clinical involvement.Conclusions. We demonstrated that plasma total homocysteine level (tHcy) is increased in BD and correlated with disease activity. No association was found between homocysteine levels and clinical involvement.

scholarly journals Therapeutic options for patients with rare rheumatic diseases: a systematic review and meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Tim T. A. Bender ◽  
Judith Leyens ◽  
Julia Sellin ◽  
Dmitrij Kravchenko ◽  
Rupert Conrad ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systemic Sclerosis ◽  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Behcet's Disease ◽  
Randomized Controlled ◽  
Anca Associated Vasculitis

Abstract Background Rare diseases (RDs) in rheumatology as a group have a high prevalence, but randomized controlled trials are hampered by their heterogeneity and low individual prevalence. To survey the current evidence of pharmacotherapies for rare rheumatic diseases, we conducted a systematic review and meta-analysis. Randomized controlled trials (RCTs) of RDs in rheumatology for different pharmaco-interventions were included into this meta-analysis if there were two or more trials investigating the same RD and using the same assessment tools or outcome parameters. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PUBMED were searched up to April 2nd 2020. The overall objective of this study was to identify RCTs of RDs in rheumatology, evaluate the overall quality of these studies, outline the evidence of pharmacotherapy, and summarize recommended therapeutic regimens. Results We screened 187 publications, and 50 RCTs met our inclusion criteria. In total, we analyzed data of 13 different RDs. We identified several sources of potential bias, such as a lack of description of blinding methods and allocation concealment, as well as small size of the study population. Meta-analysis was possible for 26 studies covering six RDs: Hunter disease, Behçet’s disease, giant cell arteritis, ANCA-associated vasculitis, reactive arthritis, and systemic sclerosis. The pharmacotherapies tested in these studies consisted of immunosuppressants, such as corticosteroids, methotrexate and azathioprine, or biologicals. We found solid evidence for idursulfase as a treatment for Hunter syndrome. In Behçet’s disease, apremilast and IF-α showed promising results with regard to total and partial remission, and Tocilizumab with regard to relapse-free remission in giant cell arteritis. Rituximab, cyclophosphamide, and azathioprine were equally effective in ANCA-associated vasculitis, while mepolizumab improved the efficacy of glucocorticoids. The combination of rifampicin and azithromycin showed promising results in reactive arthritis, while there was no convincing evidence for the efficacy of pharmacotherapy in systemic sclerosis. Conclusion For some diseases such as systemic sclerosis, ANCA-associated vasculitis, or Behcet's disease, higher quality trials were available. These RCTs showed satisfactory efficacies for immunosuppressants or biological drugs, except for systemic sclerosis. More high quality RCTs are urgently warranted for a wide spectrum of RDs in rheumatology.

scholarly journals Association of LACC1, CEBPB-PTPN1, RIPK2 and ADO-EGR2 with ocular Behcet’s disease in a Chinese Han population

2018 ◽  
Vol 102 (9) ◽  
pp. 1308-1314 ◽  
Author(s):  
Pengcheng Wu ◽  
Liping Du ◽  
Shengping Hou ◽  
Guannan Su ◽  
Lu Yang ◽  
...  
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Meta Analysis ◽  
Allelic Association ◽  
Nucleotide Polymorphisms ◽  
Genetic Loci ◽  
Chinese Han ◽  
Behcet's Disease ◽  
Genome Wide

BackgroundAn Immunochip study recently identified the association of a number of new genetic loci with Behcet’s disease (BD).ObjectiveTo confirm the association between new genetic loci reported in an Immunochip study and BD in a Han Chinese population.MethodsA two-stage association study was carried out in 1238 patients with BD and 1458 healthy controls. Twenty-two candidate single nucleotide polymorphisms (SNPs) were selected for genotyping by iPLEXGold genotyping or TaqMan SNP assays and a meta-analysis was performed for significantly associated markers.ResultsThe results showed that four SNPs (LACC1/rs9316059, CEBPB-PTPN1/rs913678, ADO-EGR2/rs224127 and RIPK2/rs10094579) were associated with BD in an allelic association test (rs9316059 T allele: pc=4.95×10−8, OR=0.687; rs913678 C allele: pc=3.01×10−4, OR=1.297; rs224127 A allele: pc=3.77×10−4, OR=1.274; rs10094579 A allele: pc=6.93×10−4, OR=1.302). For four SNPs tested by meta-analysis, the association with BD was strengthened and all exceeded genome-wide significance (rs9316059: p=2.96×10−16; rs913678: p=2.09×10−16; rs224127: p=5.28×10−13; rs10094579: p=9.21×10−11).ConclusionsOur findings confirmed the association of four loci (LACC1, CEBPB-PTPN1, ADO-EGR2 and RIPK2) in Chinese Han patients with BD.

scholarly journals Effectiveness and Safety of Chinese Medicine Decoctions for Behcet’s Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-19
Author(s):  
Jingxian Yan ◽  
Yi Yan ◽  
Andrew Young ◽  
Zhiyong Yan ◽  
Zhimin Yan
Keyword(s):  
Chinese Medicine ◽  
Adverse Events ◽  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Systemic Vasculitis ◽  
Meta Analysis ◽  
Clinical Feature ◽  
Behcet's Disease ◽  
Secondary Outcomes

Background. Behcet’s disease (BD) is an autoimmune disease of systemic vasculitis with an unclear pathogenesis. Although western medicines remain the mainstay interventions, effectiveness and safety are significant challenges. Complementary and alternative medicine, including herbal medicine, are gaining more attention. Chinese medicine decoctions, which have been used for centuries, are the most common form of traditional therapies. Objective. The purpose of the review was to evaluate the effectiveness and safety of Chinese medicine decoctions in the treatment of BD. Methods. Randomized controlled trials (RCTs) for BD treatment with Chinese medicine decoctions were searched in six electronic databases until March 2021. Primary outcomes were total effective rate, recovery rate, and recurrence rate. Secondary outcomes were clinical feature scores (oral ulcers, eye lesions, genital ulcers, skin lesions, arthropathies, fever, and pathergy reactions) and laboratory index levels (erythrocyte sedimentation rate, C-reactive protein, and immunoglobulin A). The risk of bias was assessed with the Cochrane Handbook, and a meta-analysis was performed with RevMan 5.4.1. Results. Sixteen RCTs with 924 patients were included in the review. The meta-analysis indicated that Chinese medicine decoctions were effective for BD when compared with control groups for all the primary outcomes and 7/10 of the secondary outcomes. Adverse events were reported in 11 of the 16 RCTs, with the Chinese medicine decoctions possibly having fewer adverse events than western drugs. This review included a range of classical prescriptions. An additional meta-analysis of modified Gancao Xiexin Decoction for BD treatment was conducted. Gancao Xiexin decoction is also discussed as a representative prescription, as well as high-frequency herbs, and warrants further exploration for individualized medicine and pharmacology. Conclusion. Chinese medicine decoctions have the potential to be effective and safe for treating BD. However, additional well-designed RCTs are needed to confirm the findings because of the unsatisfactory quality of the included studies.

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