P120 - Effects of anticoagulant treatment on the incidence of new

P120 - Effects of anticoagulant treatment on the incidence of new
vascular events in patients with Behçet’s disease with vascular
involvement
Alibaz-Oner Fatma (1), Karadeniz Aslı (2), Yılmaz Sema (3), Balkarlı Ayşe (4), Cobankara Veli (5), Yazıcı
Ayten (6), Cefle Ayşe (7), Kimyon Gezmiş (8), Kısacık Bunyamin (9), Onat Ahmet Mesut (10), Yıldız Fatih (11),
Erken Eren (12), Yaşar Bilge Şule (13), Kasifoglu Timucin (14), Yıldırım Çetin Gözde (15), Sayarlıoglu Mehmet
(16)
, Direskeneli Haner (17)
(1) Marmara University, School of Medicine, Department of Rheumatology., ISTANBUL, Turkey ; (2)
Marmara University, Schol of Medicine, Department of Rheumatology., Istanbul, Turkey ; (3) Selcuk
University, School of Medicine, Department of Rheumatology, Konya, Turkey ; (4) Pamukkale
University, School of Medicine, Department of Rheumatology, Denizli, Turkey ; (5) Pamukkale
University, School of Medicine, Department of Rheumatology., Denizli, Turkey ; (6) Kocaeli University,
School of Medicine, Department of Rheumatology., Kocaeli, Turkey ; (7) Kocaeli University, School of
Medicine, Department of Rheumatology, Kocaeli, Turkey ; (8) Gaziantep University, School of
Medicine, Department of Rheumatology, Gaziantep, Turkey ; (9) Gaziantep University, School of
Medicine, Department of Rheumatology., Gaziantep, Turkey ; (10) Gaziantep University, School of
Medicine, Department of Rheumatology., Gaziantep, Turkey ; (11) Çukurova University, School of
Medicine, Department of Rheumatology, Adana, Turkey ; (12) Çukurova University, School of
Medicine, Department of Rheumatology, Adana, Turkey ; (13) Osmangazi University, School of
Medicine, Department of Rheumatology, Eskişehir, Turkey ; (14) Osmangazi University, School of
Medicine, Department of Rheumatology., Eskişehir, Turkey ; (15) Sutcu Imam University, School of
Medicine, Department of Rheumatology, Kahramanmaras, Turkey ; (16) Ondokuz Mayıs University,
School of Medicine, Department of Rheumatology, Samsun, Turkey ; (17) Marmara University, School
of Medicine, Department of Rheumatology., ISTANBUL, Turkey
Purpose
Vascular involvement (VI) is one of the major causes of mortality and morbidity in Behçet’s Disease
(BD). However, there are no controlled studies for the management of major vascular involvement in
BD. According to the EULAR recommendations, only immunosuppressive (IS) agents such as
corticosteroids, azathioprine, cyclophosphamide or cyclosporine A are recommended for VI. In this
study, we aimed to investigate the effects of anticoagulant (AC) treatment on the development of
new vascular events in patients with BD followed up for vascular disease.
Method
In this retrospective study, 637 patients with BD (F/M: 283/354, mean age: 38.5±11.1 years)
classified according to ISG criteria from 8 Rheumatology centers in Turkey, were included. The
demographic data, clinical characteristics of first vascular event and relapses, treatment protocols
and data about complications were acquired from patient files.
Results
Two hundred eighty-one BD patients (44.1%) were of mucocutaneus type, whereas 356 patients
(55.9%) had major organ involvement [Uveitis: 42.4% (n=270), VI: 20.6% (n=131), neurologic
involvement: 6.9% (n=44)]. VI developed in 131 patients during the follow-up. When the first vascular
event developed, the mean disease duration was 3.5 (0-28) years and mean age was 33.2±8 years.
After the first vascular event, IS treatment was given to 88.5% (n=105) and AC treatment to 62.6%
(n=76) of the patients. Minor hemorrhage (as a complication related to AC treatment) was observed
in 3 (3.9%) patients. A second vascular event developed in 47 (35.9%) patients. The rate of new
vascular event development was similar between the patients taking only ISs and AC plus IS
treatments after the first vascular event (27.2% vs 29.6%, p=0.78). Relapse rate was significantly
higher in the group taking only ACs than taking only ISs (91.6%, p=0.002). During follow-up, a third
vascular event developed in 11 patients. The rate of new vascular event development was again
similar between the patients taking only IS and AC plus IS treatments. There was no relationship
between the total duration of AC treatment and number of vascular events. However, total number
of vascular events negatively correlated with the age during the first vascular event (r:-0.215,
p=0.02). However, treatment rates before and after vascular events also showed a severe
compliance problem during the follow-up
Conclusion
In this study, we did not find any extra effect of AC treatment adding on to IS treatment in the course
of vascular involvement in patients with BD. Severe complications related to AC treatment were also
not frequent. Our results suggest that there is also a severe compliance problem in BD patients with
VI during follow-up.

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