Behcet′s disease in India: A dermatological perspective

Singal, Archana; Chhabra, Namrata; Pandhi, Deepika; Rohatgi, Jolly

doi:10.4103/0378-6323.107636

Cited by 21 publications

(13 citation statements)

References 20 publications

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“…The prevalence of GI involvement causing intestinal ulcers has been reported to be 15%-20%, 4 although it varies between different populations. [7][8][9][10][11][12] Notably, GI involvement is common in Japanese patients with BD and is estimated to be approximately 50% 13,14 and based on an analysis from 2007, has been steadily rising. 15 According to the revised Japanese consensus guidelines (2014), 16 a diagnosis of intestinal BD is based on the presence of a typical oval-shaped large ulcer in the terminal ileum, or ulcerations or inflammation in the small or large intestine.…”

Section: Introductionmentioning

confidence: 99%

Long-term safety and effectiveness of adalimumab in 462 patients with intestinal Behçet’s disease: results from a large real-world observational study

et al. 2021

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Mediterranean basin, corresponding to the Old Silk Road, an ancient trading route stretching between the Mediterranean, the Middle East, and the Far East 3 with an estimated prevalence of 13.5-20 cases per 100,000 people in Japan, Korea, China, Iran, and Saudi Arabia. 2 In Japan, the estimated prevalence of BD was reported as 14.9 per 100,000 people in 2002. 4 According to the diagnostic criteria published by the Japanese Ministry of Health, Labour and Welfare, 5,6 the major symptoms of BD include recurrent oral and genital ulceration, skin lesions such as erythema nodosum, subcutaneous thrombophlebitis, pseudofolliculitis and acneiform nodules, and ocular

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Section: Introductionmentioning

confidence: 99%

Long-term safety and effectiveness of adalimumab in 462 patients with intestinal Behçet’s disease: results from a large real-world observational study

et al. 2021

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“…BD with GI involvement is known as intestinal BD [3]. The frequency of GI involvement among BD patients varies, with lower frequency in Turkey (2.8%), India (3.4%), and Saudi Arabia (4%); moderate frequency in China (10%); and the highest frequency reported in the United Kingdom (38%–53%) and Japan (50%–60%) [4–7]. BD lesions may occur in any segment of the alimentary tract and various GI organs; however, the ileocecal region was predominantly involved.…”

Section: Introductionmentioning

confidence: 99%

Comparison between Intestinal Behçet’s Disease and Crohn’s Disease in Characteristics of Symptom, Endoscopy, and Radiology

Zhang

Hong

Wang

et al. 2017

Gastroenterology Research and Practice

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Aim To evaluate different parameters in differentiating intestinal BD from CD. Methods The medical records of inpatients with intestinal BD and CD were retrospectively reviewed. The univariate value of different parameters was analyzed, respectively. A differentiation model was established by pooling all valuable parameters together. Diagnostic efficacy was evaluated, and a receiver operating curve (ROC) was plotted. Results Forty-two BD patients and ninety-seven CD patients were reviewed. Demographic and clinical parameters that showed significant value included diarrhea, fever, perianal disease, oral ulcers, genital ulcers, skin lesions, and musculoskeletal lesions. Endoscopic parameters reaching clinical significance included multiple-site lesions, lesions confined to the ileocecal region, longitudinal ulcers, round or oval ulcers, punch-out ulcers, ulcers with discrete margin, ulcer size > 2 cm, stricture of bowel, and anorectal involvement. Radiologic parameters aiding the differentiation included involvement segments ≤ 3, asymmetrical pattern of involvement, intraluminal pseudopolyp formation, target sign, stricture with proximal dilation, comb sign, and fistula. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the differentiation model were 90.5%, 93.8%, 92.8%, 86.4%, and 95.8%, respectively. The cutoff value was 0.5 while the area under the ROC curve was 0.981. Conclusion The differentiation model that integrated the various parameters together may yield a high diagnostic efficacy in the differential diagnosis between intestinal BD and CD.

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“…The first report on the use of MTX in uveitis was published in 1965 by Wong and Hersh, 188 who described positive effects in 9 of 10 patients with a diagnosis of ‘cyclitis’ who were refractory to systemic steroid therapy. Since then, small series have reported MTX to be effective for ocular inflammation in general, 189 and for specific ocular inflammatory conditions, including uveitis associated to juvenile idiopathic arthritis, 190 – 193 sarcoidosis, 194 Behcet’s disease, 195 mucous membrane pemphigoid, 196 and rheumatoid arthritis. 197 …”

Section: Resultsmentioning

confidence: 99%

Evidence-based efficacy of methotrexate in adult Crohn’s disease in different intestinal and extraintestinal indications

Cassinotti¹,

Batticciotto²,

Parravicini³

et al. 2022

Therap Adv Gastroenterol

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Introduction: Methotrexate (MTX) is included in the therapeutic armamentarium of Crohn’s disease (CD), although its positioning is currently uncertain in an era in which many effective biological drugs are available. No systematic reviews or meta-analysis have stratified the clinical outcomes of MTX according to the specific clinical scenarios of its use. Methods: Medline, PubMed and Scopus were used to extract eligible studies, from database inception to May 2021. A total of 163 studies were included. A systematic review was performed by stratifying the outcomes of MTX according to formulation, clinical indication and criteria of efficacy. Results: The use of MTX is supported by randomized clinical trials only in steroid-dependent CD, with similar outcomes to thiopurines. The use of MTX in patients with steroid-refractoriness, failure of thiopurines or in combination with biologics is not supported by high levels of evidence. Combination therapy with biologics can optimize the immunogenic profile of the biological drug, but the impact on long-term clinical outcomes is described only in small series with anti-TNFα. Other off-label uses, such as fistulizing disease, mucosal healing, postoperative prevention and extraintestinal manifestations, are described in small uncontrolled series. The best performance in most indications was shown by parenteral MTX, favouring higher doses (25 mg/week) in the induction phase. Discussion: Evidence from high-quality studies in favour of MTX is scarce and limited to the steroid-dependent disease, in which other drugs are the leading players today. Many limitations on study design have been found, such as the prevalence of retrospective underpowered studies and the lack of stratification of outcomes according to specific types of patients and formulations of MTX. Conclusion: MTX is a valid option as steroid-sparing agent in steroid-dependent CD. Numerous other clinical scenarios require well-designed clinical studies in terms of patient profile, drug formulation and dosage, and criteria of efficacy.

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Behcet′s disease in India: A dermatological perspective

Cited by 21 publications

References 20 publications

Long-term safety and effectiveness of adalimumab in 462 patients with intestinal Behçet’s disease: results from a large real-world observational study

Long-term safety and effectiveness of adalimumab in 462 patients with intestinal Behçet’s disease: results from a large real-world observational study

Comparison between Intestinal Behçet’s Disease and Crohn’s Disease in Characteristics of Symptom, Endoscopy, and Radiology

Evidence-based efficacy of methotrexate in adult Crohn’s disease in different intestinal and extraintestinal indications

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