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OBJECTIVES: The epidemiology of Behçet's disease (BD) has not been well characterized in the UK. Evidence on the risk of cardiovascular disease, thromboembolic disease and mortality in patients with BD compared with the general population is scarce. METHODS: We used a large UK primary care database to investigate the epidemiology of BD. A retrospective matched cohort study was used to assess the following outcomes: risk of cardiovascular, thromboembolic disease and mortality. Controls were selected at a 1:4 ratio (age and gender matched). Cox proportional hazard models were used to derive adjusted hazard ratios (aHR). RESULTS: The prevalence of BD was 14.61 (95% CI 13.35-15.88) per 100 000 population in 2017. A total of 1281 patients with BD were compared with 5124 age- and gender-matched controls. There was significantly increased risk of ischaemic heart disease [aHR 3.09 (1.28-7.44)], venous thrombosis [aHR 4.80 (2.42-9.54)] and mortality [aHR 1.40 (1.07-1.84)] in patients with BD compared with corresponding controls. Patients with BD were at higher risk of pulmonary embolism compared with corresponding controls at baseline [adjusted odds ratio 4.64 (2.66-8.09), P < 0.0001]. The majority of patients with pulmonary embolism and a diagnosis of BD had pulmonary embolism preceding the diagnosis of BD, not after (87.5%; n = 28/32). CONCLUSION: BD has a higher prevalence than previously thought. Physicians should be aware of the increased risk of developing ischaemic heart disease, stroke/transient ischaemic attack and deep venous thrombosis in patients with BD at an earlier age compared with the general population. Risk of embolism in patients with BD might vary across the disease course.

Original publication

DOI

10.1093/rheumatology/keaa010

Type

Journal article

Journal

Rheumatology (oxford)

Publication Date

01/10/2020

Volume

59

Pages

2785 - 2795

Keywords

Behcet’s disease, cardiovascular risk, epidemiology, immune-mediated inflammatory diseases, mortality, thromboembolism, Adult, Behcet Syndrome, Cardiovascular Diseases, Case-Control Studies, Cohort Studies, Female, Humans, Incidence, Male, Middle Aged, Morbidity, Myocardial Ischemia, Prevalence, Proportional Hazards Models, Pulmonary Embolism, Retrospective Studies, Risk Factors, Thromboembolism, United Kingdom, Venous Thrombosis