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Influence of Gender on Behcet's Disease Phenotype and Irreversible Organ Damage: Data From the International Aida Network Behcet's Disease Registry Publisher Pubmed



Sota J1 ; Ragab G2, 3 ; Almaglouth I4 ; Lopalco G5 ; Tufan A6 ; Direskeneli H7 ; Hinojosaazaola A8 ; Mayrink Giardini HA9 ; Guerriero S10 ; Triggianese P11 ; Sfikakis PP12 ; Piga M13 ; Ruscitti P14 ; Govoni M15 Show All Authors
Authors
  1. Sota J1
  2. Ragab G2, 3
  3. Almaglouth I4
  4. Lopalco G5
  5. Tufan A6
  6. Direskeneli H7
  7. Hinojosaazaola A8
  8. Mayrink Giardini HA9
  9. Guerriero S10
  10. Triggianese P11
  11. Sfikakis PP12
  12. Piga M13
  13. Ruscitti P14
  14. Govoni M15
  15. Iagnocco A16
  16. Carubbi F17
  17. Hernandezrodriguez J18
  18. Laymouna AH2
  19. Mahmoud AAMA2
  20. Ghanema M2
  21. Aboabat AA4
  22. Asfina KN4
  23. Alanazi F4
  24. Morrone M5
  25. Spedicato V5
  26. Kucuk H6
  27. Kardas R6
  28. Alibaz Oner F7
  29. Sevik G7
  30. Torresruiz J8
  31. Kawakamicampos PA8
  32. Parente De Brito Antonelli I9
  33. Dammacco R10
  34. Chimenti MS11
  35. Arida K12
  36. Floris A13
  37. Gentile M14
  38. Ruffilli F15
  39. Bellis E16
  40. Alunno A17
  41. Espinosa G18
  42. Gentileschi S1
  43. Gaggiano C1
  44. Vitale A1
  45. Caggiano V1
  46. Lopez R1
  47. Tarsia M1
  48. Monti S19
  49. Hatemi G20, 21
  50. Karakoc A20
  51. Frassi M22
  52. Giacomelli R23
  53. Tharwat S24, 25
  54. Thabet M26
  55. Ciccia F27
  56. Emmi G28, 29, 30
  57. Viapiana O31
  58. Sahin A32
  59. Sebastiani GD33
  60. Batu ED34
  61. Ozen S34
  62. Sener S34
  63. Oprisbelinski D35
  64. Costi S36
  65. Conforti A37
  66. Cattalini M38
  67. Bartoloni E39
  68. Akkoc N40
  69. Gunduz OS40
  70. Conti G41
  71. Maier A42
  72. Giardina A43
  73. Li Gobbi F44
  74. Parronchi P45
  75. Sarzi Puttini P46
  76. Breda L47
  77. De Paulis A48, 49
  78. Carreno E50
  79. La Torre F51
  80. Wiesikscewczyk E52
  81. Dela Torre A53
  82. Mejiasalgado G53
  83. Shahram F54
  84. Guiducci S55
  85. Maggio MC56
  86. Aragona E57
  87. Rigante D58, 59
  88. Ciavarro A60
  89. Onen F61
  90. Insalaco A63
  91. Del Giudice E64
  92. Barone P65
  93. Gicchino F66
  94. Brucato A67
  95. Lo Gullo A68
  96. Mauro A69, 70
  97. Karamanakos A71
  98. Balistreri A72
  99. Mazzei MA73
  100. Frediani B1
  101. Fabiani C74
  102. Cantarini L1

Source: Joint Bone Spine Published:2025


Abstract

Objectives: Gender impact on phenotypical expression of Behcet's disease (BD) has been specifically investigated only in a few large-scale studies. The main goal of the study was to examine gender differences in a large cohort of patients affected by BD. Methods: Data were retrieved from the International AIDA Network Registry for BD. We assessed differences between males and females in terms of Behcet's syndrome Overall Damage Index (BODI), differences in the disease manifestations at onset and in the cumulative manifestations throughout disease course, as well as differences in the cardiovascular risk. Finally, predictive factors leading to major organ involvement were investigated. Results: In total, 1024 BD patients (567 males, 457 females) were enrolled in the study, with a male-to-female ratio of 1.24/1. Males displayed a significantly higher mean ± SD BODI (1.92 ± 2.09) at the last follow-up, compared to female patients (1.25 ± 1.87) (P < 0.0001). Uveitis (P < 0.0001) and vascular involvement (P = 0.0076) were significantly more frequent among males whereas female patients were significantly over-represented in arthralgia (P < 0.0001), arthritis (P = 0.00025), isolated headache (P < 0.0001), central nervous system (CNS) involvement (P = 0.040), and gastrointestinal involvement (P = 0.00046). Regarding cardiovascular risk, no differences between the two groups emerged (P = 0.617). Four variables were associated with the development of major organ involvement: male gender (OR = 2.104, P = 0.001), current treatment with biologic agents (OR = 2.257, P = 0.0003), origin from endemic countries (OR = 2.661, P = 0.0009), and disease duration (OR = 1.002, P = 0.024). Conclusion: BD displays a more severe course among males. This subgroup develops more irreversible damage and presents more frequently ocular and vascular involvement during disease course. On the other hand, female patients are prone to experience articular involvement, headache, CNS and gastrointestinal involvement. These data suggest the existence of a gender-driven disease expression. © 2024 The Author(s)
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