Behçet syndrome manifestations and activity in the United States versus Turkey - A cross-sectional cohort comparison

Cailin Sibley, Yusuf Yazici, Koray Tascilar, Nafiz Khan, Yasmin Bata, Hasan Yazici, Raphaela Goldbach-Mansky, Gulen Hatemi

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective. To compare clinical manifestations and activity of Behçet syndrome (BS) in the United States versus Turkey using validated outcome measures. Methods. Consecutive patients with BS from the US National Institutes of Health (NIH), New York University, and the University of Istanbul were evaluated. Disease activity was measured using the Behçet's Syndrome Activity Scale (BSAS) and the Behçet's Disease Current Activity Form (BDCAF) with quality of life measured by the Behçet Disease Quality of Life (BDQOL) form. One-way ANOVA, t-tests, and multivariate regression analyses were performed. Results. Mean age did not differ between sites; however, more women were seen in the United States versus in Turkey (p <0.001), and disease duration was longer in the United States (p = 0.02). Organ manifestations were similar for oral and genital ulcers, skin disease, arthralgia, eye disease, and thrombosis. However, more gastrointestinal (p <0.001) and neurologic disease (p = 0.003) was seen in the United States. BSAS and BDCAF scores were worse in the United States compared to Turkey (p = 0.013 and <0.001, respectively). Worse mean BDQOL scores were observed at the NIH compared to Istanbul (not significant). Multivariable regression models showed worse scores in ethnically atypical patients for BSAS and BDCAF (p = 0.04 and p = 0.001), American patients for BDCAF (p = 0.01), older age for BDCAF (p = 0.005), and women for BDQOL (p = 0.01). Conclusion. Demographic and clinical manifestations of BS differ between sites with higher disease activity in the United States compared to Turkey. Referral patterns, age, sex, ethnicity, and country of origin may be important in these differences. These observations raise the question of whether pathogenic mechanisms differ in Turkish and American patients.

Original languageEnglish (US)
Pages (from-to)1379-1384
Number of pages6
JournalJournal of Rheumatology
Volume41
Issue number7
DOIs
StatePublished - 2014

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Turkey
Quality of Life
National Institutes of Health (U.S.)
Oral Ulcer
Eye Diseases
Arthralgia
Nervous System Diseases
Skin Diseases
Analysis of Variance
Thrombosis
Referral and Consultation
Multivariate Analysis
Regression Analysis
Demography
Outcome Assessment (Health Care)

Keywords

  • Behçet syndrome
  • Disease manifestations
  • Turkey
  • United States

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy
  • Medicine(all)

Cite this

Behçet syndrome manifestations and activity in the United States versus Turkey - A cross-sectional cohort comparison. / Sibley, Cailin; Yazici, Yusuf; Tascilar, Koray; Khan, Nafiz; Bata, Yasmin; Yazici, Hasan; Goldbach-Mansky, Raphaela; Hatemi, Gulen.

In: Journal of Rheumatology, Vol. 41, No. 7, 2014, p. 1379-1384.

Research output: Contribution to journalArticle

Sibley, C, Yazici, Y, Tascilar, K, Khan, N, Bata, Y, Yazici, H, Goldbach-Mansky, R & Hatemi, G 2014, 'Behçet syndrome manifestations and activity in the United States versus Turkey - A cross-sectional cohort comparison', Journal of Rheumatology, vol. 41, no. 7, pp. 1379-1384. https://doi.org/10.3899/jrheum.131227
Sibley, Cailin ; Yazici, Yusuf ; Tascilar, Koray ; Khan, Nafiz ; Bata, Yasmin ; Yazici, Hasan ; Goldbach-Mansky, Raphaela ; Hatemi, Gulen. / Behçet syndrome manifestations and activity in the United States versus Turkey - A cross-sectional cohort comparison. In: Journal of Rheumatology. 2014 ; Vol. 41, No. 7. pp. 1379-1384.
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abstract = "Objective. To compare clinical manifestations and activity of Beh{\cc}et syndrome (BS) in the United States versus Turkey using validated outcome measures. Methods. Consecutive patients with BS from the US National Institutes of Health (NIH), New York University, and the University of Istanbul were evaluated. Disease activity was measured using the Beh{\cc}et's Syndrome Activity Scale (BSAS) and the Beh{\cc}et's Disease Current Activity Form (BDCAF) with quality of life measured by the Beh{\cc}et Disease Quality of Life (BDQOL) form. One-way ANOVA, t-tests, and multivariate regression analyses were performed. Results. Mean age did not differ between sites; however, more women were seen in the United States versus in Turkey (p <0.001), and disease duration was longer in the United States (p = 0.02). Organ manifestations were similar for oral and genital ulcers, skin disease, arthralgia, eye disease, and thrombosis. However, more gastrointestinal (p <0.001) and neurologic disease (p = 0.003) was seen in the United States. BSAS and BDCAF scores were worse in the United States compared to Turkey (p = 0.013 and <0.001, respectively). Worse mean BDQOL scores were observed at the NIH compared to Istanbul (not significant). Multivariable regression models showed worse scores in ethnically atypical patients for BSAS and BDCAF (p = 0.04 and p = 0.001), American patients for BDCAF (p = 0.01), older age for BDCAF (p = 0.005), and women for BDQOL (p = 0.01). Conclusion. Demographic and clinical manifestations of BS differ between sites with higher disease activity in the United States compared to Turkey. Referral patterns, age, sex, ethnicity, and country of origin may be important in these differences. These observations raise the question of whether pathogenic mechanisms differ in Turkish and American patients.",
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AU - Bata, Yasmin

AU - Yazici, Hasan

AU - Goldbach-Mansky, Raphaela

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N2 - Objective. To compare clinical manifestations and activity of Behçet syndrome (BS) in the United States versus Turkey using validated outcome measures. Methods. Consecutive patients with BS from the US National Institutes of Health (NIH), New York University, and the University of Istanbul were evaluated. Disease activity was measured using the Behçet's Syndrome Activity Scale (BSAS) and the Behçet's Disease Current Activity Form (BDCAF) with quality of life measured by the Behçet Disease Quality of Life (BDQOL) form. One-way ANOVA, t-tests, and multivariate regression analyses were performed. Results. Mean age did not differ between sites; however, more women were seen in the United States versus in Turkey (p <0.001), and disease duration was longer in the United States (p = 0.02). Organ manifestations were similar for oral and genital ulcers, skin disease, arthralgia, eye disease, and thrombosis. However, more gastrointestinal (p <0.001) and neurologic disease (p = 0.003) was seen in the United States. BSAS and BDCAF scores were worse in the United States compared to Turkey (p = 0.013 and <0.001, respectively). Worse mean BDQOL scores were observed at the NIH compared to Istanbul (not significant). Multivariable regression models showed worse scores in ethnically atypical patients for BSAS and BDCAF (p = 0.04 and p = 0.001), American patients for BDCAF (p = 0.01), older age for BDCAF (p = 0.005), and women for BDQOL (p = 0.01). Conclusion. Demographic and clinical manifestations of BS differ between sites with higher disease activity in the United States compared to Turkey. Referral patterns, age, sex, ethnicity, and country of origin may be important in these differences. These observations raise the question of whether pathogenic mechanisms differ in Turkish and American patients.

AB - Objective. To compare clinical manifestations and activity of Behçet syndrome (BS) in the United States versus Turkey using validated outcome measures. Methods. Consecutive patients with BS from the US National Institutes of Health (NIH), New York University, and the University of Istanbul were evaluated. Disease activity was measured using the Behçet's Syndrome Activity Scale (BSAS) and the Behçet's Disease Current Activity Form (BDCAF) with quality of life measured by the Behçet Disease Quality of Life (BDQOL) form. One-way ANOVA, t-tests, and multivariate regression analyses were performed. Results. Mean age did not differ between sites; however, more women were seen in the United States versus in Turkey (p <0.001), and disease duration was longer in the United States (p = 0.02). Organ manifestations were similar for oral and genital ulcers, skin disease, arthralgia, eye disease, and thrombosis. However, more gastrointestinal (p <0.001) and neurologic disease (p = 0.003) was seen in the United States. BSAS and BDCAF scores were worse in the United States compared to Turkey (p = 0.013 and <0.001, respectively). Worse mean BDQOL scores were observed at the NIH compared to Istanbul (not significant). Multivariable regression models showed worse scores in ethnically atypical patients for BSAS and BDCAF (p = 0.04 and p = 0.001), American patients for BDCAF (p = 0.01), older age for BDCAF (p = 0.005), and women for BDQOL (p = 0.01). Conclusion. Demographic and clinical manifestations of BS differ between sites with higher disease activity in the United States compared to Turkey. Referral patterns, age, sex, ethnicity, and country of origin may be important in these differences. These observations raise the question of whether pathogenic mechanisms differ in Turkish and American patients.

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