Does anticoagulation in combination with immunosuppressive therapy prevent recurrent thrombosis in Behçet's disease?
Vascular involvement in Behçet's disease (BD) occurs in up to 50% of patients. The main mechanism of thrombosis is inflammation. Thus, immunosuppressants (IS) are the mainstay of therapy, and adding anticoagulation (AC) is controversial. In daily practice, we observed that patients who received AC in combination with IS experienced less recurrent thrombosis and decided to investigate our BD patients retrospectively. We hypothesized that adding AC to immunosuppressive therapy may lower the risk of recurrent thrombosis. Treatment at the time of first or recurrent thrombotic events was recorded. Events under the only IS and IS + AC treatments were compared. There were 40 patients (33 males). The most common types of first vascular events were deep vein thrombosis (77.5%) followed by pulmonary embolism (PE) (52.5%). One patient did not receive any treatment. Among the 39 patients, 32 received glucocorticoid and at least one of the azathioprine, or cyclophosphamide, anti-TNF, 5 received monotherapy with azathioprine, 1 received monotherapy with corticosteroid, and the remaining 1 received monotherapy with cyclophosphamide. In total, 22 patients (55%) experienced 27 recurrent venous thromboembolism (VTE) events. Two (7.4%) events while only on AC, 2 (7.4%) events while on AC + IS, and 15 (55.5%) events occurred while on only IS. Eight (19.6%) patients were not receiving any treatment during relapses. The recurrence rate was statistically significantly lower in the IS + AC treatment group compared to IS alone. In conclusion, IS are the mainstay of treatment for BD, and adding AC may help to lower the recurrence risk of thrombotic events.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:72 |
|---|---|
| Enthalten in: |
Journal of investigative medicine : the official publication of the American Federation for Clinical Research - 72(2024), 4 vom: 15. Apr., Seite 387-391 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Erol, Serhat [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 04.04.2024 Date Revised 04.04.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1177/10815589241232368 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM368479706 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM368479706 | ||
| 003 | DE-627 | ||
| 005 | 20240404234808.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240215s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/10815589241232368 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1364.xml |
| 035 | |a (DE-627)NLM368479706 | ||
| 035 | |a (NLM)38357865 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Erol, Serhat |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Does anticoagulation in combination with immunosuppressive therapy prevent recurrent thrombosis in Behçet's disease? |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 04.04.2024 | ||
| 500 | |a Date Revised 04.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Vascular involvement in Behçet's disease (BD) occurs in up to 50% of patients. The main mechanism of thrombosis is inflammation. Thus, immunosuppressants (IS) are the mainstay of therapy, and adding anticoagulation (AC) is controversial. In daily practice, we observed that patients who received AC in combination with IS experienced less recurrent thrombosis and decided to investigate our BD patients retrospectively. We hypothesized that adding AC to immunosuppressive therapy may lower the risk of recurrent thrombosis. Treatment at the time of first or recurrent thrombotic events was recorded. Events under the only IS and IS + AC treatments were compared. There were 40 patients (33 males). The most common types of first vascular events were deep vein thrombosis (77.5%) followed by pulmonary embolism (PE) (52.5%). One patient did not receive any treatment. Among the 39 patients, 32 received glucocorticoid and at least one of the azathioprine, or cyclophosphamide, anti-TNF, 5 received monotherapy with azathioprine, 1 received monotherapy with corticosteroid, and the remaining 1 received monotherapy with cyclophosphamide. In total, 22 patients (55%) experienced 27 recurrent venous thromboembolism (VTE) events. Two (7.4%) events while only on AC, 2 (7.4%) events while on AC + IS, and 15 (55.5%) events occurred while on only IS. Eight (19.6%) patients were not receiving any treatment during relapses. The recurrence rate was statistically significantly lower in the IS + AC treatment group compared to IS alone. In conclusion, IS are the mainstay of treatment for BD, and adding AC may help to lower the recurrence risk of thrombotic events | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Chronic disease | |
| 650 | 4 | |a disease management | |
| 650 | 4 | |a immunosuppression | |
| 650 | 4 | |a pulmonary embolism | |
| 650 | 4 | |a vascular diseases | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 650 | 7 | |a Azathioprine |2 NLM | |
| 650 | 7 | |a MRK240IY2L |2 NLM | |
| 650 | 7 | |a Tumor Necrosis Factor Inhibitors |2 NLM | |
| 650 | 7 | |a Immunosuppressive Agents |2 NLM | |
| 650 | 7 | |a Cyclophosphamide |2 NLM | |
| 650 | 7 | |a 8N3DW7272P |2 NLM | |
| 700 | 1 | |a Gürün Kaya, Aslıhan |e verfasserin |4 aut | |
| 700 | 1 | |a Arslan, Fatma |e verfasserin |4 aut | |
| 700 | 1 | |a Hasanzade, Hasan |e verfasserin |4 aut | |
| 700 | 1 | |a Daştan, Ahmet Onur |e verfasserin |4 aut | |
| 700 | 1 | |a Çiledağ, Aydın |e verfasserin |4 aut | |
| 700 | 1 | |a Eriş Gülbay, Banu |e verfasserin |4 aut | |
| 700 | 1 | |a Kaya, Akın |e verfasserin |4 aut | |
| 700 | 1 | |a Özdemir Kumbasar, Özlem |e verfasserin |4 aut | |
| 700 | 1 | |a Çelik, Gökhan |e verfasserin |4 aut | |
| 700 | 1 | |a Acıcan, Turan |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of investigative medicine : the official publication of the American Federation for Clinical Research |d 1998 |g 72(2024), 4 vom: 15. Apr., Seite 387-391 |w (DE-627)NLM075137704 |x 1708-8267 |7 nnns |
| 773 | 1 | 8 | |g volume:72 |g year:2024 |g number:4 |g day:15 |g month:04 |g pages:387-391 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/10815589241232368 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 72 |j 2024 |e 4 |b 15 |c 04 |h 387-391 | ||