BEHCET'S SYNDROME AND THE ATHEROSCLEROTIC RISK

Background: The prevalence of atherosclerosis is increased in chronic inflammatory diseases like rheumatoid arthritis (RA) or systemic lupus erythematosus. Available data suggest that atherosclerosis is not increased in Behce's syndrome (BS). A previous study reported that 20–30% of RA patients would require lipid lowering therapy according to National Cholesterol Education Program III (NCEP III) guidelines [1]. We hypothesized that the requirement of lipid lowering therapy would be low in BS patients when NCEP III guidelines are applied.Methods: BS and RA patients aged between 25 and 55 years and whose disease duration was more than 5 years were studied. All patients with BS had at least one major organ involvement requiring treatment with steroids and immunosuppressive drugs. Patients with renal impairment (serum creatinine: >1.4 mg/dl) (BS = 2 patients), myocardial infarction or stroke (BS = 3, RA = 3 patients) and those who were using lipid-lowering drugs (RA = 1 patient) were not included in the study. Classical atherosclerotic risk factors were screened and blood was drawn for total cholesterol, HDL, LDL and triglyceride levels. NCEP III guidelines and Framingham risk scoring were applied to all patients.Results: We studied 163 (128 M/35 F) BS patients and 94 (24 M/70 F) RA patients. RA patients were significantly older than patients with BS (Table). Among men, more patients with RA required lipid lowering therapy according to NCEP III compared to patients with BS (p=0.007). The percent of patients with a Framingham 10 year risk score above 10 was higher among men with RA compared to men with BS but this did not reach statistical significance. There was no difference between women regarding the 2 parameters. Atherosclerotic risk profile of BS and RA patients Males Females BS (n = 128) RA (n = 24) P BS (n = 35) RA (n = 70) P Age, mean ± SD yr 40 ± 7 46 ± 6 < 0.01 41 ± 7 44 ± 7 < 0.01 Need LLD* n (%) 15 (12) 8 (33) 0.007 2 (6) 4 (6) NS Framingham 10 year risk ≤10%, n (%) 104 (81) 16 (67) NS 34 (97) 67 (96) NS >10%, n (%) 24 (19) 8 (33) NS 1 (3) 3 (4) NS *LLD: lipid lowering drugs; NS: not significantConclusion: This study shows that men with BS have lower atherosclerotic risk factors compared to men with RA.References: 1. Arthritis Rheum 2004; 50 (9) suppl: 379.Citation: Ann Rheum Dis, volume 65, supplement II, year 2006, page 379Session: Vasculitis