Article
Author: Laymouna, Ahmed Hatem ; Gicchino, Francesca ; Gentileschi, Stefano ; Cattalini, Marco ; Bellis, Elisa ; Frediani, Bruno ; Batu, Ezgi Deniz ; Gunduz, Ozgul Soysal ; Lo Gullo, Alberto ; Cantarini, Luca ; Alanazi, Fehaid ; Mazzei, Maria Antonietta ; Mejía-Salgado, Germán ; Brucato, Antonio ; Hatemi, Gülen ; Mayrink Giardini, Henrique Ayres ; Gaggiano, Carla ; Karamanakos, Anastasios ; Więsik-Scewczyk, Ewa ; Asfina, Kazi Nur ; Fabiani, Claudia ; Sebastiani, Gian Domenico ; Lopez, Roberta ; Tarsia, Maria ; Kucuk, Hamit ; Sevik, Gizem ; Alunno, Alessia ; Vitale, Antonio ; Spedicato, Veronica ; Giardina, Annarita ; Insalaco, Antonella ; Govoni, Marcello ; Conforti, Alessandro ; Kardas, Riza ; Maggio, Maria Cristina ; Lopalco, Giuseppe ; De Paulis, Amato ; Erten, Şükran ; Thabet, Maissa ; Tharwat, Samar ; Morrone, Maria ; Ruffilli, Francesca ; Aragona, Emma ; Piga, Matteo ; Del Giudice, Emanuela ; Gentile, Martina ; Mahmoud, Ayman Abdel-Monem Ahmed ; Balistreri, Alberto ; Mauro, Angela ; Opris-Belinski, Daniela ; Barone, Patrizia ; Floris, Alberto ; Parente de Brito Antonelli, Isabelle ; AlMaglouth, Ibrahim ; Espinosa, Gerard ; Ciavarro, Alessandro ; Önen, Fatos ; La Torre, Francesco ; Ragab, Gaafar ; Caggiano, Valeria ; Torres-Ruiz, Jiram ; Ruscitti, Piero ; Tufan, Abdurrahman ; Kawakami-Campos, Perla Ayumi ; Carreño, Ester ; Iagnocco, Annamaria ; Chimenti, Maria Sole ; Alibaz Öner, Fatma ; Shahram, Farhad ; Guiducci, Serena ; Sarzi Puttini, Piercarlo ; Direskeneli, Haner ; Costi, Stefania ; Arida, Katerina ; Parronchi, Paola ; Rigante, Donato ; Guerriero, Silvana ; Giacomelli, Roberto ; Emmi, Giacomo ; Carubbi, Francesco ; Ozen, Seza ; Maier, Armin ; Hernández-Rodríguez, José ; Conti, Giovanni ; Frassi, Micol ; Aboabat, Aos A ; Sfikakis, Petros P ; Li Gobbi, Francesca ; Triggianese, Paola ; Breda, Luciana ; Karakoç, Alican ; Şahin, Ali ; Monti, Sara ; Dammacco, Rosanna ; Bartoloni, Elena ; Ciccia, Francesco ; Sota, Jurgen ; Ghanema, Mahmoud ; Akkoç, Nurullah ; Viapiana, Ombretta ; Hinojosa-Azaola, Andrea ; Sener, Seher ; de-la Torre, Alejandra
OBJECTIVESGender impact on phenotypical expression of Behçet'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.METHODSData were retrieved from the International AIDA Network Registry for BD. We assessed differences between males and females in terms of Behçet'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.RESULTSIn 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).CONCLUSIONBD 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.