NEW recommendations for the management of Behҫet’s syndrome (BS) have been published by the European League Against Rheumatism (EULAR). These recommendations, which provide an update to existing EULAR guidance on managing the syndrome, have taken into account the results of new studies and also identify areas that should be targeted for future research.
Five Principles
In addition to 10 recommendations, five overarching principles were formulated:
- AIM of treatment is to prevent irreversible organ damage by promptly suppressing inflammatory exacerbations and recurrences as the syndrome typically runs a relapsing a remitting course.
- MULTIDISCIPLINARY approach is required to achieve optimal care for patients.
- INDIVIDUALISED treatment according to age, gender, type, and severity of organ involvement, as well as patient preferences, should be sought after.
- POOR prognosis may be linked to ocular, vascular, neurologic, and gastrointestinal involvement.
- IMPROVEMENTS in disease manifestations may be observed in many patients over time.
Process
In creating the updated guidance, EULAR undertook a process that included the analysis of the results of systematic reviews and a collaboration of 20 BS experts drawn from different parts of the world in addition to a nurse, two BS patients, two fellows responsible for the systematic literature review, and one senior methodologist. The breadth of knowledge required reflects the complicated nature of the syndrome. It affects multiple areas of the body, including the skin, joints, gastrointestinal system, veins, and nervous system. Additionally, there are geographical variations in its clinical features.
New Information
Information taken into account in the new recommendations include the substantial increase of knowledge into the use of biologic agents and greater evidence available for the management of gastrointestinal involvement.
Individualised Treatments
The emphasis on individualised treatment approaches is due to the varying degrees and types of organ and system involvement, as well as the relapsing and remitting nature of BS. Additionally, there are notable differences in disease course between men and women; for example, more aggressive treatment and greater caution during follow-up should take place when dealing with the more severe disease course among men who are at a young age at disease onset.
Target Audience
The recommendations are aimed at all physicians and surgeons involved in treating BS.
James Coker, Reporter
For the source and further details about the recommendations, click here.
