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Influence of Gender on Behcet's Disease Phenotype and Irreversible Organ Damage: Data From the International Aida Network Behcet's Disease Registry Publisher Pubmed



Sota J1 ; Ragab G2, 3 ; Almaglouth I4 ; Lopalco G5 ; Tufan A6 ; Direskeneli H7 ; Hinojosaazaola A8 ; Mayrink Giardini HA9 ; Guerriero S10 ; Triggianese P11 ; Sfikakis PP12 ; Piga M13 ; Ruscitti P14 ; Govoni M15 Show All Authors
Authors
  1. Sota J1
  2. Ragab G2, 3
  3. Almaglouth I4
  4. Lopalco G5
  5. Tufan A6
  6. Direskeneli H7
  7. Hinojosaazaola A8
  8. Mayrink Giardini HA9
  9. Guerriero S10
  10. Triggianese P11
  11. Sfikakis PP12
  12. Piga M13
  13. Ruscitti P14
  14. Govoni M15
  15. Iagnocco A16
  16. Carubbi F17
  17. Hernandezrodriguez J18
  18. Laymouna AH2
  19. Mahmoud AAMA2
  20. Ghanema M2
  21. Aboabat AA4
  22. Asfina KN4
  23. Alanazi F4
  24. Morrone M5
  25. Spedicato V5
  26. Kucuk H6
  27. Kardas R6
  28. Alibaz Oner F7
  29. Sevik G7
  30. Torresruiz J8
  31. Kawakamicampos PA8
  32. Parente De Brito Antonelli I9
  33. Dammacco R10
  34. Chimenti MS11
  35. Arida K12
  36. Floris A13
  37. Gentile M14
  38. Ruffilli F15
  39. Bellis E16
  40. Alunno A17
  41. Espinosa G18
  42. Gentileschi S1
  43. Gaggiano C1
  44. Vitale A1
  45. Caggiano V1
  46. Lopez R1
  47. Tarsia M1
  48. Monti S19
  49. Hatemi G20, 21
  50. Karakoc A20
  51. Frassi M22
  52. Giacomelli R23
  53. Tharwat S24, 25
  54. Thabet M26
  55. Ciccia F27
  56. Emmi G28, 29, 30
  57. Viapiana O31
  58. Sahin A32
  59. Sebastiani GD33
  60. Batu ED34
  61. Ozen S34
  62. Sener S34
  63. Oprisbelinski D35
  64. Costi S36
  65. Conforti A37
  66. Cattalini M38
  67. Bartoloni E39
  68. Akkoc N40
  69. Gunduz OS40
  70. Conti G41
  71. Maier A42
  72. Giardina A43
  73. Li Gobbi F44
  74. Parronchi P45
  75. Sarzi Puttini P46
  76. Breda L47
  77. De Paulis A48, 49
  78. Carreno E50
  79. La Torre F51
  80. Wiesikscewczyk E52
  81. Dela Torre A53
  82. Mejiasalgado G53
  83. Shahram F54
  84. Guiducci S55
  85. Maggio MC56
  86. Aragona E57
  87. Rigante D58, 59
  88. Ciavarro A60
  89. Onen F61
  90. Insalaco A63
  91. Del Giudice E64
  92. Barone P65
  93. Gicchino F66
  94. Brucato A67
  95. Lo Gullo A68
  96. Mauro A69, 70
  97. Karamanakos A71
  98. Balistreri A72
  99. Mazzei MA73
  100. Frediani B1
  101. Fabiani C74
  102. Cantarini L1
Show Affiliations
Authors Affiliations
  1. 1. Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences Department of Medical Sciences, Surgery and Neurosciences, University of Siena and Azienda Ospedaliero-Universitaria Senese [European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory, and Autoimmune Diseases (RITA) Center], Siena, Italy
  2. 2. Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Giza, Egypt
  3. 3. Faculty of Medicine, Newgiza University, 6th of October City, Egypt
  4. 4. Rheumatology Unit, Department of Medicine, King Saud University, Riyadh, Saudi Arabia
  5. 5. Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Policlinic Hospital, University of Bari, Bari, Italy
  6. 6. Division of Rheumatology, Department of Internal Medicine, Gazi University Hospital, Ankara, Turkey
  7. 7. Department of Internal Medicine, Division of Rheumatology, School of Medicine, Marmara University, Istanbul, Turkey
  8. 8. Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
  9. 9. Rheumatology Division, Faculdade de Medicina, Hospital das Clinicas (HCFMUSP), Universidade de Sao Paulo, Sao Paulo, Brazil
  10. 10. DiBrain department, University of Bari, Bari, Italy
  11. 11. Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
  12. 12. Joint Academic Rheumatology Program, National and Kapodistrian University of Athens Medical School, [European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA) Center], Athens, Greece
  13. 13. Rheumatology Unit, Department of Medical Sciences and Public health, University and AOU of Cagliari, Cagliari, Italy
  14. 14. Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
  15. 15. Rheumatology Unit, Department of Medical Sciences, Azienda Ospedaliero-Universitaria S. Anna-Ferrara, University of Ferrara, Ferrara, Italy
  16. 16. Academic Rheumatology Center, Dipartimento Scienze Cliniche e Biologiche, Universita degli Studi di Torino, Turin, Italy
  17. 17. University of L'Aquila, Department of Life, Health & Environmental Sciences, Internal Medicine and Nephrology Division, ASL1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy
  18. 18. Autoinflammatory Diseases Clinical Unit, Department of Autoimmune Diseases, Hospital Clinic of Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Center of the European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA), Barcelona, Spain
  19. 19. Rheumatology Department, IRCCS Policlinico S. Matteo Fondazione, University of Pavia, [European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA) Center], Pavia, Italy
  20. 20. Department of Internal Medicine, Division of Rheumatology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
  21. 21. Behcet's Disease Research Center, Istanbul University-Cerrahpasa, Istanbul, Turkey
  22. 22. Rheumatology and Clinical Immunology, Spedali Civili and Department of Clinical and Experimental Sciences, University of Brescia, [European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA) Center], Brescia, Italy
  23. 23. Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Universita Campus Bio-Medico di Roma, Rome, Italy
  24. 24. Rheumatology and Immunology Unit, Internal Medicine Department, Mansoura University, Mansoura, Egypt
  25. 25. Department of Internal Medicine, Faculty of Medicine, Horus University, New Damietta, Egypt
  26. 26. Internal Medicine Department, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
  27. 27. Department of Precision Medicine, Universita Degli Studi Della Campania Luigi Vanvitelli, Naples, Italy
  28. 28. Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
  29. 29. Clinical Medicine and Rheumatology Unit, Cattinara University Hospital, Trieste, Italy
  30. 30. Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Melbourne, Australia
  31. 31. Rheumatology Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
  32. 32. Division of Rheumatology, Department of Internal Medicine, Sivas Cumhuriyet University Medical Faculty, Sivas, Turkey
  33. 33. U.O.C. Reumatologia, Ospedale San Camillo-Forlanini, Rome, Italy
  34. 34. Pediatric Rheumatology Unit, Department of Pediatrics, Hacettepe University School of Medicine, Ankara, Turkey
  35. 35. Rheumatology and Internal Medicine Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  36. 36. Unit of Pediatric Rheumatology, Azienda Socio-Sanitaria Territoriale (ASST) Gaetano Pini-Centro Specialistico Ortopedico Traumatologico (CTO), Milan, Italy
  37. 37. U.O. Medicina Generale, Ospedale San Paolo di Civitavecchia, ASL Roma 4, Civitavecchia, Rome, Italy
  38. 38. Pediatric Clinic, University of Brescia and Spedali Civili di Brescia [European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory, and Autoimmune Diseases (RITA) Center], Brescia, Italy
  39. 39. Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
  40. 40. Division of Rheumatology, Department of Internal Medicine, School of Medicine, Manisa Celal Bayar University, Manisa, Turkey
  41. 41. Pediatric Nephrology and Rheumatology Unit, Azienda Ospedaliero Universitaria (AOU) G Martino, Messina, Italy
  42. 42. Rheumatology Unit, Department of Medicine, Central Hospital of Bolzano, Bolzano, Italy
  43. 43. UOC Medicina Interna, Ambulatorio di Reumatologia, ARNAS Civico Di Cristina Benfratelli, Palermo, Italy
  44. 44. Rheumatology Unit, San Giovanni di Dio Hospital, Firenze, Italy
  45. 45. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
  46. 46. Rheumatology Unit, Ospedale Sacco, Milan, Italy
  47. 47. Department of Paediatrics, University of Chieti-Pescara, Chieti, Italy
  48. 48. Section of Clinical Immunology, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
  49. 49. Department of Translational Medical Sciences, Center for Basic and Clinical Immunology Research (CISI), World Allergy Organisation Center of Excellence, University of Naples Federico II, Naples, Italy
  50. 50. Department of Ophthalmology, Fundacion Jimenez Diaz University Hospital (FJD), Madrid, Spain
  51. 51. Department of Pediatrics, Giovanni XXIII Pediatric Hospital, University of Bari, Bari, Italy
  52. 52. Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine, National Research Institute, Warsaw, Poland
  53. 53. Neuroscience Research Group (NEUROS), Neurovitae Center for Neuroscience, Institute of Translational Medicine (IMT), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
  54. 54. Behcet's Disease Unit, Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  55. 55. Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
  56. 56. University Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) “G. D'Alessandro”, University of Palermo, Palermo, Italy
  57. 57. Division of Gastroenterology, Ospedali Riuniti Villa Sofia-Vincenzo Cervello, Palermo, Italy
  58. 58. Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  59. 59. Rare Diseases and Periodic Fevers Research Centre, Universita Cattolica Sacro Cuore, Rome, Italy
  60. 60. Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Via Cracovia, 50, Rome, 00133, Italy
  61. 61. Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University, School of Medicine, Izmir, Turkey
  62. 62. Department of Rheumatology, Faculty of Medicine Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
  63. 63. Division of Rheumatology, Ospedale Pediatrico Bambino Gesu, IRCCS [European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA) Center], Rome, Italy
  64. 64. Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Polo Pontino, Rome, Italy
  65. 65. Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
  66. 66. Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
  67. 67. Pediatric Unit, Fatebenefratelli Hospital, Milan, Italy
  68. 68. UOSD Reumatologia, ARNAS Garibaldi, Catania, Italy
  69. 69. Department of Biomedical and Clinical Sciences, Fatebenefratelli Hospital, Universita di Milano, Milan, Italy
  70. 70. Pediatric Rheumatology Unit, Department of Childhood and Developmental Medicine, Fatebenefratelli-Sacco Hospital, Milan, Italy
  71. 71. Department of Rheumatology, Evangelismos General Hospital, Athens, Greece
  72. 72. Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, [European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory, and Autoimmune Diseases (RITA) Center], Siena, Italy
  73. 73. Unit of Diagnostic Imaging, Department of Medical, Surgical and NeuroSciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, [European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory, and Autoimmune Diseases (RITA) Center], Siena, Italy
  74. 74. Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena and Azienda Ospedaliero-Universitaria Senese [European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory, and Autoimmune Diseases (RITA) Center], Siena, Italy

Source: Joint Bone Spine Published:2025


Abstract

Objectives: Gender impact on phenotypical expression of Behcet'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. Methods: Data were retrieved from the International AIDA Network Registry for BD. We assessed differences between males and females in terms of Behcet'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. Results: In 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). Conclusion: BD 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. © 2024 The Author(s)
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