Management of Behçet disease: a systematic literature review for the European League Against Rheumatism evidence-based recommendations for the management of Behçet disease.

Abstract:

OBJECTIVES:To present and analyse the literature sources regarding the management of Behçet disease (BD) identified during the systematic literature research, which formed the basis for the European League Against Rheumatism (EULAR) evidence-based recommendations for the management of BD. METHODS:Problem areas and related keywords regarding the management of BD were determined by the multidisciplinary expert committee commissioned by EULAR for developing the recommendations. A systematic literature research was performed using MedLine and Cochrane Library resources through to December 2006. Meta-analyses, systematic reviews, randomised controlled trials (RCTs), open studies, observational studies, case control studies and case series' involving > or = 5 patients were included. For each intervention the effect size and number needed to treat were calculated for efficacy. Odds ratios and numbers needed to harm were calculated for safety issues of different treatment modalities where possible. RESULTS:The literature research yielded 137 articles that met the inclusion criteria; 20 of these were RCTs. There was good evidence supporting the use of azathioprine and cyclosporin A in eye involvement and interferon (IFN)alpha in mucocutaneous involvement. There were no RCTs with IFNalpha or tumour necrosis factor (TNF)alpha antagonists in eye involvement. Similarly controlled data for the management of vascular, gastrointestinal and neurological involvement is lacking. CONCLUSION:Properly designed, controlled studies (new and confirmatory) are still needed to guide us in managing BD.

journal_name

Ann Rheum Dis

authors

Hatemi G,Silman A,Bang D,Bodaghi B,Chamberlain AM,Gul A,Houman MH,Kötter I,Olivieri I,Salvarani C,Sfikakis PP,Siva A,Stanford MR,Stübiger N,Yurdakul S,Yazici H

doi

10.1136/ard.2008.087957

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

1528-34

issue

10

eissn

0003-4967

issn

1468-2060

pii

ard.2008.087957

journal_volume

68

pub_type

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