Search

Objective Colchicine is a widely used treatment for Behcet's syndrome, even though in a previous 6-month controlled study, it was shown to be effective only in controlling erythema nodosum and arthralgias. We reassessed the effect of colchicine in Behcet's syndrome in a study conducted among a larger group of patients for 2 years. Methods We randomized 116 patients with Behcet's syndrome (60 male/56 female), who had active mucocutaneous disease without eye or major organ involvement, to receive either placebo or colchicine (1–2 mg/day, adjusted to body weight) in a double-blind trial for 2 years. The primary outcome measure was the sustained absence of any lesions during treatment (complete response). The secondary outcome measure was the difference in the number of mucocutaneous lesions or arthritic joints between the active drug and placebo arms. Women and men were analyzed separately. Results Eighty-four patients (72%; 45 male, 39 female) completed the 24-month study. Kaplan-Meier analyses showed significantly more complete responses in the colchicine treatment group in terms of reduced occurrence of genital ulcers (P = 0.004), erythema nodosum (P = 0.004), and arthritis (P = 0.033) among the women, and reduced occurrence of arthritis (P = 0.012) among the men. The mean numbers of genital ulcers (P = 0.001), erythema nodosum lesions (P = 0.002), and arthritic joints (P = 0.014) among the women were less in the colchicine group, and the mean number of arthritic joints (P = 0.026) among the men was less in the colchicine group. Adverse effects were similar in both groups. Conclusion Colchicine may be useful for treating some of the manifestations of Behcet's syndrome, especially among women. This might be a reflection of less severe disease among the women.

Objective. To assess the effect of azathioprine (AZA) treatment on long-term prognosis in Behcet's syndrome. Methods. Patients (all male) who took part in a double-blind, placebo-controlled trial of AZA a mean ± SD of 94 ± 10 months previously were reevaluated. Results. The emergence of blindness (log rank χ2 = 5.6, P = 0.02) and a 2-line drop in the visual acuity of the right eye (log rank χ2 = 5.9, P = 0.015) occurred significantly more frequently among the patients originally allocated to the placebo group compared with patients who originally received AZA, despite posttrial treatment for patients in both groups when needed. There was also a trend toward more frequent occurrence of extraocular complications in the placebo group. The beneficial effect of AZA was especially pronounced among patients who had eye involvement of short duration prior to their entry into the trial. Conclusion. Early treatment with AZA tends to favorably affect the long-term prognosis of Behcet's syndrome.