Objectives To identify predictive factors for successful oral glucocorticoid (GC) tapering in a longitudinal cohort of Behçet’s disease (BD) patients in remission or with low disease activity, and to evaluate post-tapering outcomes over a one-year period. Methods This is an observational longitudinal cohort study, focusing on BD patients who began GC tapering and achieved remission or low disease activity. Patients who achieved sustained remission or low disease activity while maintaining a prednisone dose of ≤ 5 mg/day were classified as "successful tapering," while those who failed to achieve this outcome were classified as "failed tapering". A regression model was used to identify predictors of successful GC tapering to ≤ 5 mg/day. Results A total of 72 BD patients were enrolled and followed-up for 12 months. Multivariate analysis confirmed that short disease duration (odds ratio (OR) = 0.395, 95% CI: 0.197–0.794, p = 0.009), low activity at disease onset (OR = 0.177, 95% CI: 0. 037–0.846, p = 0.03), low severity score for BD at baseline (OR = 0.092, 95% CI:.010–0.876, p = 0.038), and low C-reactive protein value at baseline (OR = 0.186, 95% CI:0.039–0.883, p = 0.034) were the predictors for successful GC tapering. Conclusion The independent factors linked to success in tapering glucocorticoid in BD were shorter disease duration, low activity at disease onset, low severity score at baseline, and low C-reactive protein value. These findings suggest that they could be used in clinical settings to identify tapering candidates.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry nameend="c2" namest="c1"> Key Points •1- Behcet disease is a challenge to treat and usually necessitates a multidisciplinary strategy •2- Glucocorticoids have been used to treat almost all disease lesions •3- Long-term Glucocorticoids use is associated with adverse events •4- The independent factors linked to success in tapering glucocorticoid in Behcet disease were short disease duration, low activity at disease onset, low severity score at baseline, and low C-reactive protein value. </entry> </row> </tbody> </tgroup> </Table>

Evaluation of predictors and clinical outcome after tapering of chronic systemic corticosteroids in Behçet’s disease patients

期刊论文
发表日期：

2025年11月5日

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Rabab S. Zaghlol,
Ghada A. Dawa,
Wafaa K. Makarm

摘要

Objectives

To identify predictive factors for successful oral glucocorticoid (GC) tapering in a longitudinal cohort of Behçet’s disease (BD) patients in remission or with low disease activity, and to evaluate post-tapering outcomes over a one-year period.

Methods

This is an observational longitudinal cohort study, focusing on BD patients who began GC tapering and achieved remission or low disease activity. Patients who achieved sustained remission or low disease activity while maintaining a prednisone dose of ≤ 5 mg/day were classified as "successful tapering," while those who failed to achieve this outcome were classified as "failed tapering". A regression model was used to identify predictors of successful GC tapering to ≤ 5 mg/day.

Results

A total of 72 BD patients were enrolled and followed-up for 12 months. Multivariate analysis confirmed that short disease duration (odds ratio (OR) = 0.395, 95% CI: 0.197–0.794, p = 0.009), low activity at disease onset (OR = 0.177, 95% CI: 0. 037–0.846, p = 0.03), low severity score for BD at baseline (OR = 0.092, 95% CI:.010–0.876, p = 0.038), and low C-reactive protein value at baseline (OR = 0.186, 95% CI:0.039–0.883, p = 0.034) were the predictors for successful GC tapering.

Conclusion

The independent factors linked to success in tapering glucocorticoid in BD were shorter disease duration, low activity at disease onset, low severity score at baseline, and low C-reactive protein value. These findings suggest that they could be used in clinical settings to identify tapering candidates.

Key Points

•1- Behcet disease is a challenge to treat and usually necessitates a multidisciplinary strategy

•2- Glucocorticoids have been used to treat almost all disease lesions

•3- Long-term Glucocorticoids use is associated with adverse events

•4- The independent factors linked to success in tapering glucocorticoid in Behcet disease were short disease duration, low activity at disease onset, low severity score at baseline, and low C-reactive protein value.