Alborz University

Introduction: Considering the clinical importance and remarkable prevalence of Behçet's disease (BD) in area, and since studies about an association between cigarette smoking and BD are limited and conflicting and because the effect of cigarette smoking on long-term outcome of this disease is not clear exactly and no study has been conducted in this regard in our country so far, therefore, present research designed to assess the impact of cigarette smoking on BD outcomes.
Methods: In present study, 110 males aged > 18 years with diagnosis of BD were selected from rheumatology outpatient clinic of Tabriz University of Medical Sciences. Subjects were divided into two smoking and non-smoking groups and were followed-up for three years (2021-2024). Cigarette smoking status was assessed with questionnaire and disease outcomes including disease activity, response to treatment or remission, and organ damage were evaluated by a rheumatologist. Disease activity and organ damage were assessed using Behçet's disease Current Activity Form (BDCAF) and Behçet's syndrome Overall Damage Index (BODI), respectively. Remission status was evaluated as sustained remission and/or medication-free remission. The study was approved by the Ethics Committee of the Tabriz University of Medical Sciences (IR.TBZMED.REC.1402.258).
Results: The mean ± SD age at the time of study entry was 37.65±9.92 years and the mean ± SD cigarette smoking was 14.60±10.50 pack-years among smokers. The most common clinical features were oral ulcers, uveitis, genital ulcers, and skin lesions. In the smoking group, disease activity decreased during follow-up and the degree of ocular damage increased, although the difference between the two groups was not significant (P>0.05). Sustained remission and medication-free remission increased in both smoking and non-smoking during follow-up, but no significant difference was observed between the two groups (P>0.05). There was also a positive and significant correlation between the pack-year of smoking and BODI (r=0.380, P=0.004).
Conclusion: According to the results, there was no significant difference in disease activity, organ damage, and remission status between the smoking and non-smoking groups during three-year follow-up. However, high BODI in smokers and positive association between pack-year of smoking and BODI indicated that although smoking is likely a risk factor for causing damage in BD, a longer period of more than three years is needed to determine its effect.