SAT0679 Cigarette smoking and risk of behcet’s disease: a case-control study
Authors: A. Khabbazi, A. Malekmahdavi
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Bechet's disease (BD) is a chronic inflammatory multisystem disease characterised by recurrent oral and genital aphthous ulcers, uveitis and skin lesions. Smoking play an important role in the development of inflammatory diseases.<sup>1</sup> <h3>Objectives</h3> BD is an inflammatory disease and smoking may have a role in its triggering. Although few studies reported association between smoking and clinical manifestations of BD, to the best of our knowledge, there is no research on the risk of developing BD in smokers.<sup>2–4</sup> This case-control study was conducted to investigate the association between smoking and the risk of BD. <h3>Methods</h3> We included 192 patients with BD and 822 healthy siblings of patient with BD and 373 age and sex matched healthy unrelated persons as control groups (table 1). Written informed consent was obtained from all the participants. Demographic data and smoking history of patients and their siblings were obtained by direct and in some cases by telephone interview with the participants. Demographic data and smoking history of healthy controls were obtained by direct interview. Current and former smokers were classified together as ever smokers for the purposes of this analysis. We carried out multivariate analyses with a logistic regression model with BD as the main outcome variable and smoking history as the main predictor variable. Models were adjusted for age, gender, marital status, educational status and pack-years. <h3>Results</h3> The patients with BD were more often ever smokers than healthy siblings of patients and healthy unrelated controls (table 1). However, pack-years of smoking in control groups were significantly more than the BD group. By multivariate logistic regression and after adjustment for age, sex, marital status and educational status (model 1), ever smoking was significantly associated with an increased risk of BD compared with never smoking. In comparison with healthy siblings and healthy unrelated persons who never smoked, the relative risk (RR) of developing BD was 1.43 and 1.51, respectively. After including pack year in multivariate analysis (model 2), the RR of developing BD in ever smokers increased to 2.23 and 2.01, respectively. No significant differences were observed in the clinical manifestations of BD patients in ever smokers and never smokers. However, disease activity, at disease presentation and last visit in ever smokers was significantly more than never smokers. <h3>Conclusions</h3> Our data suggest that smoking is a significant risk factor for BD and genetic factors may play an important role in the developing of BD in smokers. We also show a particularly strong relationship between smoking with BD activity and response to treatment. <h3>Conflict of interest</h3> We have no potential conflict of interest. <h3>References</h3> [] Klareskog L, Padyukov L, Alfredsson L. Smoking as a trigger for inflammatory rheumatic diseases. Curr Opin Rheumatol 2007;19(1):49–54. [] Soy M, Erken E, Konca K, et al. Smoking and Behcet's Disease. Clinical Rheumatology 2000;19(6):508–509. [] Lee SS, Choi CB, Lee EK, et al. The association between smoking and clinical manifestations in patients with Behcet9s disease. Korean J Med 2008;75(2):202–209. [] Tuna S, Alan S, Turkoglu EB. Effects of smoking and HLA-B51 on clinical manifestations in Behcet's disease: retrospective analysis of 209 patients in a Turkish population. Arch Rheumatol2015;30(x):i-vii. <h3>Acknowledgements</h3> We would like to express our thanks to Leila Khabbazi who helped us in editing the text. <h3>Disclosure of Interest</h3> None declared