The impact of demographics on organ damage in Behçets syndrome: A cross-sectional analysis of the international PROBE cohort

Floris A. Laconi R. Chadli S. Laymouna A. Hegazy M.T. Yagiz Ozogul Y. Ozguler Y. Serpa Pinto L. Alikhani M. Oliveira N.L. Sota J. Lopalco G. Carboni P. Poddighe D. Kougkas N. Khabbazi A. De Souza A.W.S. Lo Monaco A. Espinosa G. Butendieck R.R., Jr. Govoni M. Issayeva B. Iannone F. Fabiani C. Cantarini L. Shahram F. Araújo Correia J. Tazi Mezalek Z. Ragab G. Arnaud L. Cauli A. Hatemi G. Piga M. Avgerou P. Akhlaghi M. Faezi S.T. Filho F.P.
1 February 2026 Oxford University Press

Rheumatology
2026 #65 Issue 2

Objective To examine the influence of demographics on organ damage in a broad, multiethnic cohort of patients with Behçets syndrome (BS). Methods In this cross-sectional ancillary analysis of the PROBE project, the investigated demographic variables were sex, age, education level and geographic area of residence. Damage was measured by the BS Overall Damage Index (BODI). Multivariate linear (β) and logistic (adjusted odds ratio [adjOR]) regression analyses examined associations between demographics and the extent and prevalence of damage. Results A total of 970 patients were enrolled. The median (interquartile range) age was 40 (31-50) years; 56.5% were males; 21.4% had a low level of education. The median BODI score was 1 (0-3), with 65.6% of patients having a BODI ≥1. Males had higher damage (β 0.103) and a higher prevalence of total (adjOR 1.7, per 10 years), ocular (adjOR 1.6), and vascular (adjOR 2.1) damage. Age was associated with greater damage (β 0.104), and a higher prevalence of overall (adjOR 1.4), neuropsychiatric (adjOR 1.2) and miscellaneous (adjOR 2.0) damage. Low education was associated with a greater frequency of overall (adjOR 1.9) and ocular (adjOR 1.6) damage. North African patients experienced greater damage than South European (β 0.400) and Middle Eastern (β 0.314) patients, as well as a higher risk of overall damage (adjOR 13.9 and 10.7, respectively) across all organ domains, except for the reproductive and gastrointestinal systems. Conclusions This study demonstrates how the extent, prevalence and characteristics of damage in BS vary with demographic factors, underscoring their importance in research and personalized management.

age , Behçets syndrome , damage , education , geographic variability , sex

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Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
Department of Internal Medicine/Clinical Hematology, Ibn Sina University Hospital, University Mohammed v, Rabat, Morocco
Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Division of Rheumatology, Department of Internal Medicine, Istanbul University - Cerrahpasa, Istanbul, Turkey
Unidade de Imunologia Clinica, Hospital Santo Antonio Centro Hospitalar Do Porto, Porto, Portugal
Rheumatology Research Center, Department of Internal Medicine, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Unidade de Doenças Autoimunes, Serviço de Medicina Interna, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçets Disease Clinic, University of Siena, Siena, Italy
Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari, Bari, Italy
Clinical Academic Department of Pediatrics, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
College of Health Sciences, VinUniversity, Hanoi, Viet Nam
4th Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Departamento de Medicina, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil
Rheumatology Unit, Department of Medical Sciences, AOU S.Anna and University of Ferrara, Ferrara, Italy
Department of Autoimmune Diseases, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, United States
Department of Rheumatology, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Unit of Ophthalmology, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
Behcets Disease Unit, Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Ctr. National de Reference des Maladies Systemiques et Auto-immunes Rares Grand-Est Sud-Ouest (RESO), Department of Rheumatology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France

Department of Medical Sciences and Public Health
Department of Internal Medicine/Clinical Hematology
Rheumatology and Clinical Immunology Unit
Division of Rheumatology
Unidade de Imunologia Clinica
Rheumatology Research Center
Unidade de Doenças Autoimunes
Department of Medical Sciences
Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J)
Clinical Academic Department of Pediatrics
College of Health Sciences
4th Department of Internal Medicine
Connective Tissue Diseases Research Center
Departamento de Medicina
Rheumatology Unit
Department of Autoimmune Diseases
Division of Rheumatology
Department of Rheumatology
Unit of Ophthalmology
Behcets Disease Unit
Ctr. National de Reference des Maladies Systemiques et Auto-immunes Rares Grand-Est Sud-Ouest (RESO)

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