SAIMSARA Journal

Machine Generated Science • ISSN 3054-3991

Behçet's Disease: Scoping Review with ☸️SAIMSARA.

Cardiac & Vascular Health icon

Cardiac & Vascular Health

Issue 1, Volume 1, 2026

DOI: 10.62487/saimsarac6b709d7

Editorial note
• Last update: 2026-05-03 10:42:17
What is this paper about
Behçet’s disease is far more than recurrent mouth ulcers: this evidence map shows it as a whole-body inflammatory vasculitis that can threaten vision, veins, arteries, brain, gut, and quality of life. The full review explains which diagnostic signals, genetic mimics, and modern therapies — especially anti-TNF agents, apremilast, colchicine, and emerging JAK inhibitors — may change how Behçet’s disease is recognized and treated.
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Abstract: To synthesize current evidence regarding the pathophysiology, clinical manifestations, diagnostic biomarkers, and therapeutic strategies for Behçet's disease based on a structured extraction of multi-center cohorts, case-control studies, and clinical trials. The review utilises 3695 original studies with 103639919 total participants (topic deduplicated ΣN). The mapped evidence supports Behçet's disease as a polygenic autoinflammatory vasculitis in which HLA-B*51–ERAP1 interactions, neutrophil hyperactivation with NETosis, and monocyte–macrophage dysregulation converge to drive multisystem injury, with the International Criteria for Behçet's Disease showing higher diagnostic sensitivity/coverage (81.0%–88.1%) than the older ISG criteria (43.3%–59.1%) and Paediatric Behçet's Disease criteria (37.3%). Across topics, anti-TNF therapy emerged as a recurrent signal of benefit in refractory ocular, vascular, neurologic, and intestinal disease, with vascular remission reported in approximately 89% of cases and adalimumab plus corticosteroids superior to ciclosporin for severe uveitis. Apremilast and emerging JAK inhibitors (baricitinib, upadacitinib) were associated with improvement in mucocutaneous and refractory intestinal/vascular phenotypes, while colchicine retained a role for mucocutaneous and joint manifestations. Diagnostic signals including common femoral vein wall thickness, OCT angiography, deep-learning endoscopy, and proteomic/metabolomic panels indicate a shift toward multimodal, non-invasive phenotyping, although venous thrombosis (~14% of patients), arterial aneurysms, and neuro-Behçet's disease continue to drive morbidity and mortality, particularly in young males. The map also highlights underrecognized burdens of fatigue, depression, sexual dysfunction, and monogenic Behçet-like mimics that warrant integrated psychosocial care and targeted genetic screening in early-onset or refractory presentations. Given the heterogeneity of small retrospective cohorts and the absence of pooled effect estimation, future work should prioritize multi-center randomized trials of JAK inhibitors, longitudinal microbiome studies, and standardized anticoagulation–immunosuppression protocols to resolve the most persistent uncertainties identified across this evidence map.

Keywords: Neuro-Behçet's disease; Intestinal Behçet's disease; Pulmonary artery aneurysm; Anti-TNF therapy; Transverse myelitis; MicroRNA155; Coronary artery aneurysm; Pediatric Beh

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Reference Index (457)