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Reply to ‘Potential benefit of anticoagulation in Behçet syndrome’

Nature Reviews Rheumatology volume 21, page 755 (2025)Cite this article

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We thank Serhat Erol et al. for their interest in our Review article (Bello, F. et al. Arterial and venous thrombosis in systemic and monogenic vasculitis. Nat. Rev. Rheumatol. 21, 355–369 (2025))1 and for raising important points regarding the role of anticoagulation in Behçet syndrome with vascular involvement2. We appreciate the opportunity to clarify these points.

The study by Erol et al.3 that we cited in our Review reported 27 recurrent venous thrombotic events among 22 of 40 (55%) patients with Behçet syndrome. Of these 27 events, 15 (55.5%) occurred while patients were on immunosuppressants alone, 2 (7.4%) occurred on combined immunosuppressants and anticoagulation, and 2 (7.4%) occurred on anticoagulation alone. The recurrence rate was significantly lower in the group receiving the combination therapy than in the group receiving immunosuppressants only, suggestive of a potential benefit of combination therapy in selected cases.

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References

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Authors and Affiliations

  1. Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany

    Filippo Fagni & Iacopo Olivotto

  2. Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany

    Filippo Fagni

  3. Department of Clinical and Biological Sciences, University of Torino, Torino, Italy

    Giacomo Bagni

  4. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    Federica Bello

  5. Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, South Australia, Australia

    Catherine L. Hill

  6. Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia

    Catherine L. Hill

  7. Department of Clinical Sciences, Rheumatology, Lund University, Lund, Sweden

    Aladdin J. Mohammad

  8. Department of Medicine, University of Cambridge, Cambridge, UK

    Aladdin J. Mohammad

  9. Tareev Clinic of Internal Disease, Sechenov First Moscow State Medical University, Moscow, Russia

    Sergey Moiseev

  10. Meyer Children’s Hospital IRCCS, Florence, Italy

    Iacopo Olivotto

  11. Division of Rheumatology, Department of Internal Medicine and Behçet’s Disease Research Centre, Istanbul University-Cerrahpasa, School of Medicine, Istanbul, Turkey

    Emire Seyahi

  12. Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy

    Giacomo Emmi

  13. Clinical Medicine and Rheumatology Unit, Cattinara University Hospital, Trieste, Italy

    Giacomo Emmi

  14. Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Melbourne, Victoria, Australia

    Giacomo Emmi

Authors
  1. Filippo Fagni
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  2. Giacomo Bagni
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  3. Federica Bello
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  4. Catherine L. Hill
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  5. Aladdin J. Mohammad
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  6. Sergey Moiseev
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  7. Iacopo Olivotto
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  8. Emire Seyahi
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  9. Giacomo Emmi
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Correspondence to Giacomo Emmi.

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The authors declare no competing interests.

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Fagni, F., Bagni, G., Bello, F. et al. Reply to ‘Potential benefit of anticoagulation in Behçet syndrome’. Nat Rev Rheumatol 21, 755 (2025). https://doi.org/10.1038/s41584-025-01317-7

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