Recommendations for the management of the vascular involvement in Behcet's disease by the Japanese National Research Committee for Behcet's disease-secondary publication

Objectives: This study aimed to develop clinical guidelines for the management of vascular Behcet's disease (BD) by the Behcet's Disease Research Committee of the Ministry of Health, Labour and Welfare of the Japanese Government. Methods: A task force proposed clinical questions (CQs) concerning vascular BD based on a literature search. After screening, draft recommendations were developed for each CQ and brushed up in three blinded Delphi rounds, leading to the final recommendations. Results: This study provides recommendations for 17 CQs concerning diagnosis and differential diagnoses, assessment of disease activity, and treatment. The guidelines recommend immunosuppressive treatments, for both arterial and venous involvement with active inflammation. Anticoagulation is also recommended for deep vein thrombosis except in high-risk patients. Surgical and endovascular therapies can be optional, particularly in patients with urgent arterial lesions undergoing immunosuppression. In addition, two sets of algorithms for diagnosis and treatment are shown for arterial and venous involvement. Conclusions: These recommendations are expected to serve as useful tools in the daily clinical practice of BD. This content has already been published in Japanese in the Guideline for the Management of Behcet's Disease 2020 and is submitted with permission from both the primary and secondary publishers.