Peer Review Report For: Quality of Life and Sexual Health in Patients with Behçet’s Disease: A Cross-Sectional Study in a Tunisian Cohort [version 1; peer review: 1 approved with reservations]

Résumé

Background Behçet’s disease (BD) is a chronic, inflammatory disorder with unpredictable relapses. It can significantly impair quality of life (QoL) and sexual function, but data on these outcomes remain limited. This study aimed to evaluate QoL and sexual function in patients followed for BD and identify associated clinical factors. Methods We conducted a cross-sectional, monocentric study involving 35 adult patients with BD, diagnosed according to the 2013 International Criteria. Demographic, clinical, and therapeutic data were collected. Disease activity was measured using the Behçet’s Disease Current Activity Form (BDCAF). Quality of life was assessed with the SF-36 and the Behçet’s Disease Quality of Life questionnaire (BD-QoL). Sexual function was evaluated using the IIEF-5 for men and the FSFI for women. Statistical analyses included correlations, group comparisons, and assessment of associations with clinical factors. Results Participants had a mean age of 45.3, with 74.3 % male. Common manifestations included oral ulcers (97 %), articular involvement (54 %), ocular lesions (40 %), and vascular involvement (34 %). Impaired QoL was identified in 66 % of patients via SF-36 and 40 % via BD-QoL. SF-36 and BD-QoL scores were strongly inversely correlated (p < 0.001). Higher disease activity, ocular and vascular involvement, elevated inflammatory markers, and comorbidities were significantly associated with poorer QoL. Erectile dysfunction occurred in 82.6 % of men and sexual dysfunction in 71.4 % of women; vascular involvement was significantly associated with male erectile dysfunction (p = 0.024). Conclusions BD imposes a substantial negative impact on quality of life and sexual health. Disease activity, particular organ involvement, inflammation, and comorbidities are key determinants of reduced QoL. Sexual dysfunction is highly prevalent, notably among men with vascular involvement. These findings support the need for routine QoL and sexual health assessments in BD and for integrated multidisciplinary care to address these concerns.

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