For clinicians
Behcet's disease
Behcet's, Behcet syndrome
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Bottom lineBottom line: Behcet's frequently improves in pregnancy, and colchicine is continued (compatible). Outcomes are generally favourable. Key considerations are mucocutaneous and ocular flares and, in vascular Behcet's, thrombosis risk requiring anticoagulation planning.
By domain
Will pregnancy affect Behcet's? ●●○○low evidenceconditional
Disease activity often decreases in pregnancy, though flares occur; course is variable.[2]
Medicines ●●●○moderate evidenceconditional
Continue colchicine (compatible); glucocorticoids and azathioprine for flares; avoid methotrexate, mycophenolate, cyclophosphamide, and thalidomide. TNF inhibitors for severe or ocular disease.[1, 2]
Blood clot risk ●●○○low evidenceconditional
Vascular Behcet's carries thrombosis risk; coordinate anticoagulation strategy for pregnancy and postpartum.[2]
Eye involvement ●●○○low evidenceconditional
Ocular Behcet's requires vigilant monitoring; sight-threatening flares need prompt, compatible immunosuppression (including TNF inhibitors).[2]
Key points
| Point | Evidence |
|---|---|
| Colchicine is compatible and generally continued for control.[2] | ●●●○moderate evidenceconditional |
References
- Sammaritano LR, et al. 2020 ACR Guideline for the Management of Reproductive Health in RMD. Arthritis Rheumatol. 2020;72(3):529-556. https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.41191
- Ruegg L, et al. EULAR recommendations for antirheumatic drugs in reproduction, pregnancy, and lactation: 2024 update. Ann Rheum Dis. 2025;84(6):910-926. https://ard.eular.org/article/S0003-4967(25)00818-0/fulltext