Efficacy of anti-TNF alpha in severe and refractory major vessel involvement of Behcet's disease: A multicenter observational study of 18 patients

Desbois, Anne-Claire; Biard, Lucie; Addimanda, Olga; Lambert, Michel; Hachulla, É.; Launay, David; Ackermann, Félix; Pérard, L.; Hot, A.; Maurier, F.; Mausservey, C.; Bernard, F.; Noël, Nicolas; Alric, Laurent; Mirault, Tristan; Cohen, Fleur; Boussouar, Samia; Resche‐Rigon, M.; Cacoub, P.; Saadoun, David

doi:10.1016/j.clim.2018.08.004

Cited by 53 publications

(30 citation statements)

References 19 publications

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“…This is especially important in patients with BD refractory to conventional ISs as these patients usually receive a high cumulative dose of CSs. In our study acute phase reactants were significantly decreased at the third month of treatment as with previous studies, which showed significant decrease of acute phase reactants even 2‐4 weeks after initiating TNFα inhibitor drugs …”

Section: Discussionsupporting

confidence: 89%

“…Discontinuation of TNFα inhibitors led to relapses in 1 out of 3 patients in our study. This is like Desbois et al reporting relapses in two patients when TNFα inhibitors are stopped and Hamuryudan et al reporting two relapses in four patients . Hamuryudan et al also reported two BD patients who developed pulmonary artery aneurysm while being treated with IFX .…”

Section: Discussionsupporting

confidence: 60%

“…Median steroid dosage also significantly decreased at 12 months. Relapse developed in 2 (11%) patients after discontinuation of TNFα inhibitors …”

Section: Discussionmentioning

confidence: 99%

“…However, like other series, we observed a case of tuberculosis, surprisingly after the completion of 9 months of isoniazid treatment, suggesting a re‐infection. In the other major series (information is available for 5 out of 7 studies), there were four serious bacterial infections, one herpes zoster infection and one tuberculosis reported for a total 77 VBD patients treated with TNFα inhibitors (Table ) …”

Section: Discussionmentioning

confidence: 99%

“…Retrospective studies or case series showed the efficacy of TNFα inhibitor agents in BD patients with especially refractory mucocutaneous, articular, ocular, gastrointestinal and central nervous system involvement . Desbois et al reported the largest series with TNFα inhibitors, showing efficacy and safety in prevention of relapses of VBD. However, published experience with biological agents for vascular involvement in BD is still limited.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of TNFα inhibitors for refractory vascular Behçet's disease: A multicenter observational study of 27 patients and a review of the literature

et al. 2020

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Objectives Vascular involvement is one of the major causes of morbidity and mortality in Behçet's disease (BD) patients. Immunosuppressive (IS) agents are the mainstay of vascular BD (VBD) treatment; however, up to one‐third of patients relapse under conventional ISs. In this case series, we present the results of tumor necrosis factor‐alpha (TNFα) inhibitor use for the treatment of VBD patients who were refractory to conventional ISs and corticosteroids. Methods This retrospective multicenter study included 27 refractory VBD patients treated with TNFα inhibitor agents. All data were acquired from patient charts. Results Complete clinical remission was achieved in 22 (80%) patients within 3 months of the initiation of TNFα inhibitors. Infliximab was the first choice of TNFα inhibitor in 24 and adalimumab in three patients. The median daily dose of corticosteroids significantly decreased at 3 months. A trend toward a higher rate of complete remission was observed with concomitant IS use compared to monotherapy of TNFα inhibitors (93% vs 67%, P = .09). Serious side effects were observed in two patients (one pneumonia and one tuberculosis). Conclusion Tumor necrosis factor‐alpha inhibitors seem a highly effective option for remission‐induction of refractory VBD with an acceptable safety data. Concomitant IS use may achieve higher complete remission rates as compared to TNFα inhibitor monotherapy. Comparative efficacy and safety of biological agents for VBD require further prospective, randomized controlled studies with a longer duration of follow‐up.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 60%

“…Median steroid dosage also significantly decreased at 12 months. Relapse developed in 2 (11%) patients after discontinuation of TNFα inhibitors …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%