Successful Long-term Treatment of Refractory Adamantiades-Behçet’ss Disease (ABD) with Infliximab: Report of Two Patients

Off-Label Dermatologic Uses of Anti-TNF-a Therapies

“…46,47 However, successful treatment of mucocutaneous manifestations of BehçetÕs disease with infliximab has been reported in six case reportsinvolving a total of six patients. [48][49][50][51][52][53] In each case, patients had failed conventional immunosuppressive therapies for BehçetÕs disease before responding to infliximab.…”

Off-label uses of biologics in dermatology: Rituximab, omalizumab, infliximab, etanercept, adalimumab, efalizumab, and alefacept (Part 2 of 2)

“…Complete remission on maintenance therapy continued through 12 months of follow-up in two patients and 20 months of followup in another. 235,237,241 One patient not initially given maintenance treatment had a relapse of her disease 6 weeks after her fourth infusion; this resolved completely with reinstitution of therapy. 240 The other patient not treated with maintenance therapy had continued remission through the 8 weeks of follow-up.…”

“…Since then, 7 additional cases of infliximab used in conjunction with other immunosuppressive medications for refractory mucocutaneous Behcet's disease have been reported. [235][236][237][238][239][240][241] These patients were treated with either 3 mg/kg (2 patients) or 5 mg/kg (5 patients) infusions of infliximab administered as an induction regimen of between 2 and 5 infusions followed by maintenance therapy in 6 patients at 4-to 8-week intervals. All patients had complete remission of their disease occurring between 3 days and 6 weeks after the first infusion.…”

The Use of Biologic Agents in the Treatment of Ocular Manifestations of Behcet’s Disease

“…With ongoing infusions every 8 weeks he was able to gradually taper and discontinue all other immunosuppressive medications (over the course of 14 months) and had no disease activity during the 16 months he was monitored; the final two months were under infliximab monotherapy. 19 Encouraged by the early successful case reports, other groups began treating difficult cases of Behçet's uveitis with infliximab and the number of case reports and series increased exponentially. Unless otherwise mentioned, patients were treated with infusions at weeks 0, 2, 6, and then every 8 weeks thereafter.…”

“…41 As was reported with interferon-α, some patients treated with infliximab developed autoantibodies during treatment with infliximab, particularly antinuclear antibodies or anti-double-stranded DNA antibodies, and as with interferon-α these markers were not associated with clinical disease. 19,34,37,25 The primary barriers to treatment with infliximab, apart from the lack of prospective, controlled trials, are its cost, which is prohibitive in many circumstances, and the fact that it requires intravenous infusion. Because of these factors, infliximab is unlikely to become first-line therapy in the United States unless randomized, controlled trials can prove its superiority to conventional therapy and to interferon-α.…”