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Efficacy of anti-TNF alpha in severe and/or refractory Behçet's disease: Multicenter study of 124 patients.
- Source :
-
Journal of autoimmunity [J Autoimmun] 2015 Aug; Vol. 62, pp. 67-74. Date of Electronic Publication: 2015 Jul 08. - Publication Year :
- 2015
-
Abstract
- Objective: To report the efficacy and safety of anti-TNF agents in patients with severe and/or refractory manifestations of Behçet's disease (BD).<br />Methods: We performed a multicenter study of main characteristics and outcomes of anti-TNF alpha treatments [mainly infliximab (62%), and adalimumab (30%)] in 124 BD patients [48% of men; median age of 33.5 (28-40) years].<br />Results: Overall response (i.e. complete and partial) rate was 90.4%. Clinical responses were observed in 96.3%, 88%, 70%, 77.8%, 92.3% and 66.7% of patients with severe and/or refractory ocular, mucocutaneous, joint, gastro-intestinal manifestations, central nervous system manifestations and cardiovascular manifestations, respectively. No significant difference was found with respect to the efficacy of anti-TNF used as monotherapy or in association with an immunosuppressive agent. The incidence of BD flares/patient/year was significantly lower during anti-TNF treatment (0.2 ± 0.5 vs 1.7 ± 2.4 before the use of anti-TNF, p < 0.0001). The prednisone dose was significantly reduced at 6 and 12 months (p < 0.0001). In multivariate analysis, retinal vasculitis was negatively associated with complete response to anti-TNF (OR = 0.33 [0.12-0.89]; p = 0.03). The efficacy and relapse free survival were similar regardless of the type of anti-TNF agent used. After a median follow-up of 21 [7-36] months, side effects were reported in 28% of patients, including infections (16.3%) and hypersensitivity reactions (4.1%). Serious adverse events were reported in 13% of cases.<br />Conclusion: Anti-TNF alpha therapy is efficient in all severe and refractory BD manifestations. Efficacy appears to be similar regardless of the anti-TNF agent used (infliximab or adalimumab).<br /> (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Antibodies, Monoclonal administration & dosage
Antibodies, Monoclonal adverse effects
Behcet Syndrome diagnosis
Behcet Syndrome metabolism
Behcet Syndrome mortality
Female
Humans
Immunologic Factors administration & dosage
Immunologic Factors adverse effects
Immunosuppressive Agents administration & dosage
Immunosuppressive Agents adverse effects
Immunosuppressive Agents therapeutic use
Male
Recurrence
Retreatment
Retrospective Studies
Severity of Illness Index
Treatment Outcome
Antibodies, Monoclonal therapeutic use
Behcet Syndrome drug therapy
Immunologic Factors therapeutic use
Tumor Necrosis Factor-alpha antagonists & inhibitors
Subjects
Details
- Language :
- English
- ISSN :
- 1095-9157
- Volume :
- 62
- Database :
- MEDLINE
- Journal :
- Journal of autoimmunity
- Publication Type :
- Academic Journal
- Accession number :
- 26162757
- Full Text :
- https://doi.org/10.1016/j.jaut.2015.06.005