Therapeutic options and modern approaches for the treatment of Behcet’s disease

Authors

DOI:

https://doi.org/10.22141/2224-1507.10.1.2020.199722

Keywords:

Behcet’s disease, treatment, tumor necrosis factor inhibitors, apremilast, secukinumab, ustekinumab

Abstract

Significant successes have been achieved in the treatment of Behçet’s disease (BD) over the past 2 years: the EULAR recommendations have been updated, the first drug specifically labeled for the BD treatment, apremilast, has been approved, new data have been published on the promising new therapeutic agents that may soon be added to the treatment of this condition. The purpose of this review is to summarize the most important and potentially clinically significant recent developments in the treatment of BD patients and discuss their impact on the management of BD patients. Long-term observation data confirm the significant role of tumor necrosis factor inhibitors in the BD treatment, namely eye damage; however, they were found to be safe and effective. New treatment options, such as ustekinumab, secukinumab, tocilizumab and others, show promising data, but more research is needed to clarify their role in the BD treatment. The lack of placebo-controlled randomized trials, for the most part, still poses a challenge for expanding management capabilities for the BD patients.

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References

Hatemi G, Christensen R, Bang D, et al. 2018 Update of the EULAR recommendations for the management of Behcet’s syndrome. Ann Rheum Dis. 2018;77(6):808–818. https://doi.org/10.1136/annrheumdis-2018-213225.

Leccese P, Ozguler Y, Christensen R, et al. Management of skin, mucosa and joint involvement of Behçet's syndrome: A systematic review for update of the EULAR recommendations for the management of Behçet's syndrome. Semin Arthritis Rheum. 2019;48(4):752–762. https://doi.org/10.1016/j.semarthrit.2018.05.008.

Emmi G, Prisco D. Behçet's syndrome: focus on pathogenetic background, clinical phenotypes and specific treatments. Intern Emerg Med. 2019;14(5):639–643. https://doi.org/10.1007/s11739-019-02154-9.

Tuzun H, Seyahi E, Guzelant G, et al. Surgical Treatment of Pulmonary Complications in Behçet's Syndrome. Semin Thorac Cardiovasc Surg. 2018;30(3):369–378. https://doi.org/10.1053/j.semtcvs.2018.07.008.

Melikoglu M, Fresko I, Mat C, et al. Short-term trial of etanercept in Behçet's disease: a double blind, placebo controlled study. J Rheumatol. 2005;32(1):98–105.

Emmi G, Vitale A, Silvestri E, et al. Adalimumab-Based Treatment Versus Disease-Modifying Antirheumatic Drugs for Venous Thrombosis in Behçet's Syndrome: A Retrospective Study of Seventy Patients With Vascular Involvement. Arthritis Rheumatol. 2018;70(9):1500–1507. https://doi.org/10.1002/art.40531.

Ozguler Y, Leccese P, Christensen R, et al. Management of major organ involvement of Behçet's syndrome: a systematic review for update of the EULAR recommendations. Rheumatology (Oxford). 2018;57(12):2200–2212. https://doi.org/10.1093/rheumatology/key242.

Ohno S, Umebayashi I, Matsukawa M, Goto T, Yano T. Safety and efficacy of infliximab in the treatment of refractory uveoretinitis in Behçet's disease: a large-scale, long-term postmarketing surveillance in Japan. Arthritis Res Ther. 2019;21(1):2. https://doi.org/10.1186/s13075-018-1793-7.

Atienza-Mateo B, Martín-Varillas JL, Calvo-Río V, et al. Comparative Study of Infliximab Versus Adalimumab in Refractory Uveitis due to Behçet's Disease: National Multicenter Study of 177 Cases. Arthritis Rheumatol. 2019;71(12):2081–2089. https://doi.org/10.1002/art.41026.

Fabiani C, Vitale A, Rigante D, et al. Comparative efficacy between adalimumab and infliximab in the treatment of non-infectious intermediate uveitis, posterior uveitis, and panuveitis: a retrospective observational study of 107 patients. Clin Rheumatol. 2019;38(2):407–415. https://doi.org/10.1007/s10067-018-4228-6.

Yalçindag N, Köse HC. Comparison of the Treatment Results for Behçet Uveitis in Patients Treated with Infliximab and Interferon. Ocul Immunol Inflamm. 2020;28(2):305–314. https://doi.org/10.1080/09273948.2019.1606256.

Katsuyama A, Kusuhara S, Nishisho R, Matsumiya W, Azumi A, Nakamura M. Long-term efficacy and safety of infliximab and cyclosporine combination therapy for refractory uveoretinitis in Behçet's disease. Clin Ophthalmol. 2019;13:521–527. https://doi.org/10.2147/opth.s198648.

Martín-Varillas JL, Calvo-Río V, Beltrán E, et al. Successful Optimization of Adalimumab Therapy in Refractory Uveitis Due to Behçet's Disease. Ophthalmology. 2018;125(9):1444–1451. https://doi.org/10.1016/j.ophtha.2018.02.020.

Sfikakis PP, Arida A, Panopoulos S, et al. Brief Report: Drug-Free Long-Term Remission in Severe Behçet's Disease Following Withdrawal of Successful Anti-Tumor Necrosis Factor Treatment. Arthritis Rheumatol. 2017;69(12):2380–2385. https://doi.org/10.1002/art.40235.

Mirouse A, Barete S, Monfort JB, et al. Ustekinumab for Behçet's disease. J Autoimmun. 2017;82:41–46. https://doi.org/10.1016/j.jaut.2017.05.002.

Mirouse A, Barete S, Desbois AC, et al. Long-Term Outcome of Ustekinumab Therapy for Behçet's Disease. Arthritis Rheumatol. 2019;71(10):1727–1732. https://doi.org/10.1002/art.40912.

Di Scala G, Bettiol A, Cojan RD, Finocchi M, Silvestri E, Emmi G. Efficacy of the anti-IL 17 secukinumab in refractory Behçet's syndrome: A preliminary study. J Autoimmun. 2019;97:108–113. https://doi.org/10.1016/j.jaut.2018.09.002.

Dincses E, Yurttas B, Esatoglu SN, Melikoglu M, Hamuryudan V, Seyahi E. Secukinumab induced Behçet's syndrome: a report of two cases. Oxf Med Case Reports. 2019;2019(5):omz041. https://doi.org/10.1093/omcr/omz041.

Ding Y, Li C, Liu J, et al. Tocilizumab in the treatment of severe and/or refractory vasculo-Behçet's disease: a single-centre experience in China. Rheumatology (Oxford). 2018;57(11):2057–2059. https://doi.org/10.1093/rheumatology/key230.

Bettiol A, Silvestri E, Di Scala G, et al. The right place of interleukin-1 inhibitors in the treatment of Behçet's syndrome: a systematic review. Rheumatol Int. 2019;39(6):971–990. https://doi.org/10.1007/s00296-019-04259-y.

Tugal-Tutkun I, Pavesio C, De Cordoue A, Bernard-Poenaru O, Gül A. Use of Gevokizumab in Patients with Behçet's Disease Uveitis: An International, Randomized, Double-Masked, Placebo-Controlled Study and Open-Label Extension Study. Ocul Immunol Inflamm. 2018;26(7):1023–1033. https://doi.org/10.1080/09273948.2017.1421233.

Ozguler Y, Hatemi G, Cetinkaya F, et al. Clinical course of acute deep vein thrombosis of the legs in Behçet's syndrome. Rheumatology (Oxford). 2019;kez352. https://doi.org/10.1093/rheumatology/kez352.

Hatemi G, Mahr A, Ishigatsubo Y, et al. Efficacy of apremilast for oral ulcers associated with active Behcet’s syndrome over 28 weeks: results from a phase 3 study. Arthritis Rheumatol. 2018; Suppl:2789.

Hatemi G, Melikoglu M, Tunc R, et al. Apremilast for Behçet's syndrome--a phase 2, placebo-controlled study. N Engl J Med. 2015;372(16):1510–1518. https://doi.org/10.1056/nejmoa1408684.

Kinoshita H, Nishioka H, Ikeda A, et al. Remission induction, maintenance, and endoscopic outcome with oral 5-aminosalicylic acid in intestinal Behçet's disease. J Gastroenterol Hepatol. 2019;34(11):1929–1939. https://doi.org/10.1111/jgh.14690.

Park J, Cheon JH, Park Y, Park SJ, Kim TI, Kim WH. Efficacy and tolerability of methotrexate therapy for refractory intestinal Behçet's disease: a single center experience. Intest Res. 2018;16(2):315–318. https://doi.org/10.5217/ir.2018.16.2.315.

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Published

2021-09-24

How to Cite

Golovach, I., & Yehudina, Y. (2021). Therapeutic options and modern approaches for the treatment of Behcet’s disease. PAIN, JOINTS, SPINE, 10(1), 39–46. https://doi.org/10.22141/2224-1507.10.1.2020.199722

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