Details

Autor(en) / Beteiligte

• Vallet, H
• Riviere, S
• Sanna, A
• Deroux, A
• Moulis, G
• Addimanda, O
• Salvarani, C
• Lambert, M
• Bielefeld, P
• Seve, P
• Sibilia, J
• Pasquali, Jl
• Fraison, Jb
• Marie, I
• Perard, L
• Bouillet, L
• Cohen, F
• Sene, D
• Schoindre, Y
• Lidove, O
• Le Hoang, P
• Hachulla, E
• Fain, O
• Mariette, X
• Papo, T
• Wechsler, B
• Bodaghi, B
• Rigon, M.Resche
• Cacoub, P
• Saadoun, D

Titel

Efficacy of anti-TNF alpha in severe and/or refractory Behçet's disease: Multicenter study of 124 patients

Ist Teil von

• Journal of autoimmunity, 2015-08, Vol.62, p.67-74

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2015

Quelle

MEDLINE

Beschreibungen/Notizen

• 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). 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]. 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. 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).