Details

Autor(en) / Beteiligte

• Herrero-Morant, Alba
• Martín-Varillas, José Luis
• Castañeda, Santos
• Maíz, Olga
• Sánchez, Julio
• Ortego, Norberto
• Raya, Enrique
• Prior-Español, Águeda
• Moriano, Clara
• Melero-González, Rafael B
• Graña-Gil, Genaro
• Urruticoechea-Arana, Ana
• Ramos-Calvo, Ángel
• Loredo-Martínez, Marta
• Salgado-Pérez, Eva
• Sivera, Francisca
• Torre, Ignacio
• Narváez, Javier
• Andreu, José Luis
• Martínez-González, Olga
• Gómez-de la Torre, Ricardo
• Fernández-Aguado, Sabela
• Romero-Yuste, Susana
• González-Mazón, Íñigo
• Álvarez-Reguera, Carmen
• Hernández, José Luis
• González-Gay, Miguel Ángel
• Blanco, Ricardo

Titel

Biologic therapy in refractory Neurobehçet's disease: a multicenter study of 41 patients and literature review

Ist Teil von

• Rheumatology (Oxford, England), 2022-02

Ort / Verlag

England

Erscheinungsjahr

2022

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• To assess efficacy and safety of biologic therapy (BT) in Neurobehçet's disease (NBD) refractory to glucocorticoids and at least one conventional immunosuppressive drug. Open-label, national, multicenter study. NBD diagnosis was based on the International Consensus Recommendation criteria. Outcome variables were efficacy and safety. Main efficacy outcome was clinical remission. Other outcome variables analyzed were glucocorticoid-sparing effect and improvement in laboratory parameters. We studied 41 patients (21 women; age 40.6±10.8 years). Neurological damage was parenchymal (n = 33, 80.5%) and non-parenchymal (n = 17, 41.5%). First BTs used were infliximab (n = 19), adalimumab (n = 14), golimumab (n = 3), tocilizumab (n = 3) and etanercept (n = 2). After 6 months of BT, neurological remission was complete (n = 23, 56.1%), partial (n = 15, 37.6%), no response (n = 3, 7.3%). In addition, mean dose of oral prednisone decreased from 60 [30-60] mg/day at the initial visit to 5 [3.8-10] mg/day after 6 months, p < 0.001). It was also the case for mean erythrocyte sedimentation rate (31.5±25.6 to 15.3±11.9 mm/1st hour, p = 0.005) and median [IQR] C-reactive protein (1.4 [0.2-12.8] to 0.3 [0.1-3] mg/dL, p = 0.002). After a mean follow-up of 57.5 months, partial or complete neurological remission persisted in 37 patients (90.2%). BT was switched in 22 cases (53.6%) due to inefficacy (n = 16) or adverse events (AEs) (n = 6) and discontinued due to complete prolonged remission (n = 3) or severe AE (n = 1). Serious AEs were observed in 2 patients under infliximab treatment. BT appears to be effective and relatively safe in refractory NBD.