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Ann Rheum Dis. Nov 2002; 61(Suppl 2): ii51–ii53.
PMCID: PMC1766720

Behçet's disease: a new target for anti-tumour necrosis factor treatment

Abstract

The short-term effects of the anti-TNF monoclonal antibody infliximab have been reported in several case reports and small case series, whereas the effects of etanercept have been presented in recent conferences. Preliminary results strongly suggest that infliximab is remarkably effective in inducing short-term remission of almost all manifestations of the disease, including acute, sight threatening panuveitis. A double blind, placebo controlled, one month study on the efficacy of etanercept in suppressing the mucocutaneous manifestations of the disease showed beneficial results.

To date, significant side effects have not been reported. It seems that TNF block is an effective new treatment for patients with Behçet's disease. Whether such treatment is superior to the conventional therapeutic approaches in preventing relapses and progression of the disease remains to be determined by carefully controlled studies. At least three open, long term studies, including larger numbers of patients are currently being conducted.

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Selected References

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  • Kaklamani VG, Vaiopoulos G, Kaklamanis PG. Behçet's Disease. Semin Arthritis Rheum. 1998 Feb;27(4):197–217. [PubMed]
  • Yazici Hasan. Behçet's syndrome: where do we stand? Am J Med. 2002 Jan;112(1):75–76. [PubMed]
  • Yurdakul S, Mat C, Tüzün Y, Ozyazgan Y, Hamuryudan V, Uysal O, Senocak M, Yazici H. A double-blind trial of colchicine in Behçet's syndrome. Arthritis Rheum. 2001 Nov;44(11):2686–2692. [PubMed]
  • Hamuryudan V, Mat C, Saip S, Ozyazgan Y, Siva A, Yurdakul S, Zwingenberger K, Yazici H. Thalidomide in the treatment of the mucocutaneous lesions of the Behçet syndrome. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1998 Mar 15;128(6):443–450. [PubMed]
  • Yazici H, Pazarli H, Barnes CG, Tüzün Y, Ozyazgan Y, Silman A, Serdaroğlu S, Oğuz V, Yurdakul S, Lovatt GE, et al. A controlled trial of azathioprine in Behçet's syndrome. N Engl J Med. 1990 Feb 1;322(5):281–285. [PubMed]
  • Kaklamani VG, Kaklamanis PG. Treatment of Behçet's disease--an update. Semin Arthritis Rheum. 2001 Apr;30(5):299–312. [PubMed]
  • Masuda K, Nakajima A, Urayama A, Nakae K, Kogure M, Inaba G. Double-masked trial of cyclosporin versus colchicine and long-term open study of cyclosporin in Behçet's disease. Lancet. 1989 May 20;1(8647):1093–1096. [PubMed]
  • Ozyazgan Y, Yurdakul S, Yazici H, Tüzün B, Işimen A, Tüzün Y, Aktunç T, Pazarli H, Hamuryudan V, Müftüoğlu A. Low dose cyclosporin A versus pulsed cyclophosphamide in Behçet's syndrome: a single masked trial. Br J Ophthalmol. 1992 Apr;76(4):241–243. [PMC free article] [PubMed]
  • Ishioka M, Ohno S, Nakamura S, Isobe K, Watanabe N, Ishigatsubo Y, Tanaka S. FK506 treatment of noninfectious uveitis. Am J Ophthalmol. 1994 Dec 15;118(6):723–729. [PubMed]
  • Alpsoy Erkan, Durusoy Cicek, Yilmaz Ertan, Ozgurel Yilmaz, Ermis Oya, Yazar Sahin, Basaran Erdal. Interferon alfa-2a in the treatment of Behçet disease: a randomized placebo-controlled and double-blind study. Arch Dermatol. 2002 Apr;138(4):467–471. [PubMed]
  • Kötter I, Eckstein AK, Stübiger N, Zierhut M. Treatment of ocular symptoms of Behçet's disease with interferon alpha 2a: a pilot study. Br J Ophthalmol. 1998 May;82(5):488–494. [PMC free article] [PubMed]
  • Wechsler B, Bodaghi B, Huong DL, Fardeau C, Amoura Z, Cassoux N, Piette JC, LeHoang P. Efficacy of interferon alfa-2a in severe and refractory uveitis associated with Behçet's disease. Ocul Immunol Inflamm. 2000 Dec;8(4):293–301. [PubMed]
  • Gül A. Behçet's disease: an update on the pathogenesis. Clin Exp Rheumatol. 2001 Sep-Oct;19(5 Suppl 24):S6–12. [PubMed]
  • Yamashita N, Kaneoka H, Kaneko S, Takeno M, Oneda K, Koizumi H, Kogure M, Inaba G, Sakane T. Role of gammadelta T lymphocytes in the development of Behçet's disease. Clin Exp Immunol. 1997 Feb;107(2):241–247. [PMC free article] [PubMed]
  • Mege JL, Dilsen N, Sanguedolce V, Gul A, Bongrand P, Roux H, Ocal L, Inanç M, Capo C. Overproduction of monocyte derived tumor necrosis factor alpha, interleukin (IL) 6, IL-8 and increased neutrophil superoxide generation in Behçet's disease. A comparative study with familial Mediterranean fever and healthy subjects. J Rheumatol. 1993 Sep;20(9):1544–1549. [PubMed]
  • Turan B, Gallati H, Erdi H, Gürler A, Michel BA, Villiger PM. Systemic levels of the T cell regulatory cytokines IL-10 and IL-12 in Bechçet's disease; soluble TNFR-75 as a biological marker of disease activity. J Rheumatol. 1997 Jan;24(1):128–132. [PubMed]
  • Evereklioglu Cem, Er Hamdi, Türköz Yusuf, Cekmen Mustafa. Serum levels of TNF-alpha, sIL-2R, IL-6, and IL-8 are increased and associated with elevated lipid peroxidation in patients with Behçet's disease. Mediators Inflamm. 2002 Apr;11(2):87–93. [PMC free article] [PubMed]
  • Santos Lacomba M, Marcos Martín C, Gallardo Galera JM, Gómez Vidal MA, Collantes Estévez E, Ramírez Chamond R, Omar M. Aqueous humor and serum tumor necrosis factor-alpha in clinical uveitis. Ophthalmic Res. 2001 Sep-Oct;33(5):251–255. [PubMed]
  • Goossens PH, Verburg RJ, Breedveld FC. Remission of Behçet's syndrome with tumour necrosis factor alpha blocking therapy. Ann Rheum Dis. 2001 Jun;60(6):637–637. [PMC free article] [PubMed]
  • Robertson LP, Hickling P. Treatment of recalcitrant orogenital ulceration of Behçet's syndrome with infliximab. Rheumatology (Oxford) 2001 Apr;40(4):473–474. [PubMed]
  • Hassard PV, Binder SW, Nelson V, Vasiliauskas EA. Anti-tumor necrosis factor monoclonal antibody therapy for gastrointestinal Behçet's disease: a case report. Gastroenterology. 2001 Mar;120(4):995–999. [PubMed]
  • Travis SP, Czajkowski M, McGovern DP, Watson RG, Bell AL. Treatment of intestinal Behçet's syndrome with chimeric tumour necrosis factor alpha antibody. Gut. 2001 Nov;49(5):725–728. [PMC free article] [PubMed]
  • Muñoz-Fernández S, Hidalgo V, Fernández-Melón J, Schlincker A, Martín-Mola E. Effect of infliximab on threatening panuveitis in Behçet's disease. Lancet. 2001 Nov 10;358(9293):1644–1644. [PubMed]
  • Rozenbaum M, Rosner I, Portnoy E. Remission of Behçet's syndrome with TNFalpha blocking treatment. Ann Rheum Dis. 2002 Mar;61(3):283–284. [PMC free article] [PubMed]
  • Sfikakis PP, Theodossiadis PG, Katsiari CG, Kaklamanis P, Markomichelakis NN. Effect of infliximab on sight-threatening panuveitis in Behçet's disease. Lancet. 2001 Jul 28;358(9278):295–296. [PubMed]
  • Nussenblatt RB. Uveitis in Behçet's disease. Int Rev Immunol. 1997;14(1):67–79. [PubMed]
  • van Deventer SJ. Transmembrane TNF-alpha, induction of apoptosis, and the efficacy of TNF-targeting therapies in Crohn's disease. Gastroenterology. 2001 Nov;121(5):1242–1246. [PubMed]

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