Fatma Alibaz-Oner1, Amr H Sawalha2, Haner Direskeneli1. 1. Division of Rheumatology, School of Medicine, Marmara University, Istanbul, Turkey. 2. Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Abstract
PURPOSE OF REVIEW: Current treatment modalities in Behçet's disease will be summarized in light of new studies published within the last 2 years. RECENT FINDINGS: There is an increasing interest in the treatment of refractory mucocutaneous symptoms of Behçet's disease, and results were quite promising with apremilast, anakinra, and ustekinumab. Data from large case series confirmed both the efficacy and safety of tumor necrosis factor-α inhibitors for the treatment of refractory major organ manifestations such as ocular, neurologic, vascular, and gastrointestinal involvement. In refractory ocular disease, long-term results also confirmed the efficacy and safety of interferon-α. Interleukin-1 inhibitors and tocilizumab seem to be alternative options in patients with refractory ocular involvement. SUMMARY: Prospective and controlled studies for the management of major organ involvement in Behçet's disease are still limited. Data from primarily retrospective studies confirmed better outcomes of major organ involvement with tumor necrosis factor-α inhibitors and interferon-α. There were also acceptable results with interleukin-1 inhibitors for the management of refractory ocular disease, and with apremilast, anakinra, and ustekinumab for refractory mucocutaneous involvement.
PURPOSE OF REVIEW: Current treatment modalities in Behçet's disease will be summarized in light of new studies published within the last 2 years. RECENT FINDINGS: There is an increasing interest in the treatment of refractory mucocutaneous symptoms of Behçet's disease, and results were quite promising with apremilast, anakinra, and ustekinumab. Data from large case series confirmed both the efficacy and safety of tumor necrosis factor-α inhibitors for the treatment of refractory major organ manifestations such as ocular, neurologic, vascular, and gastrointestinal involvement. In refractory ocular disease, long-term results also confirmed the efficacy and safety of interferon-α. Interleukin-1 inhibitors and tocilizumab seem to be alternative options in patients with refractory ocular involvement. SUMMARY: Prospective and controlled studies for the management of major organ involvement in Behçet's disease are still limited. Data from primarily retrospective studies confirmed better outcomes of major organ involvement with tumor necrosis factor-α inhibitors and interferon-α. There were also acceptable results with interleukin-1 inhibitors for the management of refractory ocular disease, and with apremilast, anakinra, and ustekinumab for refractory mucocutaneous involvement.