| Abstract | PURPOSE OF REVIEW: To update clinicians on the recent advances in the treatment of Adamantiades-Behçet's disease. RECENT FINDINGS: Interferon-alpha-2a and infliximab have proved able to induce prompt remission in the vast majority of Adamantiades-Behçet's patients with DMARD-resistant uveoretinitis. Efficacy of interferon-alpha-2a has also been reported for mucocutaneous lesions, arthritis, and (more anecdotally) for neuro-Behçet, while results from small case series suggest that infliximab is beneficial for mucocutaneous lesions and (more anecdotally) for arthritis and gastro-intestinal manifestations. Two cases of neuro-Behçet treated with infliximab showed a complete resolution. Finally, in a randomized controlled trial of patients with mucocutaneous, arthritic manifestations, or both, etanercept effectively suppressed mucocutaneous lesions.A different approach is tolerization by oral administration of the 336-351 peptide of the human heat shock protein 60 (thought to have a pathogenic role in Adamantiades-Behçet's disease-associated uveitis), linked to recombinant cholera B-toxin B-subunit. Preliminary results have shown that tolerization is safe and effective in preventing relapses of uveitis. SUMMARY: Biologic agents have proved effective in patients resistant to conventional treatment. However, disease subsets characterized by severe morbidity and mortality such as vasculo-Behçet and neuro-Behçet still pose major therapeutic challenges. Further studies are needed to devise better treatment strategies for severe Adamantiades-Behçet's disease. |
| Authors | Nicolò Pipitone, Ignazio Olivieri, Fabrizio Cantini, Giovanni Triolo, Carlo Salvarani
(Affiliation: Unità Operativa di Reumatologia, Arcispedale Santa Maria Nuova, Reggio Emilia, Policlinico Universitario, Palermo, Italy.)
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| Journal | Current opinion in rheumatology
(Curr Opin Rheumatol)
Vol. 18
Issue 1
Pg. 3-9
(Jan 2006)
ISSN: 1040-8711 United States |
| PMID | 16344613
(Publication Type: Journal Article, Review)
|
| Chemical References |
- Antibodies, Monoclonal
- Chaperonin 60
- Immunoglobulin G
- Immunologic Factors
- Receptors, Tumor Necrosis Factor
- infliximab
- TNFR-Fc fusion protein
- Interferon Alfa-2a
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| Topics |
- Antibodies, Monoclonal
(therapeutic use)
- Behcet Syndrome
(drug therapy)
- Chaperonin 60
(therapeutic use)
- Humans
- Immunoglobulin G
(therapeutic use)
- Immunologic Factors
(therapeutic use)
- Interferon Alfa-2a
(therapeutic use)
- Receptors, Tumor Necrosis Factor
(therapeutic use)
|
