Behçet's disease is a multisystemic, chronic relapsing inflammatory disease classified among the
vasculitides. Recurrent mucocutaneous lesions may be the only symptoms in mild cases, but articular, ocular, vascular, and/or gastrointestinal and central nervous system involvement may occur in most of the patients. Ocular disease is the most frequent cause of morbidity leading to
blindness in 25% of those affected. The various non-specific immunosuppressive drugs, used either alone or in combinations, frequently fail to control
inflammation or maintain remissions. The aetiology of Behçet's disease is unknown, however it is currently thought that a central pathogenetic role of tumour
necrosis factor (TNF) in the inflammatory process is possible. Until June 2002, and according to published and anecdotal data, more than 80 patients from 10 different countries have received anti-TNF treatment. 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.