Purpose of review: To update clinicians on the recent advances in the treatment of Adamantiades-Behçet's disease. Recent findings: Interferon-α-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-α-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. Prelimary results have shown that tolerization is safe and effective in preventing relapses of uveitis. Summary: Biologic agents have proved effectiive 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
PIPITONE N, OLIVIERI I, CANTINI F, TRIOLO G, SALVARANI C (2006). New approaches in the treatment of Adamantiades-Behcet's disease. CURRENT OPINION IN RHEUMATOLOGY, 18(1), 3-9 [10.1097/01.bor.0000197995.27579.9b].
New approaches in the treatment of Adamantiades-Behcet's disease
TRIOLO, Giovanni;
2006-01-01
Abstract
Purpose of review: To update clinicians on the recent advances in the treatment of Adamantiades-Behçet's disease. Recent findings: Interferon-α-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-α-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. Prelimary results have shown that tolerization is safe and effective in preventing relapses of uveitis. Summary: Biologic agents have proved effectiive 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 diseaseI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.