Efficacy of anti-TNFa in severe and refractory neuro-behcet disease: An observational study

Anne Claire Desbois, Olga Addimanda, Anne Bertrand, Alban Deroux, Laurent Perard, Raphael Depaz, Eric Hachulla, Marc Lambert, David Launay, Benjamin Subran, Felix Ackerman, Xavier Mariette, Fleur Cohen, Isabelle Marie, Carlo Salvarini, Patrice Cacoub, David Saadoun

Research output: Contribution to journalArticlepeer-review

Abstract

To report the safety and efficacy of anti-tumor necrosis factor a (TNFα) therapy in severe and refractory neuro-Behcet disease (NBD) patients. Observational, multicenter study including 17 BD patients (70.6% of male, with a median age of 39.3 [24-60] years), with symptomatic parenchymal NBD, refractory to previous immunosuppressant and treated with anti-TNFα (infliximab 5 mg/kg [n=13] or adalimumab [n=4]). Complete remission was defined by the disappearance of all neurological symptoms and by the improvement of radiological abnormalities at 12 months. Overall improvement following anti-TNF was evidenced in 16/17 (94.1%) patients including 6 (35.3%) complete response and 10 (58.8%) partial response. The median time to achieve remission was 3 months (1-6). The median Rankin score was 2 (1-4) at the initiation of anti-TNFα versus 1 (0-4) at the time of remission (P=0.01). Corticosteroids have been stopped in 4 (23.5%) patients, and reduced by more than 50% as compared with the dosage at baseline in 10 (58.8%) patients. Side effects occurred in 23.5% of patients and required treatment discontinuation in 17% of cases. TNF blockade represents an effective therapeutic approach for patients with severe and refractory NBD, a difficult to treat population.

Original languageEnglish
Article numbere3550
JournalMedicine (United States)
Volume95
Issue number23
DOIs
Publication statusPublished - 2016

ASJC Scopus subject areas

  • Medicine(all)

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