New approaches in the treatment of Adamantiades-Behçet's disease

Nicolò Pipitone, Ignazio Olivieri, Fabrizio Cantini, Giovanni Triolo, Carlo Salvarani

Research output: Contribution to journalArticlepeer-review

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 disease.

Original languageEnglish
Pages (from-to)3-9
Number of pages7
JournalCurrent Opinion in Rheumatology
Volume18
Issue number1
Publication statusPublished - Jan 2006

Keywords

  • Adamantiades-Behçet's disease
  • Etanercept
  • IFN-α2a
  • Infliximab
  • Tolerization
  • Tumour necrosis factor

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

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