Efficacy of anti-TNF alpha in severe and refractory major vessel involvement of Behcet's disease: A multicenter observational study of 18 patients

Publication date: Available online 18 August 2018

Source: Clinical Immunology

Author(s): A.C. Desbois, L. Biard, O. Addimanda, M. Lambert, E. Hachulla, D. Launay, F. Ackerman, L. Pérard, A. Hot, F. Maurier, C. Mausservey, F. Bernard, N. Noel, L. Alric, T. Mirault, F. Cohen, S. Boussouar, M. Resche-Rigon, P. Cacoub, D. Saadoun

Abstract

Objective

To describe the outcome and tolerance in patients treated with anti-TNFα in severe and refractory major vessel disease in Behçet's disease (BD).

Methods

A multicenter study evaluating 18 refractory BD patients with major vessel involvement [pulmonary artery (n = 4), aorta (n = 4) or peripheral artery aneurysm (n = 1) and/or pulmonary artery (n = 7), inferior vena cava (n = 5), or intra-cardiac (n = 3) thrombosis or Budd Chiari Syndrome (n = 2)] treated with anti-TNFα agents.

Results

Vascular remission was achieved in 16 (89%) patients. The 9 months risk of relapse was significantly higher with conventional immunosuppressants used prior anti-TNFα agents as compared to anti-TNFα therapy [OR = 8.7 (1.42–62.6), p = 0.03]. The median daily dose of corticosteroids significantly decreased at 12 months. Side effects included infection (n = 4) and pulmonary edema (n = 1).

Conclusion

TNFα-antagonists are safe and might be associated with a decreased risk of relapse at 9 months compared to conventional immunosuppressants in BD patients with major vessels disease.

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