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Objective The use of biological agents in the treatment of ocular Behcet’s disease has recently become more frequent. The use of two agents, infliximab (IFX) and adalimumab (ADA), for the treatment of Behcet’s disease requires prior approval by the Turkish Medicines and Medical Devices Agency. We report on a review of such applications with a view to informing on how such agents are used off-label in Turkey. Methods Prescriptions for off-label use of IFX or ADA sent from hospitals in Turkey to the Turkish Medicines and Medical Devices Agency in 2018 were evaluated. Demographic data, previous treatment regimens and reasons for referral were extracted from the files of the cases. Results A total of 662 patients were considered for off-label use of IFX or ADA for the treatment of ocular Behcet’s disease. The mean age of the patients was 35.7±10.8 years (range 12–76); 61.5% of patients were men and 38.5% were women. Of the applications, 345 (52.1%) were for IFX and 317 (47.9%) for ADA. Among the referring hospitals, the public university hospitals ranked first, accounting for 77.9% of IFX and 88.6% of ADA prescriptions. Most applications were made after the failure of conventional therapy, which included steroids and immunosuppressive agents. Conclusion IFX and ADA are rarely used as initial therapy. Stepwise treatment is still preferred in the treatment of ocular Behcet’s disease in Turkey. Our report informs on the management of this difficult-to-treat condition.

Amac: Turkiye’de diyabetik retinopatisi olan hastalarda endikasyon disi ilac kullanimi icin yapilan basvurularin demografik ozelliklerini degerlendirmek. Gerec ve Yontem: 1 Ocak ile 3 1 Aralik 2013 tarihleri arasinda Turkiye Ilac ve Tibbi Cihaz Kurumu Baskanligina Turkiye genelindeki hastanelerden diyabetik retinopati (DRP) tanisi ile endikasyon disi ilac kullanimi (bevacizumab, ranibizumab, deksametazon implant, aflibercept) icin yapilan basvurular geriye donuk olarak incelendi. Olgularin dosyalari demografik veriler, onceki tedavi rejimleri, basvuru gerekceleri, ilacin istenilen doz ve kullanimi acisindan degerlendirildi. Bulgular: Calismaya DRP tanisi ile endikasyon disi ilac kullanimi basvurusu kabul edilen 320 hasta dahil edildi. Hastalarin ortalama yasi 63,05 ± 9,32 yildi ve % 51,9’u erkek, % 48,1’i kadindi. Bu basvurularin % 95,31’ini deksametazon implant, % 4,06’sini ranibizumab, % 0,63’unu bevacizumab, % 0 ise aflibersept olusturmaktaydi. Basvurularin bolgelere gore dagiliminda ilk uc sirada; Ege (%28,75), Ic Anadolu (%26,69) ve Marmara Bolgesi (%21,56) yer almaktaydi. Basvuru yapan hastanelerin dagiliminda ise % 55,9 oraniyla devlet universitesi birinci sirada, %22,2 oraniyla vakif universitesi ikinci sirada, % 21,3 oraniyla egitim ve arastirma hastanesi ise ucuncu sirada bulunmaktaydi. Basvuru yapan hastalarin %9,7’si (31 kisi) onceden aldigi tedavi rejimi olmayan naif hastalardan olusmaktaydi. Sonuc: Ulkemizde sik gorulen DRP’nin tedavisinde endikasyon disi ilac kullanimi basvuru bilgilerinin degerlendirilmesi, literature katkisinin yani sira, Turkiye’deki tedavi seceneklerimizi belirleme acisindan yol gosterici olacaktir.