1. Efficacy of anti-TNFa in severe and refractory neuro-behcet disease: An observational study
- Author
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Laurent Perard, Felix Ackerman, David Saadoun, Isabelle Marie, Olga Addimanda, Anne Claire Desbois, Marc Lambert, Eric Hachulla, David Launay, Anne Bertrand, Benjamin Subran, Xavier Mariette, Alban Deroux, Raphael Depaz, Patrice Cacoub, Fleur Cohen, Carlo Salvarini, Desbois, Anne Claire, Addimanda, Olga, Bertrand, Anne, Deroux, Alban, Perard, Laurent, Depaz, Raphael, Hachulla, Eric, Lambert, Marc, Launay, David, Subran, Benjamin, Ackerman, Felix, Mariette, Xavier, Cohen, Fleur, Marie, Isabelle, Salvarini, Carlo, Cacoub, Patrice, and Saadoun, David
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Necrosis ,Time Factor ,Disease ,Gastroenterology ,Severity of Illness Index ,Receptors, Tumor Necrosis Factor ,Follow-Up Studie ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Refractory ,Retrospective Studie ,Internal medicine ,Severity of illness ,medicine ,Young adult ,030203 arthritis & rheumatology ,medicine.diagnostic_test ,business.industry ,Behcet Syndrome ,Medicine (all) ,Remission Induction ,Adalimumab ,Antirheumatic Agent ,Retrospective cohort study ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,Magnetic Resonance Imaging ,Infliximab ,3. Good health ,Anti-Inflammatory Agent ,Treatment Outcome ,Tumor necrosis factor alpha ,Female ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Human - 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.
- Published
- 2016