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Efficacy of anti-TNF alpha in severe and refractory major vessel involvement of Behcet's disease: A multicenter observational study of 18 patients.
- Source :
-
Clinical immunology (Orlando, Fla.) [Clin Immunol] 2018 Dec; Vol. 197, pp. 54-59. Date of Electronic Publication: 2018 Aug 18. - Publication Year :
- 2018
-
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).<br />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.<br />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).<br />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.<br /> (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aortic Diseases etiology
Aortic Diseases physiopathology
Behcet Syndrome complications
Behcet Syndrome physiopathology
Budd-Chiari Syndrome etiology
Budd-Chiari Syndrome physiopathology
Female
Heart Diseases etiology
Heart Diseases physiopathology
Humans
Immunosuppressive Agents therapeutic use
Infections
Logistic Models
Male
Middle Aged
Pulmonary Artery physiopathology
Pulmonary Edema
Recurrence
Remission Induction
Retrospective Studies
Severity of Illness Index
Thrombosis etiology
Tumor Necrosis Factor-alpha antagonists & inhibitors
Vascular Diseases etiology
Vascular Diseases physiopathology
Vena Cava, Inferior physiopathology
Young Adult
Adalimumab therapeutic use
Antirheumatic Agents therapeutic use
Behcet Syndrome drug therapy
Infliximab therapeutic use
Thrombosis physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1521-7035
- Volume :
- 197
- Database :
- MEDLINE
- Journal :
- Clinical immunology (Orlando, Fla.)
- Publication Type :
- Academic Journal
- Accession number :
- 30125675
- Full Text :
- https://doi.org/10.1016/j.clim.2018.08.004