Skip to main content
Erschienen in: Rheumatology International 1/2011

01.01.2011 | Original Article

One year study of efficacy and safety of infliximab in the treatment of patients with ocular and neurological Behçet’s disease refractory to standard immunosuppressive drugs

verfasst von: AnnaRita Giardina, Angelo Ferrante, Francesco Ciccia, Maria Vadalà, Ennio Giardina, Giovanni Triolo

Erschienen in: Rheumatology International | Ausgabe 1/2011

Einloggen, um Zugang zu erhalten

Abstract

The aim of the study was to assess the long-term efficacy and safety of Infliximab therapy in the treatment of patients with Behçet’s disease refractory to standard immunosuppressive agents. Twenty-one patients that did not respond to corticosteroids and to at least one immunosuppressant (cyclosporin, methotrexate, azathioprine, cyclophosphamide) for the presence of ocular and/or CNS involvement were enrolled. Eighteen patients completed the study up to 54 weeks. Stable doses of prednisone (<10 mg/day) were permitted, immunosuppressants were discontinued at least 4 weeks prior baseline visit. The patients received three infusions of 5 mg/kg Infliximab (at weeks 0, 2 and 6) and then infusions of 5 mg/kg Infliximab every 8 weeks. At each visit data on clinical symptoms, response to therapy and adverse events were collected. The primary outcome of interest was to assess the clinical efficacy (total or partial recovery) of infliximab. Secondary end points were to evaluate quality of life and to monitor the safety of the drug. Eighteen patients achieved a total remission. Two patients achieved a partial remission and relapsed after 3 months from discontinuation of therapy. Infliximab was well tolerated throughout the study. A case of non-Hodgkin lymphoma was observed within 6 months. Minor side effects were headache, dizziness, tachycardia that regressed spontaneously and did not entail interruption. Anti-nuclear antibodies were not detected during the period of observation.
Literatur
1.
Zurück zum Zitat Kaklamani VG, Variopoulos G, Kaklamanis PG (1998) Behçet’s disease. Semin Arthritis Rheum 27:197–217CrossRefPubMed Kaklamani VG, Variopoulos G, Kaklamanis PG (1998) Behçet’s disease. Semin Arthritis Rheum 27:197–217CrossRefPubMed
2.
Zurück zum Zitat Nussenblatt RB (1997) Uveitis in Behçet’s disease. Int Rev Immunol 14:67–79PubMed Nussenblatt RB (1997) Uveitis in Behçet’s disease. Int Rev Immunol 14:67–79PubMed
3.
Zurück zum Zitat Nakae K, Masaki F, Hashimoto T, Inaba G, Mochizuki M, Sakane T (1993) Recent epidemiological features of Behçet’s disease in Japan. In: Wechsler B, Godeau P (eds) Behçet’s disease. Excerpta Medica, Amsterdam, pp 145–151 Nakae K, Masaki F, Hashimoto T, Inaba G, Mochizuki M, Sakane T (1993) Recent epidemiological features of Behçet’s disease in Japan. In: Wechsler B, Godeau P (eds) Behçet’s disease. Excerpta Medica, Amsterdam, pp 145–151
4.
Zurück zum Zitat Zouboulis CC, Kötter I, Djawari D et al (1997) Epidemiological features of Adamantiades-Behçet’s disease in Germany and in Europe. Yonsei Med J 38:411–422PubMed Zouboulis CC, Kötter I, Djawari D et al (1997) Epidemiological features of Adamantiades-Behçet’s disease in Germany and in Europe. Yonsei Med J 38:411–422PubMed
5.
Zurück zum Zitat Dilsen N, Konice M, Aral O, Öcal L, Inanc M, Gill A (1993) Risk factors for vital organ involvement in Behçet’s disease. In: Wechsler B, Godeau P (eds) Behçet’s disease. Excerpta Medica, Amsterdam, pp 165–169 Dilsen N, Konice M, Aral O, Öcal L, Inanc M, Gill A (1993) Risk factors for vital organ involvement in Behçet’s disease. In: Wechsler B, Godeau P (eds) Behçet’s disease. Excerpta Medica, Amsterdam, pp 165–169
6.
Zurück zum Zitat Mamo JG (1970) The rate of visual loss in Behçet’s disease. Arch Ophthalmol 84:451–452PubMed Mamo JG (1970) The rate of visual loss in Behçet’s disease. Arch Ophthalmol 84:451–452PubMed
7.
Zurück zum Zitat Pipitone N, Olivieri I, Cantini F, Triolo G, Salvarani C (2006) New approaches in the treatment of Adamantiades-Behçet’s diseases. Curr Opin Rheumatol 18:3–9CrossRefPubMed Pipitone N, Olivieri I, Cantini F, Triolo G, Salvarani C (2006) New approaches in the treatment of Adamantiades-Behçet’s diseases. Curr Opin Rheumatol 18:3–9CrossRefPubMed
8.
Zurück zum Zitat Sayinalp N, Ozcebe OI, Ozdenir O, Haznedaroglu IC, Dundar S, Kirazli S (1996) Cytokines in Behçet’s disease. J Rheumatol 23:321–322PubMed Sayinalp N, Ozcebe OI, Ozdenir O, Haznedaroglu IC, Dundar S, Kirazli S (1996) Cytokines in Behçet’s disease. J Rheumatol 23:321–322PubMed
9.
Zurück zum Zitat Frassanito MA, Dammacco R, Cafforio P, Dammacco F (1999) Th1 polarization of the immune response in Behçet’s disease: a putative role of interleukin-12. Arthritis Rheum 42:1967–1974CrossRefPubMed Frassanito MA, Dammacco R, Cafforio P, Dammacco F (1999) Th1 polarization of the immune response in Behçet’s disease: a putative role of interleukin-12. Arthritis Rheum 42:1967–1974CrossRefPubMed
10.
Zurück zum Zitat Triolo G, Accardo-Palumbo A, Dieli F, Ciccia F, Ferrante A, Giardina E, Licata G (2002) Humoral and cell mediated immune response to cow’s milk proteins in Behcet’s disease. Ann Rheum Dis 61:459–462CrossRefPubMed Triolo G, Accardo-Palumbo A, Dieli F, Ciccia F, Ferrante A, Giardina E, Licata G (2002) Humoral and cell mediated immune response to cow’s milk proteins in Behcet’s disease. Ann Rheum Dis 61:459–462CrossRefPubMed
11.
Zurück zum Zitat Caspi RR (2002) Th1 and Th2 responses in pathogenesis and regulation of experimental autoimmune uveoretinitis. Int Rev Immunol 21:197–208CrossRefPubMed Caspi RR (2002) Th1 and Th2 responses in pathogenesis and regulation of experimental autoimmune uveoretinitis. Int Rev Immunol 21:197–208CrossRefPubMed
12.
Zurück zum Zitat Triolo G, Accardo-Palumbo A, Dieli F, Ciccia F, Ferrante A, Giardina E, Sano CD, Licata G (2003) Vgamma9/Vdelta2 T lymphocytes in Italian patients with Behcet’s disease: evidence for expansion, and tumour necrosis factor receptor II and interleukin-12 receptor beta1 expression in active disease. Arthritis Res Ther 5:R262–R268CrossRefPubMed Triolo G, Accardo-Palumbo A, Dieli F, Ciccia F, Ferrante A, Giardina E, Sano CD, Licata G (2003) Vgamma9/Vdelta2 T lymphocytes in Italian patients with Behcet’s disease: evidence for expansion, and tumour necrosis factor receptor II and interleukin-12 receptor beta1 expression in active disease. Arthritis Res Ther 5:R262–R268CrossRefPubMed
13.
Zurück zum Zitat Todaro M, Zerilli M, Triolo G, Iovino F, Patti M et al (2005) NFkB protects Behçet’s disease T cells against CD95 induced apoptosis upregulating anti apoptotic proteins. Arthritis Rheum 52:2179–2191CrossRefPubMed Todaro M, Zerilli M, Triolo G, Iovino F, Patti M et al (2005) NFkB protects Behçet’s disease T cells against CD95 induced apoptosis upregulating anti apoptotic proteins. Arthritis Rheum 52:2179–2191CrossRefPubMed
14.
Zurück zum Zitat Sfikakis PP, Theodossiadis PG, Katsiari CG, Kaklamanis P, Markomichelakis NN (2001) Effect of infliximab on sight-threatening panuveitis in Behcet’s disease. Lancet 28;358(9278):295–296CrossRef Sfikakis PP, Theodossiadis PG, Katsiari CG, Kaklamanis P, Markomichelakis NN (2001) Effect of infliximab on sight-threatening panuveitis in Behcet’s disease. Lancet 28;358(9278):295–296CrossRef
15.
Zurück zum Zitat Triolo G, Vadala M, Accardo-Palumbo A, Ferrante A, Ciccia F, Giardina E, Citarrella P, Lodato G, Licata G (2002) Anti-tumour necrosis factor monoclonal antibody treatment for ocular Behcet’s disease. Ann Rheum Dis 61:560–561CrossRefPubMed Triolo G, Vadala M, Accardo-Palumbo A, Ferrante A, Ciccia F, Giardina E, Citarrella P, Lodato G, Licata G (2002) Anti-tumour necrosis factor monoclonal antibody treatment for ocular Behcet’s disease. Ann Rheum Dis 61:560–561CrossRefPubMed
16.
Zurück zum Zitat Al-Rayes H, Al-Swallen R, Al-Balawi M et al (2008) Safety and efficacy of infliximab therapy in active Behçet’s uveitis: an open-label study. Rheumatol Int 29:53–57CrossRefPubMed Al-Rayes H, Al-Swallen R, Al-Balawi M et al (2008) Safety and efficacy of infliximab therapy in active Behçet’s uveitis: an open-label study. Rheumatol Int 29:53–57CrossRefPubMed
17.
Zurück zum Zitat Licata G, Pinto A, Tuttolomondo A, Banco A, Ciccia F, Ferrante A, Triolo G (2003) Anti-tumor necrosis factor alpha monoclonal antibody therapy for recalcitrant cerebral vasculitis in a patient with Behçet’s syndrome. Ann Rheum Dis 62:280–281CrossRefPubMed Licata G, Pinto A, Tuttolomondo A, Banco A, Ciccia F, Ferrante A, Triolo G (2003) Anti-tumor necrosis factor alpha monoclonal antibody therapy for recalcitrant cerebral vasculitis in a patient with Behçet’s syndrome. Ann Rheum Dis 62:280–281CrossRefPubMed
18.
Zurück zum Zitat Pipitone N, Olivieri I, Padula A et al (2009) Infliximab for the treatment of neuro-Beheçet’s disease: a case series and review of the literature. Arthritis Rheum 59:285–290CrossRef Pipitone N, Olivieri I, Padula A et al (2009) Infliximab for the treatment of neuro-Beheçet’s disease: a case series and review of the literature. Arthritis Rheum 59:285–290CrossRef
19.
Zurück zum Zitat Goossens PH, Verburg RJ, Bredveld FC (2001) Remission of Behçet’s syndrome with tumour necrosis factor α blocking therapy. Ann Rheum Dis 60:637CrossRefPubMed Goossens PH, Verburg RJ, Bredveld FC (2001) Remission of Behçet’s syndrome with tumour necrosis factor α blocking therapy. Ann Rheum Dis 60:637CrossRefPubMed
20.
Zurück zum Zitat Hassard PV, Binder SW, Nelson V, Vasiliauskas EA (2001) Anti-tumor necrosis factor monoclonal antibody therapy for gastrointestinal Behcet’s disease: a case report. Gastroenterology 120:995–999CrossRefPubMed Hassard PV, Binder SW, Nelson V, Vasiliauskas EA (2001) Anti-tumor necrosis factor monoclonal antibody therapy for gastrointestinal Behcet’s disease: a case report. Gastroenterology 120:995–999CrossRefPubMed
21.
Zurück zum Zitat Travis SP, Czajkowski M, McGovern DP, Watson RG, Bell AL (2001) Treatment of intestinal Behcet’s syndrome with chimeric tumour necrosis factor alpha antibody. Gut 49:725–728CrossRefPubMed Travis SP, Czajkowski M, McGovern DP, Watson RG, Bell AL (2001) Treatment of intestinal Behcet’s syndrome with chimeric tumour necrosis factor alpha antibody. Gut 49:725–728CrossRefPubMed
22.
Zurück zum Zitat International Study Group for Behçet’s Disease (1990) Criteria for diagnosis of Behçet’s disease. Lancet 335:995–999 International Study Group for Behçet’s Disease (1990) Criteria for diagnosis of Behçet’s disease. Lancet 335:995–999
23.
Zurück zum Zitat Bahcta BB, Brennan P, James TE, Chamberlain A, Noble BA, Silman AJ (1999) Behçet’s disease: evaluation of a new instrument to measure clinical activity. Rheumatology 38:728–735CrossRef Bahcta BB, Brennan P, James TE, Chamberlain A, Noble BA, Silman AJ (1999) Behçet’s disease: evaluation of a new instrument to measure clinical activity. Rheumatology 38:728–735CrossRef
24.
Zurück zum Zitat Lawton G, Bahcta BB, Chamberlain AA, Tennant A (2004) Behçet’s disease activity index. Rheumatology 43:73–78CrossRefPubMed Lawton G, Bahcta BB, Chamberlain AA, Tennant A (2004) Behçet’s disease activity index. Rheumatology 43:73–78CrossRefPubMed
25.
Zurück zum Zitat Jabs DA, Nussenblatt RB, Rosenbaum JT (2005) Standardization of uveitis nomenclature (SUN) working group, Standardization of uveitis nomenclature for reporting clinical data Results of the first international workshop. Am J Ophtalmol 140:509–516CrossRef Jabs DA, Nussenblatt RB, Rosenbaum JT (2005) Standardization of uveitis nomenclature (SUN) working group, Standardization of uveitis nomenclature for reporting clinical data Results of the first international workshop. Am J Ophtalmol 140:509–516CrossRef
26.
Zurück zum Zitat Hatemi G, Silman A, Bang D, Bodaghi B et al (2008) EULAR recommendations for the management of Behçet’s disease: report of a task force of the European Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis Hatemi G, Silman A, Bang D, Bodaghi B et al (2008) EULAR recommendations for the management of Behçet’s disease: report of a task force of the European Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis
27.
Zurück zum Zitat Katsura Y, Suzukawa K, Kojima H, Yoshida C, Shimizu S, Mukai H, Hasegawa Y, Imagawa S, Mori N, Nagasawa T (2003) Cytotoxic T-cell lymphoma arising in Behcet disease. Int J Hematol 77:282–285CrossRefPubMed Katsura Y, Suzukawa K, Kojima H, Yoshida C, Shimizu S, Mukai H, Hasegawa Y, Imagawa S, Mori N, Nagasawa T (2003) Cytotoxic T-cell lymphoma arising in Behcet disease. Int J Hematol 77:282–285CrossRefPubMed
Metadaten
Titel
One year study of efficacy and safety of infliximab in the treatment of patients with ocular and neurological Behçet’s disease refractory to standard immunosuppressive drugs
verfasst von
AnnaRita Giardina
Angelo Ferrante
Francesco Ciccia
Maria Vadalà
Ennio Giardina
Giovanni Triolo
Publikationsdatum
01.01.2011
Verlag
Springer-Verlag
Erschienen in
Rheumatology International / Ausgabe 1/2011
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-009-1213-z

Weitere Artikel der Ausgabe 1/2011

Rheumatology International 1/2011 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.