Background Behçet’s disease (BD) is an inflammatory disease characterised by recurrent oral aphthous ulcers and numerous potential systemic manifestations. These include genital ulcers, ocular disease, skin lesions, neurological disease, vascular disease and arthritis.
Purpose To describe the experience of our centre with the compassionate use of adalimumab for the treatment of severe clinical manifestations in patients with BD in whom immunosuppressant treatment had failed.
Materials and methods Retrospective review of medical records of 24 months (January 2010 – December 2012) of patients with BD treated with adalimumab as compassionate use in a tertiary centre. Demographic and clinical data included age, sex, previous treatment, indication for adalimumab, side effects, concomitant drugs and clinical outcome.
Results Six patients were included in the study (2/4 women/men) with a mean age of 30 years (range 21–39). We decided to start treatment with adalimumab (40 mg/14 days sc) due to the lack of response in the control of symptoms (two patients had recurrent cutaneous lesions), ocular involvement (2 patients with repeated uveitis and visual deterioration) and adverse reaction (one patient).
The patients had received conventional treatment: steroids, azathioprine, ciclosporin, tacrolimus, mycophenolate mofetil, anti-inflammatory drugs and colchicine. Five patients received concomitant medicines, the most prescribed were azathioprine and ciclosporin (3/6 patients) followed by colchicine (2/6 patients), tacrolimus (1/6 patients) and mycophenolate mofetil (1/6 patients). One patient did not receive concomitant medicines.
We did not detect any adverse effects in patients treated with adalimumab. 4/6 of the patients showed clinical improvement, while 2/6 patients became asymptomatic.
Conclusions Adalimumab is a good option for patients with BD who are resistant to conventional treatment, with a good safety profile.
No conflict of interest.
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