Background Behçet’s disease (BD) is a rheumatic disease characterised by polyarthritis, urogenital ulcers, uveitis, cutaneous lesions, alterations in the central nervous system and vascular disease.
Purpose To describe the use of adalimumab in a patient with BD in whom immunosuppressant treatment had failed.
Material and methods Follow-up of a patient with BD treated with adalimumab after trying other treatments without success.
The most common parameters used when monitoring BD are: erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Data were collected from the medical history (Selene) and the outpatients dispensing software (Savac).
Results A 43-year-old woman visited the rheumatologist in April 2010 because of polyarthralgia and symptoms of inflammatory disease; she had had recurrent episodes of red eye, cutaneous lesions and urogenital ulcers.
She started symptomatic treatment with allopurinol and colchicine because she was suspected of suffering from BD. In June 2011, positive HLA-B51 was determined and methotrexate treatment was initiated. Despite the initial improvement, after seven months she had aphthous and cutaneous lesions and corticosteroids were added to the treatment.
In May 2012, she visited the ophthalmologist and she was diagnosed with uveitis and this confirmed the diagnosis of BD. The dose of methotrexate was increased but without results.
Finally, adalimumab was added to the methotrexate (baseline CRP = 0.7 mg/dL and ESR = 65 mm/h). She presented clear improvement (month 1: CRP < 0.4 mg/dL and ESR = 6 mm/h; month 4: CRP = 0.4 mg/dL and ESR = 6 mm/h; month 12: CRP = 0.5 mg/dL and ESR = 11 mm/h). To date, after a follow-up of 21 months, the patient is continuing to have adalimumab, with good clinical control and no side effects.
Conclusion Our patient responded well to the treatment. Although more data are needed, there are previous studies that suggest that adalimumab represents a valid option for patients with BD and severe symptoms.
References and/or Acknowledgements
Calvo-Catalá J, Campos Fernández C, Rueda Cid A, et al. Efficacy of adalimumab in Behçet’s disease. Description of 6 cases. Reumatol Clin 2011;7(4):258–61
References and/or AcknowledgementsThe support of the entire department has allowed this work.
No conflict of interest.
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