Which medications are used in Behçet disease treatment?

Updated: Dec 21, 2020
  • Author: Nicole Davey-Ranasinghe, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Infliximab was reported to successfully treat a case of Behçet disease in pregnancy. [62]  Other therapies with data from case reports or small pilot studies include the following, among others:

  • Rituximab [63, 64]
  • Alemtuzumab [65]
  • Golimumab [66]

An open-label multicenter study compared the efficacy of infliximab versus adalimumab as a first‐line treatment in 177 patients with refractory uveitis due to Behçet disease. After 1 year of therapy, both treatment groups showed improvement. However, the patients receiving adalimumab had significantly better outcomes in some parameters, including improvement in anterior chamber inflammation (92.31% versus 78.18% for infliximab; P = 0.06), improvement in vitritis (93.33% versus 78.95% for infliximab; P = 0.04), and best‐corrected visual acuity (mean ± SD 0.81 ± 0.26 versus 0.67 ± 0.34 for infliximab; P = 0.001). [67]  

Apremilast, an oral phosphodiesterase-4 inhibitor approved for the treatment of psoriasis and psoriatic arthritis, has also been studied in Behçet syndrome. A phase II, multicenter, placebo-controlled study of 111 patients with Behçet syndrome found apremilast to be effective in treating oral ulcers; at week 12, the mean number of oral ulcers per patient was significantly lower in the apremilast group than in the placebo group. [68]

The effect of apremilast on the other manifestations of Behçet disease is not known. In a phase III trial, patients taking apremilast had significantly fewer oral ulcers than individuals receiving a placebo (129.5 vs 222.1 respectively). However, 79% of those taking apremilast experienced adverse events, which included diarrhea, nausea, headache, upper respiratory tract infection, and viral upper respiratory tract infection. [69]

The role of anti–interleukin-17 in Behçet disease is not known. However, two small retrosepctive studies suggest improvement in mucocutaneous and articular symptoms with secukinumab. [70, 71]


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