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Switching of anti-TNF-α agents in Behçet's disease

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Lupus and Vasculitis Clinic, Addenbrooke's Hospital, Cambridge University Hospitals, UK. shunsuke.furuta@addenbrookes.nhs.uk

CER5766 Submission on line
2012 Vol.30, N°3 ,Suppl.72 - PI 0062, PF 0068
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Rheumatology Article

 

Abstract

OBJECTIVES:
Recent reports suggest efficacy of anti-tumour necrosis factor-alpha (TNF-α) therapy in Behçet`s disease. However, the switching of anti-TNF-α agents for treatment failure remains unexplored. Our aims were to describe the efficacy and safety of a second anti-TNF-α agent in Behçet`s disease patients after failure of a first agent.
METHODS:
In this retrospective case series, 34 Behçet`s disease patients receiving anti-TNF-α agents, 19 of whom switched to a second anti-TNF-α agent, were identified. We assessed the response to anti-TNF-α agents, the duration of anti-TNF-α therapy, the reasons for withdrawal, adverse events, the Behçet`s Disease Current Activity Form (BDCAF), C-reactive protein (CRP), ESR and concomitant therapies at the onset of the first and second anti-TNF-α therapies, and after 6, 12 and 24 months.
RESULTS:
Clinical improvements were seen in 26/34 (76%) after the first and 18/19 (95%) after the second anti-TNF-α agent. Continuation rates at 24 months were 14.4% after the first and 22.3% after the second anti-TNF-α agent. The most frequent reason for discontinuation was secondary failure in both groups (12 after the first anti-TNF-α agent and 8 after the second). Adverse events leading to treatment withdrawal were seen in 10 after the first anti-TNF-α agent and three after the second. CONLUSIONS: The second anti-TNF-α agent in Behçet`s disease demonstrated similar efficacy to that seen with the first agent without new safety concerns, supporting switching to a second anti-TNF-α agent. However, long-term continuation rates for anti-TNF-α therapy were low after both the first and second agents.

PMID: 23010387 [PubMed]

Received: 13/06/2012 - Accepted : 29/08/2012 - In Press: 27/09/2012 - Published: 19/11/2012