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Tocilizumab in Behçet’s disease with refractory ocular and/or neurological involvement: response according to different clinical phenotypes


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16

 

  1. Rheumatology and Ophthalmology Unit, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  2. Rheumatology Unit, Hospital del Mar, Barcelona, Spain.
  3. Ophthalmology Unit, Hospital General Universitario de Valencia, Spain.
  4. Rheumatology and Ophthalmology Units, Hospital Peset Valencia, Spain.
  5. Rheumatology and Ophthalmology Units, Hospital Peset Valencia, Spain.
  6. Rheumatology Unit, HUAC La Coruña, Spain.
  7. Rheumatology and Ophthalmology Units, Hospital de León, Spain.
  8. Rheumatology and Ophthalmology Units, Hospital de León, Spain.
  9. Rheumatology Unit, Hospital Universitari de Bellvitge, Barcelona, Spain.
  10. Rheumatology Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
  11. Rheumatology Unit, Hospital 12 de Octubre, Madrid, Spain.
  12. Rheumatology and Ophthalmology Unit, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  13. Rheumatology and Ophthalmology Unit, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  14. Rheumatology and Ophthalmology Unit, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  15. Rheumatology and Ophthalmology Unit, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain. miguelaggay@hotmail.com
  16. Rheumatology and Ophthalmology Unit, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain. rblanco@humv.es

CER14153
2021 Vol.39, N°5 ,Suppl.132
PI 0037, PF 0042
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PMID: 33886457 [PubMed]

Received: 26/10/2020
Accepted : 10/03/2021
In Press: 21/04/2021
Published: 06/10/2021

Abstract

OBJECTIVES:
Anti-IL6R tocilizumab (TCZ) therapy has proved to be useful in the treatment of refractory ocular and/or neurological involvement of Behçet’s disease (BD). However, TCZ efficacy in other BD manifestations remains unclear. In this study we aimed to assess the efficacy of TCZ in the different clinical phenotypes of BD.
METHODS:
This is a multicentre study of BD patients treated with TCZ, due to refractivity to standard systemic treatment.
RESULTS:
We studied 16 patients (10 men/6 women); mean age 36.5±18.2 years. The main clinical manifestations at TCZ onset were ocular, oral and/or genital ulcers, arthritis, folliculitis and/or neurological involvement. Before TCZ, they had received several conventional and/or biological immunosuppressants, such as methotrexate, cyclosporine, adalimumab or infliximab. TCZ was used in monotherapy or combined with conventional immunosuppressive drugs. The main indications for TCZ prescription were refractory uveitis (n=14) and refractory neurobehçet (n=2). After a median [IQR] follow-up of 20 [9-45] months using TCZ, neurological and ocular domains improved in most cases with complete remission in most patients with uveitis. Articular and peripheral venous manifestations also experienced a favourable evolution. However, oral/genital ulcers, skin lesions and intestinal manifestations followed a torpid course.
CONCLUSIONS:
TCZ is effective in BD with major clinical involvement. However, it does not seem to be effective in oral/genital ulcers or skin lesions.

Rheumatology Article