Behcet's diseaseAnti-TNF Agents for Behçet's Disease: Analysis of Published Data on 369 Patients
Section snippets
Methods
We conducted an extensive Medline/PubMed search for primary articles published in any language through March 2010 reporting on the therapeutic use of anti-TNF agents in BD using the guidelines of the PRISMA Statement for presentation of systematic reviews (Fig. 1). Search terms included “anti-TNF agents,” “infliximab,” “etanercept,” “adalimumab,” “certolizumab pegol,” and “golimumab,” each in combination with “Behcet's disease,” as well as with distinct BD manifestations, such as “uveitis,”
Results
We found 88 articles on the use of infliximab, 12 articles on etanercept, and 13 articles on adalimumab, reporting on 325, 37, and 28 patients, respectively. Nineteen of a total of 369 patients were treated with 2 different anti-TNF agents, whereas 1 additional patient received all 3. No articles on the use of certolizumab pegol or golimumab had been published up to March 2010. As shown in Table 1, the majority of these articles consisted of case reports (a reference list of case reports is
Discussion
To date, the published experience on the off-label use of anti-TNF agents in patients with BD is coming from 20 different countries. We analyzed the current evidence deriving from 369 patients who were refractory to conventional therapies. There was significantly more information on the therapeutic effect of infliximab compared with etanercept and adalimumab, since 83% of patients received infliximab. We found that therapeutic TNF blockade was efficacious in more than 85% of patients with
Acknowledgment
This work was supported by Athens University Medical School (ELKE Grant 967).
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The authors have no conflicts of interest to disclose.