Abstract
Objective To evaluate tocilizumab (TCZ) efficacy in refractory Behcet's Disease (BD) patients.
Methods Multicenter study of 30 patients fulfilling the International Criteria for BD and treated with TCZ at different European referral centres. The clinical response was evaluated at 6 months (M6) from TCZ initiation.
Results Ninety percent of BD patients were refractory or intolerant to anti-TNF-α agents. Overall, TCZ was effective in 25 (83%) BD patients of whom 18 (60%) and 7 (23%) were complete and partial responders, respectively. The complete response was of 67%, 60% and 42% in patients with uveitis (18/30), neurological (5/30) and muco-cutaneous and/or articular (7/30) manifestations, respectively. TCZ had a significant steroid-sparing effect allowing to decrease the median daily prednisone dose from 20mg/day [10-40] to 9mg [5-13] at 6 months (p < 0.001). The number of BD patients needing concomitant DMARDs therapy fell from 7 (23%) to 4 (13%) at 6 months. Mild to moderate side effects were observed in 6 (20%) patients and 3 (10%) presented serious adverse events [pneumonia, intestinal perforation, and septicemia] requiring therapy discontinuation in 2 cases.
Conclusion TCZ seems an effective alternative to anti-TNF-α agents in BD uveitis and neurological manifestations.
