1
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Xenitidis T, Henes JC. [An update on Behçet's syndrome]. Laryngorhinootologie 2024; 103:352-357. [PMID: 38330997 DOI: 10.1055/a-2249-2116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Behçet's syndrome (BS, synonym: Behçet's disease, or Adamantiades-Behçet's disease, ABD) is classified as a vasculitis of variable vessel size and can manifest itself in both arterial and venous vessels. Its extensive and at the same time interindividually very different clinical picture is not uncommon a challenge, both with regard to the diagnosis of this rheumatic systemic disease, which is rather rare in our latitudes, and its therapeutic options. In addition to the four cardinal symptoms of recurrent oral aphthae, genital aphthae, skin and eye lesions, the clinical picture offers numerous other manifestations which often require interdisciplinary cooperation. In addition to the above mentioned ocular involvement, which can still lead to blindness if inadequately treated, this is especially true for intestinal and cerebral manifestations as well as for large vessel vasculitis.A final revision of the European League Against Rheumatism recommendations for the management of Behcet's syndrome (EULAR) was made in 2018, and the recommendations are now established internationally as an important treatment guide. Therapy is based on the leading organ involvement. After adalimumab received approval for the treatment of posterior ocular involvement in 2016, another agent, apremilast, became available in 2020. The drug is recommended for the treatment of recurrent oral aphthae in adult Behçet's patients requiring systemic therapy. Nevertheless, there is a further need for new drugs.This article aims to highlight recent findings in the areas of epidemiology, immunopathogenesis & genetics, clinical findings, and therapy, with an emphasis on clinical relevance.
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Affiliation(s)
- Theodoros Xenitidis
- Medizinische Klinik II (Hämatologie/Onkologie/Klinische Immunologie/Rheumatologie), Vaskulitiszentrum Süd, Universitätsklinikum Tübingen, Tübingen
| | - Jörg Christoph Henes
- Medizinische Klinik II (Hämatologie/Onkologie/Klinische Immunologie/Rheumatologie), Vaskulitiszentrum Süd, Universitätsklinikum Tübingen, Tübingen
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2
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Moriano Morales C, Graña Gil J, Brito García N, Martín Varillas JL, Calvo Del Río V, Moya Alvarado P, Narváez García FJ, Espinosa G, Díaz Del Campo Fontecha P, Guerra Rodríguez M, Mateo Arranz J, López Gómez M, Francisco Hernández FM, Trujillo MM, Dos Santos Sobrín R, Martín Sánchez JI, Maese Manzano J, Suárez Cuba J. SER recommendations on treatment of refractory Behçet's syndrome. REUMATOLOGIA CLINICA 2024; 20:204-217. [PMID: 38614885 DOI: 10.1016/j.reumae.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 12/04/2023] [Indexed: 04/15/2024]
Abstract
OBJECTIVE To develop multidisciplinary recommendations based on available evidence and expert consensus for the therapeutic management of patients with refractory Behçet's syndrome (BS) (difficult to treat, severe resistant, severe relapse) to conventional treatment. METHODS A group of experts identified clinical research questions relevant to the objective of the document. These questions were reformulated in PICO format (patient, intervention, comparison and outcome). Systematic reviews of the evidence were conducted, the quality of the evidence was evaluated following the methodology of the international working group Grading of Recommendations Assessment, Development, and Evaluation (GRADE). After that, the multidisciplinary panel formulated the specific recommendations. RESULTS 4 PICO questions were selected regarding the efficacy and safety of systemic pharmacological treatments in patients with BS with clinical manifestations refractory to conventional therapy related to mucocutaneous and/or articular, vascular, neurological parenchymal and gastrointestinal phenotypes. A total of 7 recommendations were made, structured by question, based on the identified evidence and expert consensus. CONCLUSIONS The treatment of most severe clinical manifestations of BS lacks solid scientific evidence and, besides, there are no specific recommendation documents for patients with refractory disease. With the aim of providing a response to this need, here we present the first official Recommendations of the Spanish Society of Rheumatology for the management of these patients. They are devised as a tool for assistance in clinical decision making, therapeutic homogenisation and to reduce variability in the care of these patients.
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Affiliation(s)
| | - Jenaro Graña Gil
- Servicio de Reumatología, Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain
| | - Noé Brito García
- Unidad de Investigación, Sociedad Española de Reumatología, Madrid, Spain.
| | - José Luis Martín Varillas
- Servicio de Reumatología, Hospital de Laredo, Laredo, Cantabria, Spain; Grupo de Inmunopatología, Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Cantabria, Spain
| | - Vanesa Calvo Del Río
- Grupo de Inmunopatología, Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Cantabria, Spain
| | | | | | - Gerard Espinosa
- Servicio de Enfermedades Autoinmunes, Hospital Clínic, Barcelona, Spain
| | | | | | - José Mateo Arranz
- Unidad de Hemostasia y Trombosis, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - M Mar Trujillo
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias, Santa Cruz de Tenerife, Spain
| | - Raquel Dos Santos Sobrín
- Servicio de Reumatología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Juan Ignacio Martín Sánchez
- Instituto Aragonés de Ciencias de la Salud, Centro de Investigación Biomédica de Aragón (CIBA), Zaragoza, Spain
| | | | - Julio Suárez Cuba
- Servicio de Reumatología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
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3
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Lim M, Archambeaud A, Ferreira-Maldent N, Cottier JP, Samimi M. Pseudotumoral presentation of neuro-Behçet's disease in a patient receiving apremilast: A precipitating agent? Ann Dermatol Venereol 2024; 151:103251. [PMID: 38417200 DOI: 10.1016/j.annder.2024.103251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/31/2023] [Accepted: 01/08/2024] [Indexed: 03/01/2024]
Affiliation(s)
- M Lim
- Department of Dermatology, University Hospital Center of Tours, Tours, France
| | - A Archambeaud
- Department of Internal Medicine, University Hospital Center of Tours, Tours, France
| | - N Ferreira-Maldent
- Department of Internal Medicine, University Hospital Center of Tours, Tours, France
| | - J-P Cottier
- Department of Neuroradiology, University Hospital Center of Tours, Tours, France
| | - M Samimi
- Department of Dermatology, University Hospital Center of Tours, Tours, France.
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4
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Xenitidis T, Henes JC. [An update on Behçet's syndrome]. Dtsch Med Wochenschr 2023; 148:1129-1134. [PMID: 37611579 DOI: 10.1055/a-1958-2338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Behçet's syndrome (BS, synonym: Behçet's disease, or Adamantiades-Behçet's disease, ABD) is classified as a vasculitis of variable vessel size and can manifest itself in both arterial and venous vessels. Its extensive and at the same time interindividually very different clinical picture is not uncommon a challenge, both with regard to the diagnosis of this rheumatic systemic disease, which is rather rare in our latitudes, and its therapeutic options. In addition to the four cardinal symptoms of recurrent oral aphthae, genital aphthae, skin and eye lesions, the clinical picture offers numerous other manifestations which often require interdisciplinary cooperation. In addition to the above mentioned ocular involvement, which can still lead to blindness if inadequately treated, this is especially true for intestinal and cerebral manifestations as well as for large vessel vasculitis.A final revision of the European League Against Rheumatism recommendations for the management of Behcet's syndrome (EULAR) was made in 2018, and the recommendations are now established internationally as an important treatment guide. Therapy is based on the leading organ involvement. After adalimumab received approval for the treatment of posterior ocular involvement in 2016, another agent, apremilast, became available in 2020. The drug is recommended for the treatment of recurrent oral aphthae in adult Behçet's patients requiring systemic therapy. Nevertheless, there is a further need for new drugs.This article aims to highlight recent findings in the areas of epidemiology, immunopathogenesis & genetics, clinical findings, and therapy, with an emphasis on clinical relevance.
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Affiliation(s)
- Theodoros Xenitidis
- Medizinische Klinik II (Hämatologie/Onkologie/Klinische Immunologie/Rheumatologie), Vaskulitiszentrum Süd, Universitätsklinikum Tübingen, Tübingen
| | - Jörg Christoph Henes
- Medizinische Klinik II (Hämatologie/Onkologie/Klinische Immunologie/Rheumatologie), Vaskulitiszentrum Süd, Universitätsklinikum Tübingen, Tübingen
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5
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Ozguler Y, Esatoglu SN, Hatemi G. Current pharmacological solutions for Behçet's syndrome. Expert Opin Pharmacother 2023; 24:221-231. [PMID: 36458741 DOI: 10.1080/14656566.2022.2155047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Behçet's syndrome (BS) has a heterogeneous clinical phenotype, and its clinical manifestations may respond differently to drugs commonly used to treat BS. The type, dose, and duration of immunomodulatory, immunosuppressive, and biologic agents should be tailored individually. AREAS COVERED We reviewed the literature for articles on BS management that were published until June 2022 and summarized the management options in BS for each type of organ involvement. We aimed to cover all currently available pharmacological agents used in BS, as well as surgical and interventional options, focusing on recent evidence. EXPERT OPINION The management aims in BS are to preserve function and quality of life and to avoid damage. The choice of treatment modalities depends on the organs that are actively involved, the severity of that involvement, and prognostic factors. A treat-to-attack strategy would help improve long-term outcomes in BS.
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Affiliation(s)
- Yesim Ozguler
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.,Behçet's Disease Research Center, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sinem Nihal Esatoglu
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.,Behçet's Disease Research Center, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gulen Hatemi
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.,Behçet's Disease Research Center, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
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6
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Wakiya R, Ushio Y, Ueeda K, Kameda T, Shimada H, Nakashima S, Kato M, Miyagi T, Sugihara K, Mizusaki M, Mino R, Kadowaki N, Dobashi H. Efficacy and safety of apremilast and its impact on serum cytokine levels in patients with Behçet's disease. Dermatol Ther 2022; 35:e15616. [DOI: 10.1111/dth.15616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Risa Wakiya
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine Kagawa University
| | - Yusuke Ushio
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine Kagawa University
| | - Kiyo Ueeda
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine Kagawa University
| | - Tomohiro Kameda
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine Kagawa University
| | - Hiromi Shimada
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine Kagawa University
| | - Shusaku Nakashima
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine Kagawa University
| | - Mikiya Kato
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine Kagawa University
| | - Taichi Miyagi
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine Kagawa University
| | - Koichi Sugihara
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine Kagawa University
| | - Mao Mizusaki
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine Kagawa University
| | - Rina Mino
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine Kagawa University
| | - Norimitsu Kadowaki
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine Kagawa University
| | - Hiroaki Dobashi
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine Kagawa University
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Iizuka Y, Takase-Minegishi K, Hirahara L, Kirino Y, Soejima Y, Namkoong H, Horita N, Yoshimi R, Takeuchi M, Takeno M, Mizuki N, Nakajima H. Beneficial Effects of Apremilast on Genital Ulcers, Skin Lesions, and Arthritis in Patients With Behçet's Disease: A Systematic Review and Meta-Analysis. Mod Rheumatol 2021; 32:1153-1162. [PMID: 34752620 DOI: 10.1093/mr/roab098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/15/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study aimed to determine the clinical efficacy of apremilast for oral ulcers, extra-oral manifestations, and overall disease activity in patients with Behçet's disease (BD). METHODS A systematic literature search was performed in PubMed, EMBASE, Cochrane Library, and Web of Science Core Collection. Studies assessing the treatment effects of apremilast in BD were included. The odds ratios (ORs) of being symptom free for individual manifestations and mean difference (MD) of Behçet's Disease Current Activity Form (BDCAF) scores were calculated with 95% confidence intervals (CIs) at 12 and 24 weeks using a random-model meta-analysis. RESULTS Of 259 screened articles, eight were included. After 12 weeks of apremilast treatment the OR of symptom-free was as followings: oral ulcers, 45.76 (95% CI, 13.23-158.31); genital ulcers, 4.56 (95% CI, 2.47-8.44); erythema nodosum, 3.59 (95% CI, 1.11-11.61); pseudofolliculitis, 2.81 (95% CI, 1.29-6.15); and arthritis, 3.55 (95% CI, 1.71-7.40). Furthermore, BDCAF scores at 12 weeks were significantly reduced (MD=-1.38; -1.78 to -0.99). However, the proportion of oral-ulcer free patients increased at 24 weeks (OR=14.88; 4.81 to 46.07). CONCLUSION The currently accumulated data indicates an improvement in mucocutaneous and articular symptoms by short-term apremilast treatment in patients with BD.
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Affiliation(s)
- Yuki Iizuka
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kaoru Takase-Minegishi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Lisa Hirahara
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yohei Kirino
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yutaro Soejima
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ho Namkoong
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Nobuyuki Horita
- Chemotherapy Center, Yokohama City University Hospital, Yokohama, Japan
| | - Ryusuke Yoshimi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masaki Takeuchi
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Mitsuhiro Takeno
- Department of Allergy and Rheumatology, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hideaki Nakajima
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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8
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Özdede A, Hatemi G. An evaluation of apremilast for the treatment of adult patients with oral ulcers associated with Behçet's syndrome. Expert Opin Pharmacother 2021; 22:1533-1537. [PMID: 34218739 DOI: 10.1080/14656566.2021.1939307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Behçet's syndrome is a chronic, multi-system, variable vasculitis of unknown etiology that can result in significant morbidity and mortality. Mucocutaneous lesions such as oral ulcers and genital ulcers are common manifestations that can affect the quality of life of patients significantly. Treatment for mucocutaneous lesions in Behçet's syndrome continues to be critical, and an unmet need remains a significant issue. AREAS COVERED This review evaluates the mechanism of action of apremilast, its effect on the number and pain of oral ulcers, other manifestations, such as genital ulcers, disease activity, quality of life and safety profile in Behçet's syndrome patients. Data from clinical trials as well as observational studies were included. EXPERT OPINION Two randomized placebo-controlled trials and real-world observational data suggest that apremilast is an effective and well-tolerated treatment modality for oral and genital ulcers in Behçet's syndrome. Observational studies additionally showed beneficial results for skin lesions, arthritis, and intestinal involvement.
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Affiliation(s)
- Ayşe Özdede
- Division of Rheumatology, Department of Internal Medicine, Istanbul University -Cerrahpasa, Istanbul, Turkey.,Professor of Medicine, Division of Rheumatology, Department of Internal Medicine and Behçet's Disease Research Center, Istanbul University - Cerrahpasa, Istanbul, Turkey
| | - Gülen Hatemi
- Division of Rheumatology, Department of Internal Medicine, Istanbul University -Cerrahpasa, Istanbul, Turkey.,Professor of Medicine, Division of Rheumatology, Department of Internal Medicine and Behçet's Disease Research Center, Istanbul University - Cerrahpasa, Istanbul, Turkey
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9
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Abstract
Purpose of Review To assess current management of Behcet’s disease (BD). Controversies on therapeutic approaches to different manifestations, whether conventional immunosuppressives (IS) or biologic agents, should be chosen, and options for refractory disease are discussed. Recent Findings Glucocorticoids are still the main agents for remission-induction and azathioprine the first-line conventional IS in maintenance phase to prevent relapses of major organ involvement. Apremilast is shown to be a safe and effective option approved by the FDA for oral ulcers. Large case series confirmed the efficacy and safety of TNFα inhibitors and Interferon-α. Promising results are observed with IL-1 inhibitors, ustekinumab, secukinumab, and tocilizumab for refractory BD. Summary Although both conventional IS and biologic agents are effectively used to suppress inflammation in BD, there is still an unmet need for clear therapeutic strategies in the management for different manifestations. Further controlled studies with new biologic agents, anticoagulants and the benefit of concomitant IS usage with biologics are needed to optimize the management of BD.
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10
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Vieira M, Buffier S, Vautier M, Le Joncour A, Jamilloux Y, Gerfaud-Valentin M, Bouillet L, Lazaro E, Barete S, Misery L, Gobert D, Goulenok T, Fain O, Sacre K, Sève P, Cacoub P, Comarmond C, Saadoun D. Apremilast in Refractory Behçet's Syndrome: A Multicenter Observational Study. Front Immunol 2021; 11:626792. [PMID: 33613571 PMCID: PMC7889954 DOI: 10.3389/fimmu.2020.626792] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/16/2020] [Indexed: 12/17/2022] Open
Abstract
Objective Mucocutaneous and joint disorders are the most common manifestations in Behçet's syndrome (BS) and are frequently clustered in the so-called minor forms of BS. There remains a need for safe and effective treatment for joint lesions in BS. We report the long-term safety and effectiveness of apremilast in refractory joint and mucocutaneous manifestations of BS. Methods French nationwide multicenter study including 50 BS patients with either active joint and/or mucocutaneous manifestations resistant to colchicine and/or DMARDs. Patients received apremilast 30 mg twice a day. Primary effectiveness endpoint was the proportion of patients with complete response (CR) of articular symptoms at month 6 (M6), defined as resolution of inflammatory arthralgia and arthritis, with joint count equal to zero. Results At inclusion, the median tender and swollen joint count was of 4 [2-6] and 2 [1-2], respectively. The proportion of CR in joint disease at M6 was 65% (n = 15/23), and 17% (n = 4/23) were partial responders. CR of oral and genital ulcers, and pseudofolliculitis at M6 was 73% (n = 24/33), 94% (n = 16/17) and 71% (n = 10/14), respectively. The overall response at M6 was 74% for the entire cohort and 70% for the mucocutaneous-articular cluster (n = 27). The median Behçet's syndrome activity score significantly decreased during study period [50 (40-60) vs. 20 (0-40); p <0.0001]. After a median follow-up of 11 [6-13] months, 27 (54%) patients were still on apremilast. Reasons for apremilast withdrawal included adverse events (n = 15, 30%) and treatment failure (n = 8, 16%). Thirty-three (66%) patients experienced adverse events, mostly diarrhea (n = 19, 38%), nausea (n = 17, 34%) and headache (n = 16, 32%). Conclusion Apremilast seems effective in BS-related articular disease refractory to colchicine and DMARDs. Discontinuation rates were significantly higher than that reported in clinical trials.
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Affiliation(s)
- Matheus Vieira
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, Paris, France.,Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - Solène Buffier
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, Paris, France.,Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - Mathieu Vautier
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, Paris, France.,Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - Alexandre Le Joncour
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, Paris, France.,Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - Yvan Jamilloux
- Department of Internal Medicine, Hopital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Mathieu Gerfaud-Valentin
- Department of Internal Medicine, Hopital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Laurence Bouillet
- Service de Médecine Interne, CHUGA, Unité Inserm 1036, Université Grenoble Alpes (UGA), Grenoble, France.,Department of Internal Medicine, Centre de référence national des angioedèmes (CREAK), Grenoble, France
| | - Estibaliz Lazaro
- Department of Internal Medicine, Haut-Lévêque Hospital, Pessac, France
| | - Stéphane Barete
- Département Hospitalo-Universitaire Inflammation-Immunopathologie-Biotherapie (DHU i2B), Sorbonne Universités, UPMC Université Paris 06, UMR 7211, Paris, France.,INSERM, UMR_S 959, Paris, France.,UF de Dermatologie, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France
| | - Laurent Misery
- Department of Dermatology, Brest University Hospital, Brest, France Univ Brest, Brest, France
| | - Delphine Gobert
- Service de Médecine Interne et Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Faculté de Médecine Sorbonne Université, Hôpital Saint Antoine, Sorbonne Universités AP-HP, Paris, France
| | - Tiphaine Goulenok
- Département de Médecine Interne, Hôpital Bichat, Assistance Publique Hôpitaux de Paris (APHP), Institut national de la santé et de la recherche médicale (INSERM) U1149, Université de Paris, Paris, France
| | - Olivier Fain
- Service de Médecine Interne et Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Faculté de Médecine Sorbonne Université, Hôpital Saint Antoine, Sorbonne Universités AP-HP, Paris, France
| | - Karim Sacre
- Département de Médecine Interne, Hôpital Bichat, Assistance Publique Hôpitaux de Paris (APHP), Institut national de la santé et de la recherche médicale (INSERM) U1149, Université de Paris, Paris, France
| | - Pascal Sève
- Department of Internal Medicine, Hopital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Patrice Cacoub
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, Paris, France.,Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - Cloé Comarmond
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, Paris, France.,Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - David Saadoun
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, Paris, France.,Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
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