Response to Biological Therapy with Different Attack Points among 40 Hungarian Patients Treated for Behcet’s Disease - Abstract
Behcet’s disease is a systemic vasculitis with heterogeneous clinical manifestations. In the absence of a disease-specific criteria system, the diagnosis can be made after exclusion of diseases with similar symptoms. Its targeted treatment is hampered by the lack of complete knowledge of the molecular pathomechanism, therefore the selection of the most appropriate therapy for the patient is based on international recommendations and on empirical basis. More and more often, good therapeutic results are reported with biological preparations with various mechanisms of action including TNF-alpha inhibitors. Based on a retrospective review of the written documentation, 3 therapeutic uses of biologics with different points of attack occurred among patients treated at the Clinical Immunology Outpatient Clinic of our Institute. We examine the therapeutic response to the used biological preparations among the patients under care, summing up the involvement of organ systems, previous treatments, and the duration of biological therapies. We collected the available data based on the electronic documentation of patients diagnosed based on the 2006 The International Criteria of Behcet’s disease (ICBD) criteria system between January 2009 and May 2022, and then performed a statistical analysis. In the examined period, Behcet’s disease was confirmed in 40 patients based on the classification criteria system. During the follow-up biological therapy was started in 21 patients. The patients had been under biological therapy for an average of 3.82 years. It took 2 years from the diagnosis to the start of the first biologic. In all cases, the first biological drug of choice was a TNF-alpha inhibitor. In 8 cases, it became necessary to change biological therapy due to loss of efficacy. The first line therapy was switched to another TNF-alpha inhibitor in 6 patients, IL-17A inhibitor and IL-6 receptor inhibitor, both in one case. Complete remission lasting more than 6 months was achieved in 13 cases due to the first or the second chosen biological therapy in monotherapy or in combination with corticosteroid or csDMARD in all. To maintain remission, 10 patients currently require biological treatment, 5 of them receive the first preparation.