PMID- 32209197 OWN - NLM STAT- MEDLINE DCOM- 20200515 LR - 20200515 IS - 0578-1426 (Print) IS - 0578-1426 (Linking) VI - 59 IP - 4 DP - 2020 Apr 1 TI - [Efficacy and safety of anti-tumor necrosis factor alpha monoclonal antibodies in 16 patients with severe/refractory vasculo Behcet's disease]. PG - 303-308 LID - 10.3760/cma.j.cn112138-20190730-00527 [doi] AB - Objective: To explore the efficacy and safety of anti-tumor necrosis factor alpha (TNFalpha) monoclonal antibodies (mAbs) for severe/refractory vasculo-Behcet's disease (BD). Method: The clinical data of severe/refractory vasculo-BD patients treated with anti-TNFalpha mAbs were retrospectively analyzed. Response of anti TNFalpha mAbs was analyzed. The dosage changes of glucocorticoid, the level of erythrocyte sedimentation rate (ESR) and hypersensitive C-reactive protein (hsCRP) before and after treatment were recorded, as well as side effects. Result: Sixteen patients were enrolled. Arterial lesions were reported in 12 patients, including 9 with arterial aneurysm, 6 with arterial dilation, 2 with stenosis and 2 with occlusion. Seven patients presented venous thrombosis, including lower extremity veins (n=6), cerebral venous sinus (n=2) and inferior vena cava system (n=2). Two cases had both arterial and venous involvement. Before the application of TNFalpha mAbs, all 16 patients failed to response to prednisone or its equivalent dose of 40 (7.5-90) mg/d in combination with cyclophosphamide, methotrexate, thalidomide or azathioprine for median 4 (0-156) months. After a mean duration of treatment for (17.1+/-6.5) months, 15 patients achieved complete remission and 1 patient achieved partial remission. Three patients received surgery without any postoperative complications. After using anti TNFalpha mAbs, the dosage of prednisone [5(0-12.5)mg/d vs. 40(7.5-90)mg/d, P<0.01], ESR [(7.3+/-4.6) mm/1h vs. (33.5+/-26.7) mm/1h, P<0.01] and hsCRP [1.9(0.2-11.4) mg/L vs. 24.3(0.4-113.9) mg/L, P<0.01] were significantly decreased. Side effects were observed in 2 patients. One developed pulmonary infection 12 months after adalimumab with conventional treatment. Another patient had allergy to infliximab then switched to adalimumab. Conclusion: In combination with corticosteroids and immunosuppressants, anti-TNF alpha mAbs are effective and well-tolerated in severe/refractory vasculo-BD, with a favorable steroid -sparing effect and rare postoperative complications. FAU - Li, L AU - Li L AD - Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education,Peking Union Medical College Hospital Translational Medical Center, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China. FAU - Liu, J J AU - Liu JJ AD - Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education,Peking Union Medical College Hospital Translational Medical Center, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China. FAU - Yu, X AU - Yu X AD - Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education,Peking Union Medical College Hospital Translational Medical Center, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China. FAU - Wu, D AU - Wu D AD - Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education,Peking Union Medical College Hospital Translational Medical Center, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China. FAU - Zhang, S Z AU - Zhang SZ AD - Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education,Peking Union Medical College Hospital Translational Medical Center, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China. FAU - Yang, Y J AU - Yang YJ AD - Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education,Peking Union Medical College Hospital Translational Medical Center, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China. FAU - Zhou, J X AU - Zhou JX AD - Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education,Peking Union Medical College Hospital Translational Medical Center, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China. FAU - Zeng, X F AU - Zeng XF AD - Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education,Peking Union Medical College Hospital Translational Medical Center, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China. FAU - Zhang, F C AU - Zhang FC AD - Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education,Peking Union Medical College Hospital Translational Medical Center, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China. FAU - Zheng, W J AU - Zheng WJ AD - Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education,Peking Union Medical College Hospital Translational Medical Center, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China. LA - chi GR - 81871299/National Natural Science Foundation of China/ PT - Journal Article PL - China TA - Zhonghua Nei Ke Za Zhi JT - Zhonghua nei ke za zhi JID - 16210490R RN - 0 (Antibodies, Monoclonal) RN - 0 (Glucocorticoids) RN - 0 (Immunosuppressive Agents) RN - 0 (Tumor Necrosis Factor-alpha) RN - B72HH48FLU (Infliximab) RN - FYS6T7F842 (Adalimumab) SB - IM MH - Adalimumab MH - Antibodies, Monoclonal/administration & dosage/adverse effects/*therapeutic use MH - Behcet Syndrome/diagnosis/*drug therapy MH - Drug Administration Schedule MH - Glucocorticoids/administration & dosage/therapeutic use MH - Humans MH - Immunosuppressive Agents/administration & dosage/adverse effects/*therapeutic use MH - Infliximab MH - Retrospective Studies MH - Treatment Outcome MH - Tumor Necrosis Factor-alpha/*antagonists & inhibitors OTO - NOTNLM OT - Anti-tumor necrosis factor alpha monoclonal antibodies OT - Behcet syndrome OT - Efficacy OT - Safety OT - Vascular involvement EDAT- 2020/03/27 06:00 MHDA- 2020/05/16 06:00 CRDT- 2020/03/27 06:00 PHST- 2020/03/27 06:00 [entrez] PHST- 2020/03/27 06:00 [pubmed] PHST- 2020/05/16 06:00 [medline] AID - 10.3760/cma.j.cn112138-20190730-00527 [doi] PST - ppublish SO - Zhonghua Nei Ke Za Zhi. 2020 Apr 1;59(4):303-308. doi: 10.3760/cma.j.cn112138-20190730-00527.