PMID- 35166821
OWN - NLM
STAT- MEDLINE
DCOM- 20221103
LR  - 20221108
IS  - 1462-0332 (Electronic)
IS  - 1462-0324 (Linking)
VI  - 61
IP  - 11
DP  - 2022 Nov 2
TI  - Biologic therapy in refractory neurobehcet's disease: a multicentre study of 41 
      patients and literature review.
PG  - 4427-4436
LID - 10.1093/rheumatology/keac097 [doi]
AB  - OBJECTIVES: To assess efficacy and safety of biologic therapy (BT) in 
      neurobehcet's disease (NBD) refractory to glucocorticoids and at least one 
      conventional immunosuppressive drug. METHODS: Open-label, national, multicentre 
      study. NBD diagnosis was based on the International Consensus Recommendation 
      criteria. Outcome variables were efficacy and safety. Main efficacy outcome was 
      clinical remission. Other outcome variables analysed were glucocorticoid-sparing 
      effect and improvement in laboratory parameters. RESULTS: We studied 41 patients 
      [21 women; age 40.6 (10.8) years]. Neurological damage was parenchymal (n = 33, 
      80.5%) and non-parenchymal (n = 17, 41.5%). First BTs used were infliximab 
      (n = 19), adalimumab (n = 14), golimumab (n = 3), tocilizumab (n = 3) and 
      etanercept (n = 2). After 6 months of BT, neurological remission was complete 
      (n = 23, 56.1%), partial (n = 15, 37.6%) and no response (n = 3, 7.3%). In 
      addition, median (IQR) dose of oral prednisone decreased from 60 (30-60) mg/day 
      at the initial visit to 5 (3.8-10) mg/day after 6 months (P < 0.001). It was 
      also the case for mean erythrocyte sedimentation rate 
      [31.5 (25.6)-15.3 (11.9) mm/1st h, P = 0.011] and median (IQR) C-reactive protein 
      [1.4 (0.2-12.8) to 0.3 (0.1-3) mg/dl, P = 0.001]. After a mean follow-up of 
      57.5 months, partial or complete neurological remission persisted in 37 patients 
      (90.2%). BT was switched in 22 cases (53.6%) due to inefficacy (n = 16) or 
      adverse events (AEs) (n = 6) and discontinued due to complete prolonged remission 
      (n = 3) or severe AE (n = 1). Serious AEs were observed in two patients under 
      infliximab treatment. CONCLUSIONS: BT appears to be effective and relatively safe 
      in refractory NBD.
CI  - (c) The Author(s) 2022. Published by Oxford University Press on behalf of the 
      British Society for Rheumatology. All rights reserved. For permissions, please 
      email: journals.permissions@oup.com.
FAU - Herrero-Morant, Alba
AU  - Herrero-Morant A
AD  - Rheumatology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of 
      Cantabria, Santander.
FAU - Martin-Varillas, Jose Luis
AU  - Martin-Varillas JL
AD  - Rheumatology, Hospital de Sierrallana, Torrelavega.
FAU - Castaneda, Santos
AU  - Castaneda S
AD  - Rheumatology, Hospital Universitario La Princesa, IIS-Princesa, Madrid.
FAU - Maiz, Olga
AU  - Maiz O
AD  - Rheumatology and Ophthalmology, Hospital Universitario de Donostia, San 
      Sebastian.
FAU - Sanchez, Julio
AU  - Sanchez J
AUID- ORCID: 0000-0002-7623-057X
AD  - Rheumatology, Hospital 12 de Octubre, Madrid.
FAU - Ortego, Norberto
AU  - Ortego N
AD  - Rheumatology and Internal Medicine, Hospital Universitario Clinico San Cecilio, 
      Granada.
FAU - Raya, Enrique
AU  - Raya E
AD  - Rheumatology and Internal Medicine, Hospital Universitario Clinico San Cecilio, 
      Granada.
FAU - Prior-Espanol, Agueda
AU  - Prior-Espanol A
AD  - Rheumatology, Hospital Universitario Germans Trias i Pujol, Barcelona.
FAU - Moriano, Clara
AU  - Moriano C
AD  - Rheumatology, Hospital de Leon, Leon.
FAU - Melero-Gonzalez, Rafael B
AU  - Melero-Gonzalez RB
AD  - Rheumatology, Complejo Hospitalario de Vigo, Vigo.
FAU - Grana-Gil, Jenaro
AU  - Grana-Gil J
AD  - Rheumatology, Hospital Universitario de A Coruna, A Coruna.
FAU - Urruticoechea-Arana, Ana
AU  - Urruticoechea-Arana A
AD  - Rheumatology, Hospital Can Misses, Ibiza.
FAU - Ramos-Calvo, Angel
AU  - Ramos-Calvo A
AD  - Rheumatology, Complejo Hospitalario de Soria, Soria.
FAU - Loredo-Martinez, Marta
AU  - Loredo-Martinez M
AD  - Rheumatology, Hospital Clinico Lozano Blesa, Zaragoza.
FAU - Salgado-Perez, Eva
AU  - Salgado-Perez E
AD  - Rheumatology, Complejo Hospitalario Universitario de Ourense, Ourense.
FAU - Sivera, Francisca
AU  - Sivera F
AD  - Rheumatology, Hospital General Universitario de Elda, Elda.
AD  - Medicina, Universidad Miguel Hernandez, Elche.
FAU - Torre, Ignacio
AU  - Torre I
AD  - Rheumatology, Hospital de Basurto, Bilbao.
FAU - Narvaez, Javier
AU  - Narvaez J
AUID- ORCID: 0000-0002-1614-8064
AD  - Rheumatology, Hospital Bellvitge, Barcelona.
FAU - Andreu, Jose Luis
AU  - Andreu JL
AD  - Rheumatology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid.
FAU - Martinez-Gonzalez, Olga
AU  - Martinez-Gonzalez O
AD  - Rheumatology, Hospital Clinico Universitario de Salamanca, Salamanca.
FAU - Torre, Ricardo Gomez-de la
AU  - Torre RG
AD  - Internal Medicine, Hospital Universitario Central de Asturias, Oviedo.
FAU - Fernandez-Aguado, Sabela
AU  - Fernandez-Aguado S
AD  - Rheumatology, Hospital Universitario de Cabuenes, Gijon.
FAU - Romero-Yuste, Susana
AU  - Romero-Yuste S
AD  - Rheumatology, Complejo Hospitalario Universitario de Pontevedra, Pontevedra.
FAU - Gonzalez-Mazon, Inigo
AU  - Gonzalez-Mazon I
AD  - Rheumatology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of 
      Cantabria, Santander.
FAU - Alvarez-Reguera, Carmen
AU  - Alvarez-Reguera C
AD  - Rheumatology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of 
      Cantabria, Santander.
FAU - Hernandez, Jose Luis
AU  - Hernandez JL
AUID- ORCID: 0000-0002-6585-8847
AD  - Internal Medicine, Hospital Universitario Marques de Valdecilla, IDIVAL, 
      Santander, Spain.
FAU - Gonzalez-Gay, Miguel Angel
AU  - Gonzalez-Gay MA
AD  - Rheumatology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of 
      Cantabria, Santander.
FAU - Blanco, Ricardo
AU  - Blanco R
AUID- ORCID: 0000-0003-2344-2285
AD  - Rheumatology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of 
      Cantabria, Santander.
CN  - Neurobehcet Spanish Collaborative Group
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Rheumatology (Oxford)
JT  - Rheumatology (Oxford, England)
JID - 100883501
RN  - B72HH48FLU (Infliximab)
RN  - FYS6T7F842 (Adalimumab)
RN  - OP401G7OJC (Etanercept)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Glucocorticoids)
SB  - IM
MH  - Humans
MH  - Female
MH  - Adult
MH  - Infliximab/therapeutic use
MH  - Adalimumab/therapeutic use
MH  - Etanercept/therapeutic use
MH  - *Immunosuppressive Agents/therapeutic use
MH  - *Biological Therapy
MH  - Glucocorticoids
MH  - Treatment Outcome
MH  - Multicenter Studies as Topic
OTO - NOTNLM
OT  - Neurobehcet
OT  - anakinra
OT  - anti-TNF
OT  - biologic therapy
OT  - canakinumab
OT  - rituximab
OT  - tocilizumab
OT  - ustekinumab
FIR - Blanco, Ana
IR  - Blanco A
FIR - Callejas, Jose Luis
IR  - Callejas JL
FIR - Brandy-Garcia, Anahy
IR  - Brandy-Garcia A
FIR - Olive, Alejandro
IR  - Olive A
FIR - Diez, Elvira
IR  - Diez E
FIR - Seijas-Lopez, Alvaro
IR  - Seijas-Lopez A
FIR - Delgado-Beltran, Concepcion
IR  - Delgado-Beltran C
EDAT- 2022/02/16 06:00
MHDA- 2022/11/04 06:00
CRDT- 2022/02/15 12:17
PHST- 2021/11/22 00:00 [received]
PHST- 2022/01/17 00:00 [revised]
PHST- 2022/02/16 06:00 [pubmed]
PHST- 2022/11/04 06:00 [medline]
PHST- 2022/02/15 12:17 [entrez]
AID - 6528885 [pii]
AID - 10.1093/rheumatology/keac097 [doi]
PST - ppublish
SO  - Rheumatology (Oxford). 2022 Nov 2;61(11):4427-4436. doi: 
      10.1093/rheumatology/keac097.