Department of Autoimmune Diseases, Hospital Clınic, Barcelona, Catalonia, Spain.
Rheumatology (Oxford). 2012 Oct;51(10):1825-31. doi: 10.1093/rheumatology/kes130. Epub 2012 Jun 20.
To describe the experience of two tertiary Spanish centres (Hospital Clínico San Cecilio, Granada and Hospital Clínic, Barcelona) with the use of adalimumab for the treatment of severe clinical manifestations in patients with Behçet's disease (BD) in whom immunosuppressive therapy had failed.
Retrospective chart review from patients with BD treated with adalimumab in two specialized Spanish centres (Hospital Clínico San Cecilio, Granada and Hospital Clínic, Barcelona).
From November 2006 to February 2011, 19 patients with BD were treated with adalimumab. The reason to initiate adalimumab was refractory disease in 17 (89.5%) patients and adverse events to CSA and infliximab in two (10.5%) patients, respectively. The main clinical manifestations leading to adalimumab administration were panuveitis in eight patients, severe bipolar aphthosis in eight, retinal vasculitis in three and severe folliculitis in three. Overall, adalimumab achieved clinical improvement in 17 of the 19 patients. Of note, ocular manifestations (panuveitis and retinal vasculitis) responded rapidly in all cases. In addition to clinical improvement, treatment with adalimumab was associated with reduction in the number and dose of standard immunosuppressive agents. Of interest, seven patients had received TNF-α inhibitors before adalimumab, five infliximab and the remaining two etanercept. Adalimumab was withdrawn in only one patient due to severe infusional reaction in the form of urticaria and angioedema.
Adalimumab is a valid option for patients with BD and recalcitrant non-controlling manifestations with good safety profile.
描述两家西班牙三级医院（格拉纳达的圣塞西莉亚医院和巴塞罗那的 Clinic 医院）使用阿达木单抗治疗因免疫抑制治疗失败而出现严重临床表现的白塞病（BD）患者的经验。
对在两家西班牙专门中心（格拉纳达的圣塞西莉亚医院和巴塞罗那的 Clinic 医院）接受阿达木单抗治疗的 BD 患者进行回顾性图表审查。
从 2006 年 11 月至 2011 年 2 月，19 名 BD 患者接受了阿达木单抗治疗。启动阿达木单抗的原因分别为 17 名（89.5%）患者疾病难治和 2 名（10.5%）患者 CSA 和英夫利昔单抗出现不良反应。导致使用阿达木单抗的主要临床症状分别为 8 名患者出现全葡萄膜炎、8 名患者出现严重双相口腔溃疡、3 名患者出现视网膜血管炎和 3 名患者出现严重滤泡炎。总体而言，阿达木单抗使 19 名患者中的 17 名患者的病情得到了改善。值得注意的是，所有病例的眼部表现（全葡萄膜炎和视网膜血管炎）均迅速得到改善。除了临床改善之外，阿达木单抗治疗还与减少标准免疫抑制剂的数量和剂量有关。有趣的是，7 名患者在接受阿达木单抗治疗之前已接受过 TNF-α 抑制剂，其中 5 名患者接受过英夫利昔单抗，另外 2 名患者接受过依那西普。仅因荨麻疹和血管性水肿形式的严重输注反应而停用阿达木单抗的患者 1 例。
阿达木单抗是治疗 BD 患者和难治性、控制不佳的表现的有效选择，具有良好的安全性。
