Rheumatology, University of Manchester, Manchester, UK
Rheumatology, University of Manchester, Manchester, UK.
Br J Ophthalmol. 2020 Aug;104(8):1045-1051. doi: 10.1136/bjophthalmol-2019-314154. Epub 2019 Nov 1.
Biologics are increasingly used in management of Behçet's Disease (BD) including ocular BD, but the evidence base is limited, mostly from studies of uveitis and BD manifestations.
To review the evidence base for biologics in the treatment of ocular BD.
Systematic literature search was made using exploded key words-Behçet's, ocular, biologics in MEDLINE, Cochrane library, Database of Abstracts Reviews and Effects, Clinical Trials.gov, Science Direct and Google Scholar. There was no limitation on region, language or date (Search updated 16th October 2018). Literature retrieval was restricted to randomised controlled trials (RCTs) of biologics.
Of 237 papers retrieved, eight met the inclusion criteria. RCTs on interferon alpha 2a (INF-α 2a), adalimumab, secukinumab, gevokizumab, rituximab and daclizumab were retrieved (two for adalimumab and gevokizumab). The outcome measures were not met for secukinumab, daclizumab and gevokizumab. Rituximab and INF-α 2a showed promising preliminary results but sufficiently powered RCTs are needed to provide adequate evidence of efficacy. The RCTs on adalimumab did not evaluate efficacy for BD uveitis specifically, hence are of limited value for this review.
Some biologics show promise in treating BD uveitis, but more RCTs are needed for firm conclusions about efficacy. A phase IV study or, registry of adalimumab could provide data on its efficacy in BD uveitis compared to other forms.
生物制剂在包括眼部 Behçet 病（BD）在内的 BD 的治疗中越来越多地被使用，但证据基础有限，主要来自于葡萄膜炎和 BD 表现的研究。
回顾生物制剂治疗眼部 BD 的证据基础。
使用扩展的关键词-Behçet、眼部、生物制剂，在 MEDLINE、Cochrane 图书馆、文摘和效果数据库、临床试验.gov、Science Direct 和 Google Scholar 中进行系统文献检索。没有对地区、语言或日期进行限制（搜索更新于 2018 年 10 月 16 日）。文献检索仅限于生物制剂的随机对照试验（RCT）。
在检索到的 237 篇论文中，有 8 篇符合纳入标准。检索到关于干扰素α 2a（INF-α 2a）、阿达木单抗、司库奇尤单抗、 gevokizumab、利妥昔单抗和地夫可特的 RCT（阿达木单抗和 gevokizumab 各有 2 项）。司库奇尤单抗、地夫可特和 gevokizumab 的结局指标未达到。利妥昔单抗和 INF-α 2a 显示出有希望的初步结果，但需要足够的 RCT 来提供疗效的确凿证据。阿达木单抗的 RCT 没有专门评估 BD 葡萄膜炎的疗效，因此对本综述的价值有限。
一些生物制剂在治疗 BD 葡萄膜炎方面显示出希望，但需要更多的 RCT 来确定疗效。一项 IV 期研究或阿达木单抗的登记册可以提供与其他形式相比，阿达木单抗在 BD 葡萄膜炎中的疗效数据。
