Park Yehyun, Cheon Jae Hee
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
Curr Gastroenterol Rep. 2020 Mar 19;22(5):24. doi: 10.1007/s11894-020-00759-1.
The treatment of intestinal Behcet's disease (BD) is challenging, and one-third of patients require surgery due to failure of conventional therapies. Anti-tumor necrosis factor-α (TNF-α) and other new biologics have been actively investigated for managing intestinal BD. In this article, we review the updated experiences and up-to-date clinical data on anti-TNF-α and other biologics for the management of intestinal BD.
Recent prospective studies have proved the efficacy and safety of infliximab and adalimumab for treating intestinal BD. Recent studies with other biologics such as anti-interleukin (IL)-1 (anakinra and canakinumab) and anti-IL-6 (tocilizumab) have shown promising results in patients with systemic, including intestinal, BD. Both infliximab and adalimumab can be useful in managing patients with intestinal BD, especially severe or refractory cases, with a similar efficacy and safety profile. More evidence for anakinra, canakinumab, tocilizumab, anti-IL-17 (secukinumab), and anti-IL-12/23 (ustekinumab) in intestinal BD is required.
肠道白塞病(BD)的治疗具有挑战性,三分之一的患者因传统治疗失败而需要手术。抗肿瘤坏死因子-α(TNF-α)及其他新型生物制剂已被积极研究用于治疗肠道BD。在本文中,我们回顾了抗TNF-α及其他生物制剂治疗肠道BD的最新经验和临床数据。
近期的前瞻性研究证实了英夫利昔单抗和阿达木单抗治疗肠道BD的有效性和安全性。近期使用其他生物制剂的研究,如抗白细胞介素(IL)-1(阿那白滞素和卡那单抗)和抗IL-6(托珠单抗),在包括肠道BD在内的系统性BD患者中显示出了有前景的结果。英夫利昔单抗和阿达木单抗在治疗肠道BD患者,尤其是重症或难治性病例时均可能有效,且疗效和安全性相似。对于阿那白滞素、卡那单抗、托珠单抗、抗IL-17(司库奇尤单抗)和抗IL-12/23(乌司奴单抗)治疗肠道BD,还需要更多证据。