Kehribar Demet Yalçın, Ozgen Metin
Ondokuz Mayis University Faculty of Medicine Körfez Mahallesi Atakum Samsun, samsun 55139 Turkey.
Ondokuz Mayis Universitesi Tip Fakultesi Samsun, Turkey.
Vascular. 2020 Dec;28(6):829-833. doi: 10.1177/1708538120927701. Epub 2020 May 23.
This study aims to investigate the efficacy and reliability of infliximab treatment in Behcet's disease with vascular involvement.
This single-center retrospective study included a total of 18 patients diagnosed with Behcet's disease with vascular involvement who were initiated infliximab treatment after exhibiting resistance to conventional immunosuppressive treatments.
Seventeen patients achieved remission with infliximab treatment. While 18 patients were receiving a median of 50 (IQR: 20-61) mg/day equivalent of methylprednisolone before infliximab treatment, after infliximab treatment, only four patients were receiving 4 mg/day equivalent of methylprednisolone ( < 0.001). Only 4 patients were receiving oral anticoagulant treatment during infliximab treatment, and compared to the patients who were not receiving oral anticoagulants, there was no significant difference between the two groups according to occurrence of new vascular events.
Infliximab seems to be an effective and reliable treatment in Behcet's disease with vascular involvement and may also allow reduced dosage or even the discontinuation of corticosteroids. The results of our study suggest that oral anticoagulant use is unnecessary in Behcet's disease with vascular involvement. However, further long-term randomized controlled studies are needed to investigate the length of infliximab regimen, whether or not it should be discontinued, and if so, whether or not immunosuppressants should be given as maintenance after discontinuation.
本研究旨在探讨英夫利昔单抗治疗血管受累的白塞病的疗效和可靠性。
这项单中心回顾性研究共纳入18例诊断为血管受累的白塞病患者，这些患者在对传统免疫抑制治疗产生耐药后开始接受英夫利昔单抗治疗。
17例患者接受英夫利昔单抗治疗后病情缓解。在接受英夫利昔单抗治疗前，18例患者接受相当于甲基泼尼松龙50（四分位间距：20 - 61）mg/天的治疗，英夫利昔单抗治疗后，只有4例患者接受相当于4 mg/天的甲基泼尼松龙治疗（<0.001）。在英夫利昔单抗治疗期间，只有4例患者接受口服抗凝治疗，与未接受口服抗凝剂的患者相比，两组在新血管事件发生方面无显著差异。
英夫利昔单抗似乎是治疗血管受累白塞病的一种有效且可靠的治疗方法，还可能允许减少皮质类固醇的剂量甚至停用。我们的研究结果表明，血管受累的白塞病患者无需使用口服抗凝剂。然而，需要进一步的长期随机对照研究来探讨英夫利昔单抗治疗方案的时长、是否应停药，如果停药，停药后是否应给予免疫抑制剂维持治疗。
