Unit of Dermatology and Venereology, ASUGI, Trieste, Italy.
Department of Medical Sciences, Unit of Dermatology-University of Trieste, Trieste, Italy.
Dermatol Ther. 2022 Mar;35(3):e15286. doi: 10.1111/dth.15286. Epub 2022 Jan 17.
Adamantiades-Behçet's disease (ABD) is a chronic, idiopathic, relapsing immune-mediate disease that may involve multiple organs. It is characterized by recurrent oral and genital ulcers, skin lesions, ocular, gastrointestinal, vascular, neurological and joint involvement. It can lead to significant morbidity and mortality. Due to its heterogeneity in clinical findings and physiopathology, its treatment can be various as ABD manifestations in different organs may differently respond to the same drug. The cornerstone of therapy for inducing remission is systemic corticosteroid, whereas immunomodulatory and immunosuppressive agents such as colchicine, azathioprine, cyclosporine-A, interferon-alpha, and cyclophosphamide are used as steroid-sparing agents and to prevent relapses. For aggressive, refractory or frequently relapsing cases, tumor necrosis factor (TNF) alpha inhibitors (infliximab, adalimumab, etanercept) have been reported beneficial. Herein, we describe our experience of 7 patients treated with TNF-alpha inhibitors with recommendations regarding treatment choice during the COVID-19 era.
贝切特综合征(ABD)是一种慢性、特发性、复发性免疫介导性疾病,可能累及多个器官。其特征为反复发作的口腔和生殖器溃疡、皮肤损害、眼部、胃肠道、血管、神经和关节病变。该病可导致较高的发病率和死亡率。由于其临床表现和病理生理学的异质性,其治疗可能多种多样,因为不同器官的 ABD 表现可能对同一药物有不同的反应。诱导缓解的治疗基石是全身性皮质类固醇,而秋水仙碱、巯嘌呤、环孢素 A、干扰素-α和环磷酰胺等免疫调节剂和免疫抑制剂则被用作皮质类固醇的辅助药物,以预防复发。对于侵袭性、难治性或频繁复发的病例,已报告肿瘤坏死因子 (TNF)α 抑制剂(英夫利昔单抗、阿达木单抗、依那西普)有益。在此,我们描述了我们用 TNF-α 抑制剂治疗的 7 例患者的经验,并就 COVID-19 时代的治疗选择提出了建议。