Section of Clinical Immunology, Departments of Internal Medicine and Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.
Uveitis Service, Eye Hospital Rotterdam, Rotterdam, the Netherlands.
Clin Immunol. 2023 Feb;247:109242. doi: 10.1016/j.clim.2023.109242. Epub 2023 Jan 28.
Behçet's disease (BD) is a systemic, inflammatory disorder affecting multiple organ systems, frequently treated with TNF-α blocking agents, as infliximab and adalimumab. Insights about long-term use of adalimumab are lacking. Therefore, we conducted a study into the long-term efficacy and safety of adalimumab in BD.
A retrospective cohort study from patients with BD treated with adalimumab in the Erasmus Medical Center was performed. Patients included were at least 18 years of age, diagnosed according to ISG criteria, and uninterruptedly used adalimumab for at least 36 months.
In a population of 39 BD patients using adalimumab, 29 patients persisted treatment >36 months (range 37-206 months). Indications for treatment were uveitis (n = 15) 51.7%, mucocutaneous involvement (n = 9) 31%, arthritis (n = 2) 6.9%, intestinal disease (n = 3) 10.3%. Overall, adalimumab decreased the occurrence of flares from 0.64 to 0.17 flares per year and BCVA improved subsequently. Also, a steady decline in BDCAF is reported over the course of at least 5 years. Subsequently, 79% was able to reduce their use of immunosuppressive agents aside from adalimumab. Adverse effects were reported in, (n = 15) 51.7% of which (n = 13) 86.6% were infectious complications. Two of those required inpatient hospital care.
Our study illustrates durable long-term efficacy of adalimumab treatment in patients with BD. In our patient cohort long-term adalimumab treatment is safe, with a low incidence of serious adverse events.
贝赫切特病（BD）是一种影响多个器官系统的全身性炎症性疾病，常采用 TNF-α 阻断剂，如英夫利昔单抗和阿达木单抗进行治疗。阿达木单抗长期使用的相关信息尚不清楚。因此，我们进行了一项研究，以评估阿达木单抗治疗 BD 的长期疗效和安全性。
对在伊拉斯谟医疗中心接受阿达木单抗治疗的 BD 患者进行了一项回顾性队列研究。纳入的患者年龄至少为 18 岁，根据 ISG 标准诊断，且不间断使用阿达木单抗至少 36 个月。
在使用阿达木单抗的 39 名 BD 患者中，有 29 名患者持续治疗>36 个月（范围 37-206 个月）。治疗的适应证为葡萄膜炎（n=15）占 51.7%、黏膜皮肤受累（n=9）占 31%、关节炎（n=2）占 6.9%、肠道疾病（n=3）占 10.3%。总体而言，阿达木单抗使年发作次数从 0.64 次减少至 0.17 次，随后 BCVA 得到改善。此外，BDCAF 在至少 5 年内呈持续下降趋势。随后，79%的患者能够减少除阿达木单抗以外的免疫抑制剂的使用。报告了（n=15）51.7%的不良反应，其中（n=13）86.6%为感染性并发症。其中 2 人需要住院治疗。
我们的研究表明，阿达木单抗治疗 BD 患者具有持久的长期疗效。在我们的患者队列中，长期阿达木单抗治疗是安全的，严重不良事件的发生率较低。
