Division of Rheumatology, Department of Internal Medicine, Istanbul Aydın University, Istanbul, Turkey.
Department of Ophthalmology, Van Training and Research Hospital, Van, Turkey.
Clin Immunol. 2024 Jul;264:110239. doi: 10.1016/j.clim.2024.110239. Epub 2024 May 9.
We aimed to evaluate the clinical features, disease course, and associated factors for outcome in severe/refractory BD patients receiving TNF-i treatment.
This retrospective study was conducted by reviewing medical records from a tertiary referral center in Van province in Eastern Turkey. Data were obtained from patients' charts followed up between June 2019 and June 2022.
We included 469 BD patients (59.3% male) whose 80 patients (17%) received TNF-i treatment in the study. The mean ± standard deviation of the patient age was 36.7 ± 10.1 years and the median (IQR) disease duration was 12 (12) years. IFX and ADAwere initiated in 67.5% (n = 54) and 32.5% (n = 26) patients, respectively. Overall and first-line retention rates of TNF-i were 84.7% and 92.6% for IFX and 83.3% and 80.8% for ADA, respectively. IFX was discontinued in 9 patients which were in 2 patients due to allergic reaction and tuberculosis, 3 patients for inefficacy, one patient for heart failure, and one patient for orbital zona. Although no serious adverse event was observed with ADA, 5 patients switched to IFX due to inefficacy. Overall, 72 patients (90%) resumed TNF-i at the end of the study; TNF-i was discontinued in 3 patients (3.8%) due to severe adverse events and in 5 patients (6.2%) with prolonged remission.
In our study, no case of death was observed in TNF-i receiving patients. Most patients achieved attack-free and CS-free disease and retained TNF-i treatment. TNF inhibitors appear to be safe and effective in patients with severe/refractory Behçet's disease.
我们旨在评估接受 TNF-i 治疗的重症/难治性 BD 患者的临床特征、疾病过程和结局相关因素。
这项回顾性研究通过审查土耳其东部凡省的一家三级转诊中心的病历进行。数据来自于 2019 年 6 月至 2022 年 6 月期间随访的患者图表。
我们纳入了 469 名 BD 患者（59.3%为男性），其中 80 名（17%）患者在研究中接受了 TNF-i 治疗。患者年龄的平均值±标准差为 36.7±10.1 岁，中位数（IQR）疾病持续时间为 12（12）年。IFX 和 ADA 分别在 67.5%（n=54）和 32.5%（n=26）的患者中开始使用。IFX 和 ADA 的总体和一线保留率分别为 84.7%和 92.6%和 83.3%和 80.8%。IFX 因过敏反应和结核病停用 9 例，因无效停用 3 例，因心力衰竭停用 1 例，因眼眶肿块停用 1 例。虽然 ADA 未观察到严重不良事件，但因无效有 5 例改用 IFX。总的来说，72 名患者（90%）在研究结束时重新开始使用 TNF-i；3 名患者（3.8%）因严重不良事件和 5 名患者（6.2%）因延长缓解期而停用 TNF-i。
在我们的研究中，接受 TNF-i 治疗的患者中没有死亡病例。大多数患者达到了无发作和 CS 无疾病状态，并保留了 TNF-i 治疗。TNF 抑制剂似乎对重症/难治性 Behçet 病患者安全有效。
