Advertisement

Real-world efficacy of adalimumab and infliximab for refractory intestinal Behçet’s disease

Published:February 19, 2019DOI:https://doi.org/10.1016/j.dld.2018.10.024

      Abstract

      Background

      Anti-tumor necrosis factor-α agents are important for managing refractory intestinal Behçet’s disease. Few studies have reported the efficacy of anti-tumor necrosis factor-α monoclonal antibodies for intestinal Behçet’s disease due to its rarity.

      Aims

      The aim was to examine the efficacy of anti-tumor necrosis factor-α antibodies for intestinal Behçet’s disease in real-world practice.

      Methods

      This was a retrospective review of medical records at 4 hospitals in Japan. Global gastrointestinal symptom and endoscopic assessment scores were analyzed in intestinal Behçet’s disease patients given anti-tumor necrosis factor-α agents at 3 and 12 months after the start of therapy.

      Results

      Of 53 intestinal Behçet’s disease patients, 22 received anti-tumor necrosis factor-α monoclonal antibody treatment. At the first line, 14 were given adalimumab, and 8 were given infliximab. After 3 and 12 months of treatment, 7 and 11 patients showed complete response of gastrointestinal symptom scores, respectively, and 5 and 9 showed complete remission of the endoscopic assessment score, respectively. Three patients switched anti-tumor necrosis factor-α agents.

      Conclusion

      Anti-tumor necrosis factor-α monoclonal antibodies are effective for refractory intestinal Behçet’s disease in real-world situations. Switching anti-tumor necrosis factor-α agents may be useful for failure of first-line anti-tumor necrosis factor-α therapy in some refractory cases.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Digestive and Liver Disease
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Hisamatsu T.
        • Ueno F.
        • Matsumoto T.
        • Kobayashi K.
        • Koganei K.
        • Kunisaki R.
        • et al.
        The 2nd edition of consensus statements for the diagnosis and management of intestinal Behcet’s disease: indication of anti-TNFalpha monoclonal antibodies.
        J Gastroenterol. 2014; 49: 156-162
        • Tanida S.
        • Inoue N.
        • Kobayashi K.
        • Naganuma M.
        • Hirai F.
        • Iizuka B.
        • et al.
        Adalimumab for the treatment of Japanese patients with intestinal Behcet’s disease.
        Clin Gastroenterol Hepatol. 2015; 13 (940–8.e3)
        • Park Y.E.
        • Cheon J.H.
        Updated treatment strategies for intestinal Behcet’s disease.
        Korean J Intern Med. 2018; 33: 1-19
        • Naganuma M.
        • Sakuraba A.
        • Hisamatsu T.
        • Ochiai H.
        • Hasegawa H.
        • Ogata H.
        • et al.
        Efficacy of infliximab for induction and maintenance of remission in intestinal Behcet’s disease.
        Inflamm Bowel Dis. 2008; 14: 1259-1264
        • Hibi T.
        • Hirohata S.
        • Kikuchi H.
        • Tateishi U.
        • Sato N.
        • Ozaki K.
        • et al.
        Infliximab therapy for intestinal, neurological, and vascular involvement in Behcet disease: efficacy, safety, and pharmacokinetics in a multicenter, prospective, open-label, single-arm phase 3 study.
        Medicine. 2016; 95: e3863
        • Mizoshita T.
        • Tanida S.
        • Tsukamoto H.
        • Ozeki K.
        • Katano T.
        • Nishiwaki H.
        • et al.
        Adalimumab treatment in biologically naive Crohn’s disease: relationship with ectopic MUC5AC expression and endoscopic improvement.
        Gastroenterol Res Pract. 2014; 2014: 687257
        • Mizoshita T.
        • Katano T.
        • Tanida S.
        • Hirano A.
        • Miyaki T.
        • Ozeki K.
        • et al.
        Prospective comparison of preference and efficacy of adalimumab and infliximab for treating ulcerative colitis naive to antitumor necrosis factor therapy.
        Medicine. 2017; 96: e7800
        • Suzuki Kurokawa M.
        • Suzuki N.
        Behcet’s disease.
        Clin Exp Med. 2004; 4: 10-20
      1. Criteria for diagnosis of Behcet’s disease. International Study Group for Behcet’s Disease.
        Lancet. 1990; 335: 1078-1080
        • Lee J.H.
        • Cheon J.H.
        • Jeon S.W.
        • Ye B.D.
        • Yang S.K.
        • Kim Y.H.
        • et al.
        Efficacy of infliximab in intestinal Behcet’s disease: a Korean multicenter retrospective study.
        Inflamm Bowel Dis. 2013; 19: 1833-1838
        • Matsumoto T.
        • Yanai S.
        • Toya Y.
        • Ueno M.
        • Nakamura S.
        Internet-orientated assessment of QOL and actual treatment status in Japanese patients with inflammatory bowel disease: the 3I survey.
        J Crohns Colitis. 2015; 9: 477-482
        • Karube H.
        • Kamoi K.
        • Ohno-Matsui K.
        Anti-TNF therapy in the management of ocular attacks in an elderly patient with long-standing Behcet’s disease.
        Int Med Case Rep J. 2016; 9: 301-304
        • Inoue N.
        • Kobayashi K.
        • Naganuma M.
        • Hirai F.
        • Ozawa M.
        • Arikan D.
        • et al.
        Long-term safety and efficacy of adalimumab for intestinal Behcet’s disease in the open label study following a phase 3 clinical trial.
        Intest Res. 2017; 15: 395-401