Biologic therapy in refractory neurobehçet's disease: a multicentre study of 41 patients and literature review.

Autor: Herrero-Morant, Alba, Martín-Varillas, José Luis, Castañeda, Santos, Maíz, Olga, Sánchez, Julio, Ortego, Norberto, Raya, Enrique, Prior-Español, Águeda, Moriano, Clara, Melero-González, Rafael B, Graña-Gil, Jenaro, Urruticoechea-Arana, Ana, Ramos-Calvo, Ángel, Loredo-Martínez, Marta, Salgado-Pérez, Eva, Sivera, Francisca, Torre, Ignacio, Narváez, Javier, Andreu, José Luis, Martínez-González, Olga
Předmět:
Zdroj: Rheumatology; Nov2022, Vol. 61 Issue 11, p4427-4436, 10p
Abstrakt: Objectives To assess efficacy and safety of biologic therapy (BT) in neurobehçet's disease (NBD) refractory to glucocorticoids and at least one conventional immunosuppressive drug. Methods Open-label, national, multicentre study. NBD diagnosis was based on the International Consensus Recommendation criteria. Outcome variables were efficacy and safety. Main efficacy outcome was clinical remission. Other outcome variables analysed were glucocorticoid-sparing effect and improvement in laboratory parameters. Results We studied 41 patients [21 women; age 40.6 (10.8) years]. Neurological damage was parenchymal (n  = 33, 80.5%) and non-parenchymal (n  = 17, 41.5%). First BTs used were infliximab (n  = 19), adalimumab (n  = 14), golimumab (n  = 3), tocilizumab (n  = 3) and etanercept (n  = 2). After 6 months of BT, neurological remission was complete (n  = 23, 56.1%), partial (n  = 15, 37.6%) and no response (n  = 3, 7.3%). In addition, median (IQR) dose of oral prednisone decreased from 60 (30–60) mg/day at the initial visit to 5 (3.8–10) mg/day after 6 months (P  < 0.001). It was also the case for mean erythrocyte sedimentation rate [31.5 (25.6)–15.3 (11.9) mm/1st h, P  = 0.011] and median (IQR) C-reactive protein [1.4 (0.2–12.8) to 0.3 (0.1–3) mg/dl, P  = 0.001]. After a mean follow-up of 57.5 months, partial or complete neurological remission persisted in 37 patients (90.2%). BT was switched in 22 cases (53.6%) due to inefficacy (n  = 16) or adverse events (AEs) (n  = 6) and discontinued due to complete prolonged remission (n  = 3) or severe AE (n  = 1). Serious AEs were observed in two patients under infliximab treatment. Conclusions BT appears to be effective and relatively safe in refractory NBD. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index