Table 1.
Main features of the biologic drugs for BU
| Drug names | Target | Route | Recommended dosage | Potential side effects |
|---|---|---|---|---|
| Infliximab | TNF-α | i.v | 5–10 mg/kg at baseline, 2nd and 6th week, then every 4–8 weeks | Infusion reactions, autoantibody formation, infection (particularly tuberculosis), demyelinating diseases |
| Adalimumab | TNF-α | s.c | Initial dose of 80 mg, followed by 40 mg every 2 weeks | Injection site reactions, infections, tuberculosis, demyelination, lupus-like syndrome |
| Golimumab | TNF-α | s.c | 50 mg per month | ANA positivity, development of resistance |
| Etanercept | TNF-α/β | s.c | 0.4 mg/kg twice a week | Exacerbate non-Behçet's syndrome ocular inflammation or even induce inflammation, infections, allergic responses |
| IFN-α | No specific target | s.c | 3–6 million units daily with slow taper | Flu-like symptoms, mild leukopenia/thrombocytopenia, elevated liver enzymes, depression, suicidal ideation, bone marrow suppression |
| Anakinra | IL-1 receptor | s.c | 100 mg/daily | Injection site reactions (for s.c.), infections, antibody development, allergic reactions |
| Canakinumab | IL-1β | s.c./i.v | 150 mg every 6 weeks | Injection site reactions (for s.c.), infections |
| Tocilizumab | IL-6R | i.v | 4 mg/kg every 4 weeks | Infections, viral hepatitis and TBC reactivation, elevated lipid parameters and transaminases, injection site reaction |
| Secukinumab | IL-17 | s.c./i.v | 150–300 mg every 4 weeks | Injection site reactions (for s.c.), infections, inflammatory bowel disease |
| Rituximab | B cells (CD20) | i.v | 375 mg/m2 body surface per week for 8 weeks, then every 4 weeks for 4 months | Infusion reactions, hepatotoxic, cardiovascular, fatigue, pruritis, nausea, urinary tract infections, antibody development |
| Alemtuzumab | Anti-CD52 | i.v | 30 mg, thrice a week for 12 months |
Infusion reactions, diminished thyroid function, bone marrow suppression, allergic reactions, reduced lymphocyte counts Abbreviations: BU Behçet’s uveitis; TNF-α/β tumor necrosis factor-alpha/beta; IL-1 interleukin-1; IFN-α interferon-α; IL-1β interleukin-1 beta; IL-6R interleukin-6 receptor; IL-17 interleukin-17; i.v. intravenous; s.c. subcutaneous; CD20 cluster of differentiation 20; CD52 cluster of differentiation 52; TBC tuberculosis |