Table 2.
Studies reporting on patients with Behçet's disease treated with tocilizumab and ustekinumab.
| First author (reference, year) | N pts | Main BS clinical and laboratory features | HLA-B51 | Previous biologic agents with causes of withdrawal | Dosage and eventual cotherapies | Followup | Outcome |
|---|---|---|---|---|---|---|---|
| Hirano (2012) [51] | 1 | Mucosal involvement, EN, and uveitis | NR | IFX: loss of efficacy | TCZ 8 mg/kg every 4 weeks | 12 months | VA improvement and resolution of EN and genital aphtosis. Partial improvement of oral aphtosis |
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| Shapiro (2012) [52] | 1 | Mucosal and neurologic involvement, bilateral uveitis, and cutaneous vasculitis | NR | IFX: concomitant onset of IgA nephropathy | TCZ 8 mg/kg every 4 weeks + PDN 30–60 mg/day |
7 months | CR after the 2nd infusion; PDN was tapered off; complete resolution of ocular, neurological, and skin manifestations; oral ulcers recurred |
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| Urbaniak (2012) [53] | 1 | Mucosal and neurologic involvement, EN, DVT, and thrombophlebitis | NR | IFX: worsening of the gait disturbance and relapse of myelitis | TCZ 8 mg/kg every 4 weeks + AZA 150 mg/day + PDN 1 mg/kg/day |
8 months | Improvement of clinical signs and symptoms; after the 4th infusion TCZ was discontinued due to a scrotal abscess |
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| Caso (2013) [54] | 1 | Fever, mucosal involvement, myalgia, bilateral uveitis, optic neuritis, EN, SPR, and increase of inflammatory markers overlapping with refractory pemphigus foliaceus | Positive | IFX and ADA: inefficacy; ANA: loss of efficacy |
TCZ 480 mg every 4 weeks | 14 months | CR with improvement of inflammatory markers within few days |
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| Redondo-Pachón (2013) [55] | 1 | Mucosal involvement, EN, iridocyclitis, secondary amyloidosis, and increase of CRP | Positive | None | TCZ 8 mg/kg every 4 weeks + colchicine 1 mg/day |
12 months | CR with decrease of proteinuria and CRP after the 2nd infusion. |
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| Diamantopoulos (2013) [56] | 2 | Mucosal involvement, pseudofolliculitis, and cutaneous vasculitis | NR | IFX and ETN: short efficacy and ADR (not specified) | TCZ 8 mg/kg every 4 weeks + AZA 150 mg/day |
Unknown | Inefficacy; worsening of mouth and genital ulcers |
| Mucosal involvement, increase of inflammatory markers | NR | IFX and ADA: incomplete response and ADR (not specified) | TCZ 8 mg/kg every 4 weeks | 3 months | Initial PR with loss of efficacy after the 3rd infusion; recurrence of genital ulcers | ||
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| Baerveldt (2013) [57] | 1 | Mucosal involvement, anterior uveitis, arthritis, and pathergy reaction overlapping with psoriasis vulgaris and hidradenitis suppurativa | NR | None | Ustekinumab 45 mg at weeks 0 and 4 and every 12 weeks | 36 months | CR within few months, clinical improvement of psoriasis |
ADA: adalimumab; ADR: adverse reactions; ANA: anakinra; AZA: azathioprine; BD: Behçet's disease; CR: complete remission; CRP: C-reactive protein; DVT: deep venous thrombosis; EN: erythema nodosum; ETN: etanercept; HLA: human leukocyte antigen; IFX: infliximab; MRI: magnetic resonance imaging; MTX: methotrexate; N: number; NR: not reported; pts: patients; PDN: prednisone; PR: partial remission; TCZ: tocilizumab; VA: visual acuity.