Skip to main content

Adalimumab effectiveness in Behçet’s disease: short and long-term data from a multicenter retrospective observational study

Clinical Rheumatology volume 36, pages 451–455 (2017)Cite this article

Abstract

Our aim was to evaluate the effectiveness of adalimumab (ADA) during a 24-month study period in patients affected with Behçet’s disease (BD). Clinical and therapeutic data from 100 consecutive BD patients treated with ADA were retrospectively collected and statistically analyzed. At 12-week follow-up, ADA induced clinical efficacy in 81 patients, with a mean time to response of 7.63 ± 3.43 weeks; 25 (30.9 %) patients underwent a disease relapse after 22.17 ± 1.57 months, but treatment adjustments allowed a recovery of efficacy in 11 cases. At 24-month follow-up, 67/100 patients were still on ADA therapy despite concomitant treatments. No differences were identified between ADA monotherapy and co-treatment with DMARDs about efficacy (p = 0.09), time to response (p = 0.61), relapses (p = 0.36), and ADA discontinuation (p = 0.40). No differences existed in patients switched from other tumor necrosis factor (TNF)-α inhibitors about efficacy at 12 weeks (p = 0.13) and rapidity of response (p = 0.93) while relapses (p = 0.01) and ADA discontinuation at 24 months (p = 0.001) were significantly more common. Adverse events occurred in 10 patients. ADA confirmed its effectiveness in BD. Combination therapy with DMARDs seems not significantly superior to monotherapy. Frequency and time to response for ADA was not conditioned by a previous lack or loss of efficacy to other TNF-α inhibitors, but long-term loss of efficacy seemed more likely in patients switched from other anti-TNF agents.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Alpsoy E (2016) Behçet’s disease: a comprehensive review with a focus on epidemiology, etiology and clinical features, and management of mucocutaneous lesions. J Dermatol 43:620–632. doi:10.1111/1346-8138.13381

    CAS  Article  PubMed  Google Scholar 

  2. Rotondo C, Lopalco G, Iannone F et al (2015) Mucocutaneous involvement in Behçet’s disease: how systemic treatment has changed in the last decades and future perspectives. Mediat Inflamm 2015:451675. doi:10.1155/2015/451675

    Article  Google Scholar 

  3. Hatemi G, Seyahi E, Fresko I, Talarico R, Hamuryudan V (2015) Behçet’s syndrome: a critical digest of the 2014–2015 literature. Clin Exp Rheumatol 33:S3–14

    PubMed  Google Scholar 

  4. Saadoun D, Wechsler B, Desseaux K et al (2010) Mortality in Behçet’s disease. Arthritis Rheum 62:2806–2812. doi:10.1002/art.27568

    CAS  Article  PubMed  Google Scholar 

  5. Vitale A, Rigante D, Lopalco G et al (2016) Interleukin-1 inhibition in Behçet’s disease. Isr Med Assoc J 18:171–176

    PubMed  Google Scholar 

  6. Rigante D (2010) The protean visage of systemic autoinflammatory syndromes: a challenge for inter-professional collaboration. Eur Rev Med Pharmacol Sci 14:1–18

    CAS  PubMed  Google Scholar 

  7. Caso F, Costa L, Rigante D et al (2014) Biological treatments in Behçet’s disease: beyond anti-TNF therapy. Mediat Inflamm 2014:107421. doi:10.1155/2014/107421

    Article  Google Scholar 

  8. Vitale A, Rigante D, Lopalco G et al (2016) New therapeutic solutions for Behçet’s syndrome. Expert Opin Investig Drugs 25:827–840. doi:10.1080/13543784

    CAS  Article  PubMed  Google Scholar 

  9. Hatemi G, Silman A, Bang D et al (2008) EULAR recommendations for the management of Behçet disease. Ann Rheum Dis 67:1656–1662. doi:10.1136/ard.2007.080432

    CAS  Article  PubMed  Google Scholar 

  10. Vallet H, Riviere S, Sanna A et al (2015) Efficacy of anti-TNF alpha in severe and/or refractory Behçet’s disease: multicenter study of 124 patients. J Autoimmun 62:67–74. doi:10.1016/j.jaut.2015.06.005

    CAS  Article  PubMed  Google Scholar 

  11. Tanida S, Inoue N, Kobayashi K et al (2015) Adalimumab for the treatment of Japanese patients with intestinal Behçet’s disease. Clin Gastroenterol Hepatol 13:940–8.e3. doi:10.1016/j.cgh.2014.08.042

    CAS  Article  PubMed  Google Scholar 

  12. Interlandi E, Leccese P, Olivieri I, Latanza L (2014) Adalimumab for treatment of severe Behçet’s uveitis: a retrospective long-term follow-up study. Clin Exp Rheumatol 32:S58–S62

    PubMed  Google Scholar 

  13. Calvo-Río V, Blanco R, Beltrán E et al (2014) Anti-TNF-α therapy in patients with refractory uveitis due to Behçet’s disease: a 1-year follow-up study of 124 patients. Rheumatology (Oxford) 53:2223–2231. doi:10.1093/rheumatology/keu266

    Article  Google Scholar 

  14. Aamar S, Peleg H, Leibowitz D, Chajek-Shaul T, Hiller N, Heyman SN (2014) Efficacy of adalimumab therapy for life-threatening pulmonary vasculitis in Behçet’s disease. Rheumatol Int 34:857–860. doi:10.1007/s00296-013-2693-4

    CAS  Article  PubMed  Google Scholar 

  15. Criteria for diagnosis of Behçet’s disease (1990) International study group for Behçet’s disease. Lancet 335:1078–1080

    Google Scholar 

  16. International Team for the Revision of the International Criteria for Behçet’s Disease (ITR-ICBD) (2014) The international criteria for Behçet’s disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol 28:338–347. doi:10.1111/jdv.12107

    Article  Google Scholar 

  17. Neves FS, Moraes JC, Kowalski SC, Goldenstein-Schainberg C, Lage LV, Gonçalves CR (2007) Cross-cultural adaptation of the Behçet’s disease current activity form (BDCAF) to Brazilian Portuguese language. Clin Rheumatol 26:1263–1267

    CAS  Article  PubMed  Google Scholar 

  18. Olivieri I, Leccese P, D’Angelo S et al (2011) Efficacy of adalimumab in patients with Behçet’s disease unsuccessfully treated with infliximab. Clin Exp Rheumatol 29:S54–S57

    PubMed  Google Scholar 

  19. Perra D, Alba MA, Callejas JL et al (2012) Adalimumab for the treatment of Behçet’s disease: experience in 19 patients. Rheumatology (Oxford) 51:1825–1831

    CAS  Article  Google Scholar 

  20. Cantarini L, Talarico R, Generali E (2015) Safety profile of biologic agents for Behçet’s disease in a multicenter observational cohort study. Int J Rheum Dis. doi:10.1111/1756-185X.12732

    Google Scholar 

  21. Cantarini L, Lopalco G, Caso F et al (2015) Effectiveness and tuberculosis-related safety profile of interleukin-1 blocking agents in the management of Behçet’s disease. Autoimmun Rev 14:1–9. doi:10.1016/j.autrev.2014.08.008

    CAS  Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. Research Center of Systemic Autoinflammatory Diseases and Behçet’s Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy

    Antonio Vitale, Stefano Gentileschi, Bruno Frediani, Mauro Galeazzi & Luca Cantarini

  2. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    Giacomo Emmi, Elena Silvestri & Maria Letizia Urban

  3. Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Bari, Italy

    Giuseppe Lopalco & Florenzo Iannone

  4. Department of Ophthalmology, Humanitas Research Hospital, Rozzano, Milan, Italy

    Claudia Fabiani

  5. Institute of Pediatrics, Fondazione Policlinico A. Gemelli, Università Cattolica Sacro Cuore, Rome, Italy

    Donato Rigante

  6. Rheumatology Unit, Policlinico “Le Scotte”, University of Siena, viale Bracci 1, 53100, Siena, Italy

    Luca Cantarini

Authors
  1. Antonio Vitale
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Giacomo Emmi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giuseppe Lopalco
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stefano Gentileschi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elena Silvestri
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Claudia Fabiani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Maria Letizia Urban
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Bruno Frediani
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mauro Galeazzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Florenzo Iannone
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Donato Rigante
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Luca Cantarini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luca Cantarini.

Ethics declarations

Disclosures

None.

Additional information

Donato Rigante and Luca Cantarini equally contributed to this manuscript.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Vitale, A., Emmi, G., Lopalco, G. et al. Adalimumab effectiveness in Behçet’s disease: short and long-term data from a multicenter retrospective observational study. Clin Rheumatol 36, 451–455 (2017). https://doi.org/10.1007/s10067-016-3417-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-016-3417-4

Keywords

  • Adalimumab
  • BDCAF
  • Behçet’s disease
  • Biologics
  • Disease activity