Skip to main content

Advertisement

SpringerLink
Log in

Current and future treatments for Behçet’s uveitis: road to remission

  • Review
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Behçet’s disease (BD) is a multisystem inflammatory disorder of uncertain origin, although it remains defined within the spectrum of systemic immune-mediated vasculitic disorders and also represents a spectrum of putative autoimmune disease. Major symptoms include oral aphthous ulcers, genital ulcerations, skin lesions, and ocular lesions. Despite afflicting many systems, ocular complications of BD are some of the more devastating for the patient and their quality of life. Eye involvement, which affects 60–80 % of BD patients, is characterized in its more severe form by posterior or panuveitis including occlusive retinal vasculitis. While pathogenesis of BD remains complex, association with Class I MHC (HLA-B*51) predisposing to inflammation with engagement of the innate-immune system (neutrophils, NK cells), and perpetuated by the adaptive T cell responses against infectious- and/or auto-antigens. Despite the choice of conventional immunosuppressive therapies available, only recently with the advent of biologic therapy has visual prognosis and outcomes been substantially and favorably altered. For example, both interferon-α (IFN-α) and tumour necrosis factor (TNF)-α antagonists deliver promising results and for the first time improve prognosis. With IFN-α therapy, durable remissions of uveitis can be achieved and lead to drug-free remission. Similarly, anti-TNF therapy with infliximab is reported to be rapidly effective in inducing and maintaining remission. Most recently, rising evidence reports on the use of adalimumab, etanercept, and golimumab, while use of anti-interleukin (IL)-1 agents (anakinra, canakinumab, gevokizumab), IL-6 blockers (tocilizumab), and rituximab (depleting anti-CD20 antibody) is also increasing. The aim of this review is to provide evidence for the role of conventional therapies combined with evidence for advantages and disadvantages of biologic therapies in the treatment of ocular BD. Although randomized controlled trials remain sparse, evidence remains strong and enticing that biologic agents are invaluable for the treatment of sight-threatening Behçet’s uveitis and makes it an exciting time for Behçet’s specialists worldwide.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Deuter CM, Kötter I, Wallace GR, Murray PI, Stübiger N, Zierhut M (2008) Behçet’s disease: ocular effects and treatment. Prog Retin Eye Res 27:111–136

    Article  PubMed  CAS  Google Scholar 

  2. Behçet H (1937) Überrezidivierendeaphthösedurchein Virus verursachte Geschwüre am Mund, am Auge und an den Genitalien. Dermatol Wochenschr 105:1152–1157

    Google Scholar 

  3. International Study Group for Behçet’s Disease (1990) Criteria for diagnosis of Behçet’s disease. Lancet 335:1078–1080

    Google Scholar 

  4. Khairallah M, Accorinti M, Muccioli C, Kahloun R, Kempen JH (2012) Epidemiology of Behçet disease. Ocul Immunol Inflamm 20:324–335

    Article  PubMed  CAS  Google Scholar 

  5. Azizerli G, Kose AA, Sarica R et al (2003) Prevalence of Behçet’s disease in Istanbul, Turkey. Int J Dermatol 42:803–806

    Article  Google Scholar 

  6. Kapsimali VD, Kanakis MA, Vaiopoulos GA, Kaklamanis PG (2010) Etiopathogenesis of Behçet’s disease with emphasis on the role of immunological aberrations. Clin Rheumatol 29:1211–1216

    Article  PubMed  Google Scholar 

  7. Mendoza-Pinto C, García-Carrasco M, Jiménez-Hernández M et al (2010) Etiopathogenesis of Behcet’s disease. Autoimmun Rev 9:241–245

    Article  PubMed  CAS  Google Scholar 

  8. Maldini C, Lavalley MP, Cheminant M, de Menthon M, Mahr A (2012) Relationships of HLA-B51 or B5 genotype with Behcet’s disease clinical characteristics: systematic review and meta-analyses of observational studies. Rheumatology (Oxf) 51:887–900

    Article  Google Scholar 

  9. Hazirolan D, Stübiger N, Pleyer U (2012) Light on the Horizont: biologicals in Behçet uveitis. Acta Ophthalmol. doi:10.1111/j.1755-3768.2011.02348.x

  10. Zhou ZY, Chen SL, Shen N, Lu Y (2012) Cytokines and Behcet’s disease. Autoimmun Rev 11:699–704

    Article  PubMed  CAS  Google Scholar 

  11. Hamzaoui K, Hamzaoui A, Guemira F et al (2002) Cytokine profile in Behçet’s disease patients. Relationship with disease activity. Scand J Rheumatol 31:205–210

    Article  PubMed  Google Scholar 

  12. Mochizuki M, Akduman L, Nussenblatt RB (1996) Behçet’s disease. In: Pepose JS, Holland GN, Wilhelmus KR (eds) Ocular infection and immunity. Mosby, St. Louis, pp 663–675

    Google Scholar 

  13. Davatchi F, Shahram F, Chams-Davatchi C et al (2010) Behçet’s disease: from East to West. Clin Rheumatol 29:823–833

    Article  PubMed  Google Scholar 

  14. Tugal-Tutkun I, Onal S, Altan-Yaycioglu R, Huseyin Altunbas H, Urgancioglu M (2004) Uveitis in Behçet disease: an analysis of 880 patients. Am J Ophthalmol 138:373–380

    Article  PubMed  Google Scholar 

  15. Yang P, Fang W, Meng Q et al (2008) Clinical features of Chinese patients with Behçet’s disease. Ophthalmology 115:312–318

    Article  PubMed  Google Scholar 

  16. Kitaichi N, Miyazaki A, Stanford MR et al (2007) Ocular features of Behçet’s disease: an international collaborative study. Br J Ophthalmol 91:1579–1582

    Article  PubMed Central  PubMed  Google Scholar 

  17. Saleh OA, Birnbaum AD, Tessler HH et al (2012) Behçet uveitis in the American Midwest. Ocul Immunol Inflamm 20:12–17

    Article  PubMed  Google Scholar 

  18. Markomichelakis N, Delicha E, Masselos S et al (2011) A single infliximab infusion vs corticosteroids for acute panuveitis attacks in Behçet’s disease: a comparative 4-week study. Rheumatology (Oxf) 50:593–597

    Article  CAS  Google Scholar 

  19. Rhen T, Cidlowski JA (2005) Antiinflammatory action of glucocorticoids—new mechanisms for old drugs. N Engl J Med 353:1711–1723

    Article  PubMed  CAS  Google Scholar 

  20. Tanaka T, Suzuki J, Yamakawa N, Usui M (2000) Steroid sensitivity and postoperative course of seven patients with Behçet’s disease. Ophthalmic Res 32:41–43

    Article  PubMed  CAS  Google Scholar 

  21. Taylor SR, Singh J, Menezo V et al (2011) Behçet disease: visual prognosis and factors influencing the development of visual loss. Am J Ophthalmol 152:1059–1066

    Article  PubMed  Google Scholar 

  22. Binder AI, Graham EM, Sanders MD, Dinning W, James DG, Denman AM (1987) Cyclosporin A in the treatment of severe Behcet’s uveitis. Br J Rheumatol 26:285–291

    Article  PubMed  CAS  Google Scholar 

  23. BenEzra D, Cohen E, Chajek T et al (1988) Evaluation of conventional therapy versus cyclosporine A in Behçet’s syndrome. Transplant Proc 20:136–143

    PubMed  CAS  Google Scholar 

  24. Ozyazgan Y, Yurdakul S, Yazici H et al (1992) Low dose cyclosporin A versus pulsed cyclophosphamide in Behcet’s syndrome: a single masked trial. Br J Ophthalmol 76:241–243

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  25. Kotake S, Higashi K, Yoshikawa K et al (1999) Central nervous system symptoms in patients with Behcet disease receiving cyclosporine therapy. Ophthalmology 106:586–589

    Article  PubMed  CAS  Google Scholar 

  26. Yazici H, Yurdakul S, Hamuryudan V (2001) Behcet disease. Curr Opin Rheumatol 13:18–22

    Article  PubMed  CAS  Google Scholar 

  27. Kilmartin DJ, Forrester JV, Dick AD (1998) Tacrolimus (FK506) in failed cyclosporin A therapy in endogenous posterior uveitis. Ocul Immunol Inflamm 6:101–109

    Article  PubMed  CAS  Google Scholar 

  28. Murphy CC, Greiner K, Plskova J et al (2005) Cyclosporine vs tacrolimus therapy for posterior and intermediate uveitis. Arch Ophthalmol 123:634–641

    Article  PubMed  CAS  Google Scholar 

  29. Tanabe K (2003) Calcineurin inhibitors in renal transplantation: what is the best option? Drugs 63:1535–1548

    Article  PubMed  CAS  Google Scholar 

  30. Yazici H, Pazarli H, Barnes CG et al (1990) A controlled trial of azathioprine in Behcet’s syndrome. N Engl J Med 322:281–285

    Article  PubMed  CAS  Google Scholar 

  31. Saadoun D, Wechsler B, Terrada C et al (2010) Azathioprine in severe uveitis of Behçet’s disease. Arthritis Care Res (Hoboken) 62:1733–1738

    Article  CAS  Google Scholar 

  32. Hatemi G, Silman A, Bang D et al (2009) Management of Behçet disease: a systematic literature review for the European League Against Rheumatism evidence-based recommendations for the management of Behçet disease. Ann Rheum Dis 68:1528–1534

    Article  PubMed  CAS  Google Scholar 

  33. Kaburaki T, Araki F, Takamoto M et al (2010) Best-corrected visual acuity and frequency of ocular attacks during the initial 10 years in patients with Behçet’s disease. Graefes Arch Clin Exp Ophthalmol 248:709–714

    Article  PubMed  Google Scholar 

  34. Sharma SM, Nestel AR, Lee RW, Dick AD (2009) Clinical review: anti-TNFalpha therapies in uveitis: perspective on 5 years of clinical experience. Ocul Immunol Inflamm 17(6):403–414

    Article  PubMed  CAS  Google Scholar 

  35. Theofilopoulos AN, Baccala R, Beutler B, Kono DH (2005) Type I interferons (alpha/-beta) in immunity and autoimmunity. Annu Rev Immunol 23:307–336

    Article  PubMed  CAS  Google Scholar 

  36. Treusch M, Vonthein R, Baur M et al (2004) Influence of human recombinant interferon-alpha2a (rhIFN-alpha2a) on altered lymphocyte subpopulations and monocytes in Behcet’s disease. Rheumatology (Oxf) 43:1275–1282

    Article  CAS  Google Scholar 

  37. Yang DS, Talylor SR, Lightman SL (2008) Interferon-alpha in the management of patients with Behçet’s disease. Br J Hosp Med (Lond) 69:575–579

    Google Scholar 

  38. Zouboulis CC, Orfanos CE (1998) Treatment of Adamantiades–Behcet disease with systemic interferon alfa. Arch Dermatol 134:1010–1016

    Article  PubMed  CAS  Google Scholar 

  39. Alpsoy E, Durusoy C, Yilmaz E et al (2002) Interferon alfa-2a in the treatment of Behcet disease: a randomized placebo-controlled and double-blind study. Arch Dermatol 138:467–471

    Article  PubMed  CAS  Google Scholar 

  40. Warde N (2010) Therapy: Behçet uveitis: good results for IFN-alpha-2a. Nat Rev Rheumatol 6:437

    Article  PubMed  Google Scholar 

  41. Deuter CM, Zierhut M, Möhle A et al (2010) Long-term remission after cessation of interferon-α treatment in patients with severe uveitis due to Behçet’s disease. Arthritis Rheum 62:2796–2805

    Article  PubMed  CAS  Google Scholar 

  42. Kötter I, Günaydin I, Zierhut M, Stübiger N (2004) The use of interferon a in Behcet disease: review of the literature. Semin Arthritis Rheum 33:320–335

    Article  PubMed  CAS  Google Scholar 

  43. Stübiger N, Kötter I, Zierhut M (2000) Complete regression of retinal neovascularisation after therapy with interferon alfa in Behcet’s disease. Br J Ophthalmol 84:1437–1438

    Google Scholar 

  44. Dick AD, Forrester JV, Liversidge J et al (2004) The role of tumour necrosis factor (TNF-alpha) in experimental autoimmune uveoretinitis (EAU). Prog Retin Eye Res 23:617–637

    Article  PubMed  CAS  Google Scholar 

  45. El-Asrar AM, Struyf S, Kangave D et al (2011) Cytokine profiles in aqueous humor of patients with different clinical entities of endogenous uveitis. Clin Immunol 139:177–184

    Article  PubMed  CAS  Google Scholar 

  46. Ahn JK, Yu HG, Chung H, Park YG (2006) Intraocular cytokine environment in active Behçet uveitis. Am J Ophthalmol 142:429–434

    Article  PubMed  CAS  Google Scholar 

  47. Dick AD, McMenamin PG, Körner H, Scallon BJ, Ghrayeb J, Forrester JV et al (1996) Inhibition of tumor necrosis factor activity minimizes target organ damage in experimental autoimmune uveoretinitis despite quantitatively normal activated T cell traffic to the retina. Eur J Immunol 26:1018–1025

    Article  PubMed  CAS  Google Scholar 

  48. Murphy CC, Greiner K, Plskova J, Duncan L, Frost A, Isaacs JD et al (2004) Neutralizing tumor necrosis factor activity leads to remission in patients with refractory noninfectious posterior uveitis. Arch Ophthalmol 122:845–851

    Article  PubMed  CAS  Google Scholar 

  49. Arida A, Fragiadaki K, Giavri E, Sfikakis PP (2011) Anti-TNF agents for Behçet’s disease: analysis of published data on 369 patients. Semin Arthritis Rheum 41(1):61–70

    Article  PubMed  CAS  Google Scholar 

  50. Sfikakis PP, Kaklamanis PH, Elezoglou A et al (2004) Infliximab for recurrent, sight-threatening ocular inflammation in Adamantiades–Behcet disease. Ann Intern Med 140:404–406

    Article  PubMed  CAS  Google Scholar 

  51. Ohno S, Nakamura S, Hori S et al (2004) Efficacy, safety, and pharmacokinetics of multiple administration of infliximab in Behcet’s disease with refractory uveoretinitis. J Rheumatol 31:1362–1368

    PubMed  CAS  Google Scholar 

  52. Yamada Y, Sugita S, Tanaka H et al (2010) Comparison of infliximab versus cyclosporin during the initial 6-month treatment period in Behçet disease. Br J Ophthalmol 94:284–288

    Article  PubMed  Google Scholar 

  53. Tugal-Tutkun I, Mudun A, Urgancioglu M et al (2005) Efficacy of infliximab in the treatment of uveitis that is refractory to treatment with the combination of azathioprine, cyclosporine, and corticosteroids in Behçet’s disease. An open-label trial. Arthritis Rheum 52:2478–2484

    Article  PubMed  CAS  Google Scholar 

  54. Okada AA, Goto H, Ohno S, Mochizuki M, Ocular Behçet’s Disease Research Group Of Japan (2012) Multicenter study of infliximab for refractory uveoretinitis in Behçet disease. Arch Ophthalmol 130(5):592–598

    Article  PubMed  CAS  Google Scholar 

  55. Bawazeer A, Raffa LH, Nizamuddin SH (2010) Clinical experience with adalimumab in the treatment of ocular Behçet disease. Ocul Immunol Inflamm 18:226–232

    Article  PubMed  CAS  Google Scholar 

  56. Díaz-Llopis M, Salom D, Garcia-de-Vicuña C, Cordero-Coma M, Ortega G, Ortego N et al (2012) Treatment of refractory uveitis with adalimumab: a prospective multicenter study of 131 patients. Ophthalmology 119:1575–1581

    Article  PubMed  Google Scholar 

  57. Perra D, Alba MA, Callejas JL, Mesquida M, Ríos-Fernández R, Adán A et al (2012) Adalimumab for the treatment of Behcet’s disease: experience in 19 patients. Rheumatology (Oxf) 51:1825–1831

    Article  CAS  Google Scholar 

  58. Takase K, Ohno S, Ideguchi H, Uchio E, Takeno M, Ishigatsubo Y (2011) Successful switching to adalimumab in an infliximab-allergic patient with severe Behçet disease-related uveitis. Rheumatol Int 31:243–245

    Article  PubMed  CAS  Google Scholar 

  59. Leccese P, Latanza L, D’Angelo S, Padula A, Olivieri I (2011) Efficacy of switching to adalimumab in a patient with refractory uveitis of Behçet’s disease to infliximab. Clin Exp Rheumatol 29(4 Suppl 67):S93

    PubMed  Google Scholar 

  60. Cordero-Coma M, Salom D, Díaz-Llopis M, López-Prats MJ, Calleja S (2011) Golimumab for uveitis. Ophthalmology 118:1892.e3–1892.e4

    Article  Google Scholar 

  61. William M, Faez S, Papaliodis GN, Lobo AM (2012) Golimumab for the treatment of refractory juvenile idiopathic arthritis-associated uveitis. J Ophthalmic Inflamm Infect 2(4):231–233

    Google Scholar 

  62. Mesquida M, Hernández MV, Llorenç V, Pelegrín L, Espinosa G, Dick AD, et al (2012) Behçet disease-associated uveitis successfully treated with golimumab. Ocul Immunol Inflamm 21(2):160–162

    Google Scholar 

  63. Galor A, Perez VL, Hammel JP, Lowder CY (2006) Differential effectiveness of etanercept and infliximab in the treatment of ocular inflammation. Ophthalmology 113:2137–2323

    Article  Google Scholar 

  64. Sfikakis PP, Markomichelakis N, Alpsoy E et al (2007) Anti-TNF therapy in the management of Behçet’s disease—review and basis for recommendations. Rheumatology (Oxf) 46:736–741

    Article  CAS  Google Scholar 

  65. Suhler EB, Smith JR, Wertheim MS et al (2005) A prospective trial of infliximab therapy for refractory uveitis: preliminary safety and efficacy outcomes. Arch Ophthalmol 123(7):903–912

    Article  PubMed  CAS  Google Scholar 

  66. Niccoli L, Nannini C, Benucci M et al (2007) Long-term efficacy of infliximab in refractory posterior uveitis of Behçet’s disease: a 24-month follow-up study. Rheumatology (Oxf) 46(7):1161–1164

    Article  CAS  Google Scholar 

  67. Adán A, Hernandez V, Ortiz S, Molina JJ, Pelegrin L, Espinosa G, Sanmartí R (2010) Effects of infliximab in the treatment of refractory posterior uveitis of Behçet’s disease after withdrawal of infusions. Int Ophthalmol 30(5):577–581

    Article  PubMed  Google Scholar 

  68. Sugita S, Yamada Y, Kaneko S, Horie S, Mochizuki M (2011) Induction of regulatory T cells by infliximab in Behcet’s disease. Investig Ophthalmol Vis Sci 52:476–484

    Article  CAS  Google Scholar 

  69. Bodaghi B, Gendron G, Wechsler B et al (2007) Efficacy of interferon alpha in the treatment of refractory and sight threatening uveitis: a retrospective monocentric study of 45 patients. Br J Ophthalmol 91:335–339

    Article  PubMed Central  PubMed  Google Scholar 

  70. Kotter I, Deuter C, Stubiger N, Zierhut M (2005) Interferon-a (IFN-a) application versus tumor necrosis factor-a antagonism for ocular Behçet’s disease: focusing more on IFN. J Rheumatol 32(8):1633 (author reply 1634)

    PubMed  Google Scholar 

  71. Nestorov I (2005) Clinical pharmacokinetics of TNF antagonists: How do they differ? Semin Arthritis Rheum 34(5 Suppl 1):12–18

    Article  PubMed  CAS  Google Scholar 

  72. Mushtaq B, Saeed T, Situnayake RD, Murray PI (2007) Adalimumab for sight-threatening uveitis in Behçet’s disease. Eye (Lond) 21(6):824–825

    Article  CAS  Google Scholar 

  73. Bawazeer A, Raffa LH, Nizamuddin SH (2010) Clinical experience with adalimumab in the treatment of ocular Behçet disease. Ocul Immunol Inflamm 18(3):226–232

    Article  PubMed  CAS  Google Scholar 

  74. Perra D, Alba MA, Callejas JL, Mesquida M, Ríos-Fernández R, Adán A, Ortego N, Cervera R, Espinosa G (2012) Adalimumab for the treatment of Behcet’s disease: experience in 19 patients. Rheumatology (Oxf) 51(10):1825–1831

    Article  CAS  Google Scholar 

  75. Olivieri I, Leccese P, D’Angelo S, Padula A, Nigro A, Palazzi C, Coniglio G, Latanza L (2011) Efficacy of adalimumab in patients with Behçet’s disease unsuccessfully treated with infliximab. Clin Exp Rheumatol 29(4 Suppl 67):S54–S57

    PubMed  Google Scholar 

  76. Takase K, Ohno S, Ideguchi H, Uchio E, Takeno M, Ishigatsubo Y (2011) Successful switching to adalimumab in an infliximab-allergic patient with severe Behçet disease-related uveitis. Rheumatol Int 31(2):243–245

    Article  PubMed  CAS  Google Scholar 

  77. Keystone E, Genovese MC, Klareskog L et al (2010) Golimumab in patients with active rheumatoid arthritis despite methotrexate therapy: 52-week results of the GO-FORWARD study. Ann Rheum Dis 69:1129–1135

    Article  PubMed  CAS  Google Scholar 

  78. Smolen JS, Kay J, Landewé RB et al (2012) Golimumab in patients with active rheumatoid arthritis who have previous experience with tumour necrosis factor inhibitors: results of a long-term extension of the randomised, double-blind, placebo-controlled GO-AFTER study through week 160. Ann Rheum Dis 71(10):1671–1679

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  79. Keystone E, Genovese MC, Klareskog L, Hsia EC, Hall S, Miranda PC, Pazdur J, Bae SC, Palmer W, Xu S, Rahman MU (2010) Golimumab in patients with active rheumatoid arthritis despite methotrexate therapy: 52-week results of the GO-FORWARD study. Ann Rheum Dis 69(6):1129–1135

    Article  PubMed  CAS  Google Scholar 

  80. Maini R, St Clair EW, Breedveld F, Furst D, Kalden J, Weisman M, Smolen J, Emery P, Harriman G (1999) Infliximab (chimeric anti-tumour necrosis factor alpha monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomised phase III trial. ATTRACT Study Group. Lancet 354(9194):1932–1939

    Article  PubMed  CAS  Google Scholar 

  81. Dinarello CA, Simon A, van der Meer JW (2012) Treating inflammation by blocking interleukin-1 in a broad spectrum of diseases. Nat Rev Drug Discov 11(8):633–652

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  82. Gül A (2005) Behçet’s disease as an autoinflammatory disorder. Curr Drug Targets Inflamm Allergy 4:81–83

    Article  PubMed  Google Scholar 

  83. Mege JL, Dilsen N, Sanguedolce V et al (1993) Overproduction of monocyte derived tumor necrosis factor alpha, interleukin (IL) 6, IL-8 and increased neutrophil superoxide generation in Behçet’s disease. A comparative study with familial Mediterranean fever and healthy subjects. J Rheumatol 20(9):1544–1549

    PubMed  CAS  Google Scholar 

  84. Teoh SC, Sharma S, Hogan A et al (2007) Tailoring biological treatment: anakinra treatment of posterior uveitis associated with the CINCA syndrome. Br J Ophthalmol 91:263–264

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  85. Botsios C, Sfriso P, Furlan A, Punzi L, Dinarello CA (2008) Resistant Behçet disease responsive to anakinra. Ann Intern Med 149(4):284–286

    Article  PubMed  Google Scholar 

  86. Düzgün N, Ayaşlioğlu E, Tutkak H, Aydintuğ OT (2005) Cytokine inhibitors: soluble tumor necrosis factor receptor 1 and interleukin-1 receptor antagonist in Behçet’s disease. Rheumatol Int 25(1):1–5

    Article  PubMed  Google Scholar 

  87. Blech M, Peter D, Fischer P (2012) One target-two different binding modes: structural insights into gevokizumab and canakinumab interactions to interleukin-1β. J Mol Biol (in press)

  88. Church LD, McDermott MF (2009) Canakinumab, a fully-human mAb against IL-1beta for the potential treatment of inflammatory disorders. Curr Opin Mol Ther 11:81–89

    PubMed  CAS  Google Scholar 

  89. Cantarini L, Vitale A, Borri M, Galeazzi M, Franceschini R (2012) Successful use of canakinumab in a patient with resistant Behçet’s disease. Clin Exp Rheumatol 30(3 Suppl 72):S115

    Google Scholar 

  90. Ugurlu S, Ucar D, Seyahi E, Hatemi G, Yurdakul S (2012) Canakinumab in a patient with juvenile Behçet’s syndrome with refractory eye disease. Ann Rheum Dis 71:1591–1592

    Article  Google Scholar 

  91. Geiler J, McDermott MF (2010) Gevokizumab, an anti-IL-1β mAb for the potential treatment of type 1 and 2 diabetes, rheumatoid arthritis and cardiovascular disease. Curr Opin Mol Ther 12:755–769

    PubMed  CAS  Google Scholar 

  92. Gül A, Tugal-Tutkun I, Dinarello CA, Reznikov L, Esen BA, Mirza A, Scannon P, Solinger A (2012) Interleukin-1β-regulating antibody XOMA 052 (gevokizumab) in the treatment of acute exacerbations of resistant uveitis of Behcet’s disease: an open-label pilot study. Ann Rheum Dis 71(4):563–566

    Article  PubMed  CAS  Google Scholar 

  93. Hirano T, Yasukawa K, Harada H et al (1986) Complementary DNA for a novel human interleukin (BSF-2) that induces B lymphocytes to produce immunoglobulin. Nature 324(6092):73–76

    Article  PubMed  CAS  Google Scholar 

  94. Kaly L, Rosner I (2012) Tocilizumab—a novel therapy for non-organ-specific autoimmune diseases. Best Pract Res Clin Rheumatol 26:157–165

    Article  PubMed  CAS  Google Scholar 

  95. Kimura A, Kishimoto T (2010) IL-6: regulator of Treg/Th17 balance. Eur J Immunol 40(7):1830–1835

    Article  PubMed  CAS  Google Scholar 

  96. Geri G, Terrier B, Rosenzwajg M et al (2011) Critical role of IL-21 in modulating TH17 and regulatory T cells in Behçet disease. J Allergy Clin Immunol 128(3):655–664

    Article  PubMed  CAS  Google Scholar 

  97. Ogata A, Tanaka T (2012) Tocilizumab for the treatment of rheumatoid arthritis and other systemic autoimmune diseases: current perspectives and future directions. Int J Rheumatol. doi:10.1155/2012/946048

  98. Hirano T, Ohguro N, Hohki S et al (2012) A case of Behçet’s disease treated with a humanized anti-interleukin-6 receptor antibody, tocilizumab. Mod Rheumatol 22:298–302

    Article  PubMed  Google Scholar 

  99. Miserocchi E, Pontikaki I, Modorati G, Gattinara M, Meroni PL, Gerloni V (2011) Anti-CD 20 monoclonal antibody (rituximab) treatment for inflammatory ocular diseases. Autoimmun Rev 11(1):35–39

    Article  PubMed  CAS  Google Scholar 

  100. Miserocchi E, Pontikaki I, Modorati G, Bandello F, Meroni PL, Gerloni V (2011) Rituximab for uveitis. Ophthalmology 118(1):223–224

    Article  PubMed  Google Scholar 

  101. Heiligenhaus A, Miserocchi E, Heinz C, Gerloni V, Kotaniemi K (2011) Treatment of severe uveitis associated with juvenile idiopathic arthritis with anti-CD20 monoclonal antibody (rituximab). Rheumatology (Oxf) 50(8):1390–1394

    Article  CAS  Google Scholar 

  102. Davatchi F, Shams H, Rezaipoor M et al (2010) Rituximab in intractable ocular lesions of Behcet’s disease; randomized single-blind control study (pilot study). Int J Rheum Dis 13:246–252

    Article  PubMed  Google Scholar 

  103. Sadreddini S, Noshad H, Molaeefard M, Noshad R (2008) Treatment of retinal vasculitis in Behçet’s disease with rituximab. Mod Rheumatol 18:306–308

    Article  PubMed  CAS  Google Scholar 

  104. Lee RW, Dick AD (2010) Treat early and embrace the evidence in favour of anti-TNF-alpha therapy for Behçet’s uveitis. Br J Ophthalmol 94(3):269–270

    Article  PubMed  Google Scholar 

  105. Benitah NR, Sobrin L, Papaliodis GN (2011) The use of biologic agents in the treatment of ocular manifestations of Behcet’s disease. Semin Ophthalmol 26:295–303

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by a Grant from the Catalan Society of Ophthalmology to M.M.

Conflict of interest

The authors report no proprietary interest.

Author information

Authors and Affiliations

  1. Ophthalmology Department, Hospital Clinic of Barcelona, University of Barcelona, Sabino de Arana, 1, 08028, Barcelona, Spain

    Marina Mesquida, Victor Llorenç & Alfredo Adán

  2. Clinic Foundation for the Biomedical Research, IDIBAPS, Barcelona, Spain

    Blanca Molins

  3. Rheumatology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain

    María Victoria Hernández

  4. Autoimmune Diseases Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain

    Gerard Espinosa

  5. Academic Unit of Ophthalmology, Bristol Eye Hospital, University of Bristol, Bristol, UK

    Andrew D. Dick

Authors
  1. Marina Mesquida
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Blanca Molins
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Victor Llorenç
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. María Victoria Hernández
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gerard Espinosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Andrew D. Dick
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alfredo Adán
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marina Mesquida.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mesquida, M., Molins, B., Llorenç, V. et al. Current and future treatments for Behçet’s uveitis: road to remission. Int Ophthalmol 34, 365–381 (2014). https://doi.org/10.1007/s10792-013-9788-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-013-9788-5

Keywords

Search

Navigation