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Biological therapies for the treatment of Behçet’s disease-related uveitis beyond TNF-alpha blockade: a narrative review

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Abstract

Intraocular inflammation is one of the more relevant complications of Behçet’s disease (BD), which tends to respond poorly to different medications. The ocular histopathologic changes are basically identical to those occurring in other organs and consist in a necrotizing leukocytoclastic obliterative vasculitis, which is probably immune complex-mediated and affects both arteries and veins of all sizes. There are growing evidences showing the potential role of biologic agents other than anti-tumor necrosis factor (TNF)-α agents in the management of ocular-BD, which have been collected in this review, including interleukin-1 and interleukin-6 blockade, secukinumab, ustekinumab, daclizumab, rituximab, and alemtuzumab. Further large studies are needed to fully elucidate and establish the clinical efficacy of these different tools in the refractory ocular manifestations of BD.

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  1. Claudia Fabiani and Luca Cantarini have contributed equally to this work.

Authors and Affiliations

  1. Rheumatology Unit, Policlinico “Le Scotte”, Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases, Behçet’s Disease and Rheumatology-Ophthalmology Collaborative Uveitis Center, University of Siena, viale Bracci 1, 53100, Siena, Italy

    Jurgen Sota, Bruno Frediani, Mauro Galeazzi & Luca Cantarini

  2. Institute of Pediatrics, Periodic Fever Research Center, Università Cattolica Sacro Cuore, Fondazione Policlinico A. Gemelli, Rome, Italy

    Donato Rigante

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

    Giuseppe Lopalco

  4. Ophthalmology and Neurosurgery Department, University of Siena, Siena, Italy

    Rossella Franceschini, Florenzo Iannone & Gian Marco Tosi

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

    Claudia Fabiani

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  1. Jurgen Sota
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Sota, J., Rigante, D., Lopalco, G. et al. Biological therapies for the treatment of Behçet’s disease-related uveitis beyond TNF-alpha blockade: a narrative review. Rheumatol Int 38, 25–35 (2018). https://doi.org/10.1007/s00296-017-3775-5

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