Abstract
Behcet’s disease (BD) accompanied by intestinal involvement is called intestinal BD. Although recent studies have attained positive feedback with the administration of anti-TNF-α agents in patients with BD, only a few reports on the study of etanercept in intestinal BD have been found. In this study, 35 cases of intestinal BD were treated with conventional therapy (prednisone or methotrexate) for a minimum period of 3 months (group 1). Another 19 patients who failed to respond to conventional therapy were then treated with etanercept (25 mg twice a week for 3 months). During each subsequent relapse, the patients were given the same treatment. The main outcome measures were the four criteria for diagnosis of BD (buccal ulcers, genital ulcers, ocular lesions, and skin lesions), the manifestation of intestinal involvement (abdominal symptoms, double-balloon enteroscopy), laboratory examinations of the acute phase reactants (erythrocyte sedimentation rate) and C-reactive protein, and relapses. As a result of the administered therapy, the healing rate of buccal and genital ulcers, the remission rate of ocular lesions, skin lesions, and abdominal symptoms, the healing rate of intestinal ulcers, and the recovery rate of ESR and CRP were significantly higher in group 2 than those of group 1. The relapse rate in the etanercept therapy was reduced significantly when compared with conventional therapy group. In conclusion, etanercept treatment, in contrast to the conventional therapy, can result in better curative effect and less adverse reactions in intestinal BD.
Similar content being viewed by others
References
Gul, A. (2007). Standard and novel therapeutic approaches to Behcet’s disease. Drugs, 67, 2013–2022.
Chou, S. J., Chen, V. T., Jan, H. C., Lou, M. A., & Liu, Y. M. (2007). Intestinal perforations in Behcet’s disease. Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract, 11, 508–514.
Sfikakis, P. P. (2002). Behcet’s disease: A new target for anti-tumour necrosis factor treatment. Annals of the Rheumatic Diseases, 61(Suppl 2), ii51–ii53.
Papp, K., Keystone, E., & Shear, N. (2007). Mechanism of action, pharmacokinetic and drug interaction of etanercept. Dermatology, 11, 3–13.
Sfikakis, P. P., Markomichelakis, N., Alpsoy, E., Assaad-Khalil, S., Bodaghi, B., Gul, A., et al. (2007). Anti-TNF therapy in the management of Behcet’s disease—Review and basis for recommendations. Rheumatology, 46, 736–741.
Niccoli, L., Nannini, C., Benucci, M., Chindamo, D., Cassara, E., Salvarani, C., et al. (2007). Long-term efficacy of infliximab in refractory posterior uveitis of Behcet’s disease: A 24-month follow-up study. Rheumatology, 46, 1161–1164.
Lin, P., & Liang, G. (2006). Behcet disease: Recommendation for clinical management of mucocutaneous lesions. Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases, 12, 282–286.
Arida, A., Fragiadaki, K., Giavri, E., & Sfikakis, P. P. (2011). Anti-TNF agents for Behcet’s disease: Analysis of published data on 369 patients. Seminars in Arthritis and Rheumatism, 41, 61–70.
International Study Group for Behcet’s Disease. (1990). Criteria for diagnosis of Behcet’s disease. Lancet, 335, 1078–1080.
Yurdakul, S., & Yazici, H. (2008). Behcet’s syndrome. Best Practice & Research Clinical Rheumatology, 22, 793–809.
Pipitone, N., Olivieri, I., Cantini, F., Triolo, G., & Salvarani, C. (2006). New approaches in the treatment of Adamantiades–Behcet’s disease. Current Opinion in Rheumatology, 18, 3–9.
Zhou, H. (2005). Clinical pharmacokinetics of etanercept: A fully humanized soluble recombinant tumor necrosis factor receptor fusion protein. Journal of Clinical Pharmacology, 45, 490–497.
Ohno, S., Nakamura, S., Hori, S., Shimakawa, M., Kawashima, H., Mochizuki, M., et al. (2004). Efficacy, safety, and pharmacokinetics of multiple administration of infliximab in Behcet’s disease with refractory uveoretinitis. The Journal of Rheumatology, 31, 1362–1368.
Lee, H., Kimko, H. C., Rogge, M., Wang, D., Nestorov, I., & Peck, C. C. (2003). Population pharmacokinetic and pharmacodynamic modeling of etanercept using logistic regression analysis. Clinical Pharmacology and Therapeutics, 73, 348–365.
Korth-Bradley, J. M., Rubin, A. S., Hanna, R. K., Simcoe, D. K., & Lebsack, M. E. (2000). The pharmacokinetics of etanercept in healthy volunteers. The Annals of Pharmacotherapy, 34, 161–164.
Melikoglu, M., Fresko, I., Mat, C., Ozyazgan, Y., Gogus, F., Yurdakul, S., et al. (2005). Short-term trial of etanercept in Behcet’s disease: A double blind, placebo controlled study. The Journal of Rheumatology, 32, 98–105.
Curigliano, V., Giovinale, M., Fonnesu, C., Cerquaglia, C., Verrecchia, E., Turco, S., et al. (2008). Efficacy of etanercept in the treatment of a patient with Behcet’s disease. Clinical Rheumatology, 27, 933–936.
Acknowledgments
Thanks are due to Ming Liu, Ru-Peng Wang, and Lie Wang for assistance with the study and to Hua Yang for significant guidance and valuable discussion.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ma, D., Zhang, CJ., Wang, RP. et al. Etanercept in the Treatment of Intestinal Behcet’s Disease. Cell Biochem Biophys 69, 735–739 (2014). https://doi.org/10.1007/s12013-014-9860-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12013-014-9860-4