Infliximab for patients with neuro-Behcet's disease: case series and literature review

Clin Rheumatol. 2011 Jul;30(7):1007-12. doi: 10.1007/s10067-011-1726-1. Epub 2011 Mar 24.

Abstract

This study aims to report the therapeutic effects of anti-tumor necrotic factor antibody, infliximab, for treatment of neuro-Behcet's disease (NBD) and to review the literature. We described four patients (all male, median age 40 years old) who fulfilled the International Study Group criteria for Behcet's disease (BD) and presented with neurological complication. Demographic and clinical characteristics of the patients, dose, therapeutic effects, and adverse drug reaction (ADR) of infliximab were reported. Two patients had secondary progressive, one relapsing progressive, and one primary progressive course (median duration of BD and NBD 11 and 2 years, respectively). Two patients each received infliximab with 3 and 5 mg/kg infusions, respectively. The patients received infliximab for median of 22 weeks. Clinical responses were unsatisfactory for two patients on 3 mg/kg regimen; and good in two patients on 5 mg/kg and monthly intravenous 500-1,000 mg cyclophosphamide. Varicella zoster infection was seen as a major ADR in one patient. Our results with infliximab were not as promising as the previous reports. Infliximab, 5 mg/kg per dose with adjuvant immunosuppressive therapy, is probably more effective than other regimens.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antibodies, Monoclonal / therapeutic use*
  • Behcet Syndrome / complications
  • Behcet Syndrome / diagnosis
  • Behcet Syndrome / drug therapy*
  • Cyclophosphamide / therapeutic use
  • Disease Progression
  • Drug Therapy, Combination
  • Humans
  • Immunologic Factors / therapeutic use*
  • Infliximab
  • Injections, Intravenous
  • Male
  • Nervous System Diseases / complications
  • Nervous System Diseases / diagnosis
  • Nervous System Diseases / drug therapy*
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Antibodies, Monoclonal
  • Immunologic Factors
  • Tumor Necrosis Factor-alpha
  • Cyclophosphamide
  • Infliximab