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SAT0235 BIOLOGICAL THERAPYIN NEUROBEHÇET. MULTICENTER STUDY OF 29 PATIENTS
  1. José Luis Martín-Varillas1,
  2. Iñigo González-Mazón1,
  3. Belén Atienza-Mateo1,
  4. Monica Calderón-Goercke1,
  5. D. Prieto-Peña1,
  6. Lara Sánchez Bilbao1,
  7. Vanesa Calvo-Río1,
  8. Santos Castañeda2,
  9. Esther Vicente2,
  10. Olga Maiz3,
  11. Clara Moriano4,
  12. Elvira Diez Alvarez4,
  13. José Luis Andréu Sánchez5,
  14. Concepción Delgado Beltrán6,
  15. Marta Loredo Martínez6,
  16. J. Narváez7,
  17. Angel Ramos Calvo8,
  18. Francisca Sivera9,
  19. Enrique Raya10,
  20. Norberto Ortego10,
  21. Jose Luis Callejas-Rubio10,
  22. Anahy Brandy-Garcia11,
  23. Alejandro Olive11,
  24. Sabela Fernández12,
  25. Ricardo Gómez de la Torre13,
  26. Ignacio Torre-Salaberri14,
  27. Julio Sánchez15,
  28. Ana Urruticoechea-Arana16,
  29. Eva Salgado-Pérez17,
  30. Rafael Melero18,
  31. Olga Martínez González19,
  32. Susana Romero-Yuste20,
  33. Miguel A. González-Gay1,
  34. Ricardo Blanco1
  1. 1H.U.M. Valdecilla, Santander, Spain
  2. 2H. La Princesa, Madrid, Spain
  3. 3H. Donosti, San Sebastián, Spain
  4. 4H. de León, León, Spain
  5. 5H. Puerta de Hierro, Madrid, Spain
  6. 6H. Lozano Blesa, Zaragoza, Spain
  7. 7H. Bellvitge, Barcelona, Spain
  8. 8H. de Soria, Soria, Spain
  9. 9H. de Elda, Alicante, Spain
  10. 10H. San Cecilio, Granada, Spain
  11. 11H. Germans Trias i Pujol, Barcelona, Spain
  12. 12H. San Agustín, Avilés, Spain
  13. 13H.U.C. Asturias, Oviedo, Spain
  14. 14H. Basurto, Bilbao, Spain
  15. 15H. 12 de Octubre, Madrid, Spain
  16. 16H. Can Misses, Ibiza, Spain
  17. 17H. Ourense, Ourense, Spain
  18. 18H. Vigo, Vigo, Spain
  19. 19H. Salamanca, Salamanca, Spain
  20. 20H. Pontevedra, Pontevedra, Spain

Abstract

Background: Behçet’s disease (BD) is a variable vessel vasculitis and typically presents with mucocutaneous involvement. However, any organ can be affected, being the neurological affectation (neurobehçet, NB) one of the most serious manifestations.

Objectives: Our aim was to assess the efficacy and safety of biological therapy as treatment of NB.

Methods: We set up a multicenter observational study of 29 patients with NB on treatment with biological therapy (BT). NB diagnosis was made by neuroimaging, CSF analysis and/or suggestive clinical signs of central and/or peripheral nervous system involvement, excluding infectious causes or more prevalent pathology. Results are expressed as mean±SD or as median and interquartile range (IQR) as appropriate.

Results: 29 patients (15♂/14♀) with an average age of 39.6 ± 10.5 years. HLA-B51 was positive in 48.3% of the patients. Table shows the non-neurological manifestations. Regarding the neurological manifestations, 23 patients (79.3%) had parenchymal involvement (hemiparesis (n=6), brainstem involvement (n=1), encephalopathy (n = 4), optic neuropathy (n=3), dysphasia (n=1), polyneuropathy (n=6), cognitive impairment (n=4), and non-steroidal psychosis (n=1), while the remaining 6 patients (20.7%) presented aseptic meningitis as a non-parenchymal affectation (Table).

Prior to BT, patients had received the following treatment: oral prednisone (n=27), methylprednisolone bolus (n=9), CsA (n=8), AZA (n=16), MTX (n=14) and mycophenolate (n=2).

After a median of 31 [10-60] months since the beginning of the neurological symptoms, the following BT was initiated: infliximab (IFX)(n=17), adalimumab (ADA)(n=7), tocilizumab (TCZ) (n=2), golimumab (GOL) (n=2) and Etanercept (ETN) (n=1). A first switch to ADA was necessary in 8 patients with IFX due to primary failure. In addition, 2 of them needed a second switch to TCZ, getting a partial response. The BT was discontinued in 5 patients, 2 of them for obtaining clinical remission and the remaining 3 for inefficacy.

After a median follow-up of 5.4±4.6 years, complete response was obtained in 15 patients, partial response in 11 and no response in the remaining 3. We observed an anaphylactic reaction and psoriasis induced by IFX, without other serious adverse events (Table).

Conclusion: BT, especially anti-TNF, seems effective and safe for treatment in NB.

Disclosure of Interests: José Luis Martín-Varillas: None declared, Iñigo González-Mazón: None declared, Belén Atienza-Mateo: None declared, Monica Calderón-Goercke: None declared, D. Prieto-Peña: None declared, Lara Sánchez Bilbao: None declared, Vanesa Calvo-Río: None declared, Santos Castañeda Consultant for: Amgen, BMS, Pfizer, Lilly, MSD, Roche, Sanofi, UCB, Esther Vicente: None declared, Olga Maiz: None declared, Clara Moriano: None declared, Elvira Diez Alvarez: None declared, José Luis Andréu Sánchez: None declared, Concepción Delgado Beltrán: None declared, Marta Loredo Martínez: None declared, J. Narváez Consultant for: Bristol-Myers Squibb, Angel Ramos Calvo: None declared, Francisca Sivera: None declared, Enrique Raya: None declared, Norberto Ortego: None declared, Jose Luis Callejas-Rubio: None declared, Anahy Brandy-Garcia: None declared, Alejandro Olive: None declared, Sabela Fernández: None declared, Ricardo Gómez de la Torre: None declared, Ignacio Torre-Salaberri: None declared, Julio Sánchez: None declared, ANA URRUTICOECHEA-ARANA: None declared, Eva Salgado-Pérez: None declared, Rafael Melero: None declared, Olga Martínez González: None declared, Susana Romero-Yuste: None declared, Miguel A González-Gay Grant/research support from: Prof. MA Gonzalez-Gay received grants/research supports from Abbvie, MSD, Jansen and Roche., Speakers bureau: Consultation fees/participation in company sponsored speaker’s bureau from Pfizer, Lilly, Sobi, Celgene, Novartis, Roche and Sanofi., Ricardo Blanco Grant/research support from: Abbvie, MSD, and Roche, Consultant for: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen

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