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We carefully read the recent study by Liu et al on the effectiveness of tofacitinib for refractory Behçet’s syndrome (BS).1 In total, 13 patients with BS were enrolled, including 5 cases with vascular involvement, 7 with gastrointestinal (GI) ulcers and one suffering polyarthritis. As an add-on approach, tofacitinib improved the outcomes in all patients with vascular lesions, but unchanged or worsened in 5/7 GI involvement cases. Their observation give support to the hypothesis that BS is not an independent disease, but a heterogeneous and multisystemic complex syndrome.2 Different major organ involvements, vascular and GI involvement could link to its unique underlying immunopathological mechanisms, which led to radical treatment responses.3 In their study, the only manifestation of ocular involvement was scleritis in one patient with polyarthritis, which is not a specific ophthalmological feature of BS. Notably, uveitis is one of the specific features of ocular involvement in patients with BS,4 which may lead to visual loss in up to 25% of patients in spite of biological agents.5 Here, we reported the efficacy and safety profile …
Contributors JZ and C-HL participated in follow-up, provided the figure and wrote the manuscript. JZ performed statistical analysis. C-HL and YW collected the clinical data at baseline. JZ, C-HL and YS helped to prepared the table. JZ, YS and J-LG provided critical revisions to the manuscript. J-LG designed the study, contributed to the discussion and edited the manuscript. All authors read and approved the final manuscript.
Funding This work was supported by the National Natural Science Foundation of China (81871276).
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.