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Letter
Guselkumab in Behçet’s disease
  1. Elie E Ghayad1,2,
  2. Georgina Maalouf1,2,
  3. Arsène Mekinian3,
  4. Giacomo Emmi4,
  5. Matheus Vieira1,2,
  6. Adrien Mirouse1,2,
  7. Anne-Claire Desbois1,2,
  8. Alexandre Le Joncour1,2,
  9. Fanny Domont1,2,
  10. Gaëlle Leroux1,2,
  11. Helene Bugaut1,2,
  12. Mathieu Vautier1,2,
  13. Patrice Cacoub1,2,
  14. Stéphane Barete5,
  15. David Saadoun1,2
  1. 1Département de Médecine Interne et Immunologie Clinique, Centre National de Référence Maladies Auto-immunes Systémiques Rares, Centre National de Référence Maladies Auto-inflammatoires et Amylose Inflammatoire, Hôpital Universitaire Pitié-Salpêtrière, Paris, France
  2. 2INSERM, UMR S959, Département Immunologie—Immunopathologie—Immunothérapie, Sorbonne Université, Paris, France
  3. 3Département de Médecine Interne et Immunologie Clinique DHUi2B, Hôpital Saint-Antoine, Paris, France
  4. 4Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
  5. 5Unité fonctionnelle de dermatologie—Département de Médecine Interne et Immunologie Clinique, Hopital Universitaire Pitie-Salpetriere, Paris, France
  1. Correspondence to Prof. David Saadoun; david.saadoun{at}aphp.fr

https://doi.org/10.1136/ard-2024-225913

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    The mucocutaneous and articular clinical phenotype is the most common presentation of Behçet’s disease (BD).1 Current treatment modalities, such as colchicine and apremilast, have debatable efficacy or inconsistent tolerability. There remains a need for a safe and effective treatment for refractory mucocutaneous and articular BD.

    Genetic predisposition in BD identified interleukin (IL)-23R and IL-12RB2 as BD susceptibility loci.2 Increased expression of IL-23 messenger RNA has been demonstrated in BD skin lesions.3 Guselkumab is a human anti-IL-23 monoclonal antibody approved for the management of psoriasis and psoriatic arthritis.4

    We conducted a multicentric observational retrospective study between 2019 and 2023 to evaluate the effectiveness and safety of guselkumab for the treatment of patients with refractory mucocutaneous and articular BD.

    All adult patients met the criteria of the International Study Group for BD and were initially treated with 100 mg of guselkumab subcutaneously at weeks 0 and 4, then every 8 weeks.

    The primary efficacy end point was the proportion of responders at week 12.

    The response was defined as complete for patients who had no oral ulcers in the previous 4 weeks in addition to …

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors EEG, GM and DS were involved in study conception and design. EEG, GM, AM, GE, MVi, AM, A-CD, ALJ, FD, GL, HB, MVa, PC, SB, DS were involved in the acquisition of data. EEG, GM and DS were involved in the analysis and interpretation of data. EEG, GM and DS assume full responsibility for the veracity and completeness of the reported data. All authors had full access to the data and were involved in drafting the article or revising it critically for important intellectual content, and all authors reviewed and approved the final version of the manuscript to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • 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.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.