Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 May 20;23(6):47.
doi: 10.1007/s11926-021-01011-z.

Advances in the Treatment of Behcet's Disease

Fatma Alibaz-Oner  1 , Haner Direskeneli  2
Affiliations
Review

Advances in the Treatment of Behcet's Disease

Fatma Alibaz-Oner et al. Curr Rheumatol Rep. .

Abstract

Purpose of review: To assess current management of Behcet's disease (BD). Controversies on therapeutic approaches to different manifestations, whether conventional immunosuppressives (IS) or biologic agents, should be chosen, and options for refractory disease are discussed.

Recent findings: Glucocorticoids are still the main agents for remission-induction and azathioprine the first-line conventional IS in maintenance phase to prevent relapses of major organ involvement. Apremilast is shown to be a safe and effective option approved by the FDA for oral ulcers. Large case series confirmed the efficacy and safety of TNFα inhibitors and Interferon-α. Promising results are observed with IL-1 inhibitors, ustekinumab, secukinumab, and tocilizumab for refractory BD. Although both conventional IS and biologic agents are effectively used to suppress inflammation in BD, there is still an unmet need for clear therapeutic strategies in the management for different manifestations. Further controlled studies with new biologic agents, anticoagulants and the benefit of concomitant IS usage with biologics are needed to optimize the management of BD.

Keywords: Behcet’s disease; Biological agents; Conventional immunosuppressives; Treatment.

PubMed Disclaimer

Conflict of interest statement

Haner Direskeneli participated in the phase 3 study of apremilast by Celgene as a local Principal Investigator. Fatma Alibaz-Oner declares that she has no conflict of interest.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kural-Seyahi E, Fresko I, Seyahi N, Ozyazgan Y, Mat C, Hamuryudan V, Yurdakul S, Yazici H. The long-term mortality and morbidity of Behçet syndrome: a 2-decade outcome survey of 387 patients followed at a dedicated center. Medicine (Baltimore) 2003;82(1):60–76. doi: 10.1097/00005792-200301000-00006. - DOI - PubMed
    1. McGonagle D, Aydin SZ, Gül A, Mahr A, Direskeneli H. ‘MHC-I-opathy’-unified concept for spondyloarthritis and Behçet disease. Nat Rev Rheumatol. 2015;11(12):731–740. doi: 10.1038/nrrheum.2015.147. - DOI - PubMed
    1. Gómez-Gómez A, Loza E, Rosario MP, Espinosa G, de Morales J, Herrera JM, Muñoz-Fernández S, Rodríguez-Rodríguez L, Cordero-Coma M, Spanish Society of Ocular Inflammation (SEIOC) Efficacy and safety of immunomodulatory drugs in patients with non-infectious intermediate and posterior uveitis, panuveitis and macular edema: a systematic literature review. Semin Arthritis Rheum. 2020;50(6):1299–1306. doi: 10.1016/j.semarthrit.2020.08.010. - DOI - PubMed
    1. Celiker H, Kazokoglu H, Direskeneli H. Conventional immunosuppressive therapy in severe Behcet’s uveitis: the switch rate to the biological agents. BMC Ophthalmol. 2018;18(1):261. doi: 10.1186/s12886-018-0929-5. - DOI - PMC - PubMed
    1. Mat C, Yurdakul S, Uysal S, Gogus F, Ozyazgan Y, Uysal O, Fresko I, Yazici H. A double-blind trial of depot corticosteroids in Behçet’s syndrome. Rheumatology (Oxford) 2006;45(3):348–352. doi: 10.1093/rheumatology/kei165. - DOI - PubMed

MeSH terms