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Potential role of infliximab therapy in twelve Libyan patients with Behçet’s disease
Abstract
Background: The blocking of tumour necrosis factor-α (TNF-α) with the socalled anti TNF-α agents has turned into the most important tool in the management of a variety of autoimmune disorders.
Objective: To evaluate the therapeutic effect of infliximab on ocular and extraocular manifestations in patients with Behçet’s disease (BD).
Methods: Twelve patients with active BD who were treated with infliximab at Tripoli Medical Center for more than 6 months were included in this study. Infliximab was initiated with 5mg/kg of body weight. Infusion given at (week 0, 2, 6 and every 8 week thereafter) as either first-line therapy in eight patients or given after failure of conventional immunosuppresants in the remaining four patients. All patients were assessed by clinical examination and inflammatory markers. The patients with ocular involvement were assessed clinically by an ophthalmologist every 2 months and those with neuro- Behçet’s disease had in addition MRI assessment for the brain.
Results: The follow-up period after initial introduction of infliximab ranged from 6 to 36 months (mean±SD,15.5±7.4 months). Eight (67%) patients achieved remission without any relapse while two (17%) patients had only one relapse in the same organ during the period of follow up. One (8%) patient had relapse in another system and infliximab was stopped. One (8%) other patient had no response. Immunosuppresants were stopped in all patients except one and all were kept on low dose glucocorticoids. No drug side effects were reported. In eight patients who started on infliximab as first line therapy, the remission occurred in six patients (75%) while in the other four patients who were taking infliximab after failure of conventional immunosuppresants, the remission occurred in two patients (50%).
Conclusion: Infliximab is effective in inducing remission of BD. The good effect together with excellent tolerability suggests that infliximab can be used as first line drug in BD.
Keywords: Anti TNF-α, Infliximab, Behçet’s disease
Objective: To evaluate the therapeutic effect of infliximab on ocular and extraocular manifestations in patients with Behçet’s disease (BD).
Methods: Twelve patients with active BD who were treated with infliximab at Tripoli Medical Center for more than 6 months were included in this study. Infliximab was initiated with 5mg/kg of body weight. Infusion given at (week 0, 2, 6 and every 8 week thereafter) as either first-line therapy in eight patients or given after failure of conventional immunosuppresants in the remaining four patients. All patients were assessed by clinical examination and inflammatory markers. The patients with ocular involvement were assessed clinically by an ophthalmologist every 2 months and those with neuro- Behçet’s disease had in addition MRI assessment for the brain.
Results: The follow-up period after initial introduction of infliximab ranged from 6 to 36 months (mean±SD,15.5±7.4 months). Eight (67%) patients achieved remission without any relapse while two (17%) patients had only one relapse in the same organ during the period of follow up. One (8%) patient had relapse in another system and infliximab was stopped. One (8%) other patient had no response. Immunosuppresants were stopped in all patients except one and all were kept on low dose glucocorticoids. No drug side effects were reported. In eight patients who started on infliximab as first line therapy, the remission occurred in six patients (75%) while in the other four patients who were taking infliximab after failure of conventional immunosuppresants, the remission occurred in two patients (50%).
Conclusion: Infliximab is effective in inducing remission of BD. The good effect together with excellent tolerability suggests that infliximab can be used as first line drug in BD.
Keywords: Anti TNF-α, Infliximab, Behçet’s disease
