Behçet's disease medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
Current treatment is aimed at easing the symptoms, reducing [[inflammation]], and controlling the [[immune system]]. Anti-TNF therapy, such as [[infliximab]], has shown promise in treating the [[uveitis]] associated with the disease. Another Anti-TNF agent, [[etanercept]], may be useful in patients with mainly skin and mucosal symptoms. Interferon alfa-2a, [[azathioprine]], [[colchicine]], [[thalidomide]], [[dapsone]] and [[rebamipide]] are among other agents that are used alternatives. | Current treatment is aimed at easing the [[Symptom|symptoms]], reducing [[inflammation]], and controlling the [[immune system]]. Anti-[[Tumor necrosis factors|TNF]] therapy, such as [[infliximab]], has shown promise in treating the [[uveitis]] associated with the disease. Another Anti-[[Tumor necrosis factors|TNF]] agent, [[etanercept]], may be useful in patients with mainly [[skin]] and mucosal symptoms. [[Interferon alpha|Interferon alfa-2a]], [[azathioprine]], [[colchicine]], [[thalidomide]], [[dapsone]] and [[rebamipide]] are among other agents that are used alternatives. | ||
==Medical Therapy== | ==Medical Therapy== | ||
*Current treatment is aimed at easing the symptoms, reducing inflammation, and controlling the immune system. | *Current treatment is aimed at easing the symptoms, reducing [[inflammation]], and controlling the [[immune system]]. | ||
*Anti-TNF therapy such as [[infliximab]] has shown promise in treating the uveitis associated with the disease.<ref>{{cite journal | author=Sfikakis PP, Theodossiadis PG, Katsiari CG, Kaklamanis P, Markomichelakis NN | title=Effect of infliximab on sight-threatening panuveitis in Behçet's disease | journal=Lancet | year=2001 | pages=295-6 | | *Anti-[[Tumor necrosis factors|TNF]] therapy such as [[infliximab]] has shown promise in treating the [[uveitis]] associated with the disease.<ref name="pmid11498218">{{cite journal| author=Sfikakis PP, Theodossiadis PG, Katsiari CG, Kaklamanis P, Markomichelakis NN| title=Effect of infliximab on sight-threatening panuveitis in Behçet's disease. | journal=Lancet | year= 2001 | volume= 358 | issue= 9278 | pages= 295-6 | pmid=11498218 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11498218 }} </ref><ref name="pmid12379622">{{cite journal| author=Sfikakis PP| title=Behçet's disease: a new target for anti-tumour necrosis factor treatment. | journal=Ann Rheum Dis | year= 2002 | volume= 61 Suppl 2 | issue= | pages= ii51-3 | pmid=12379622 | doi= | pmc=1766720 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12379622 }} </ref> | ||
*Another Anti-TNF agent, [[etanercept]], may be useful in patients with mainly skin and mucosal symptoms.<ref>{{cite journal | author=Melikoglu M, Fresko I, Mat C, Ozyazgan Y, Gogus F, Yurdakul S | *Another Anti-[[Tumor necrosis factors|TNF]] agent, [[etanercept]], may be useful in patients with mainly [[skin]] and [[Mucous membrane|mucosal]] [[Symptom|symptoms]].<ref name="pmid15630733">{{cite journal| author=Melikoglu M, Fresko I, Mat C, Ozyazgan Y, Gogus F, Yurdakul S et al.| title=Short-term trial of etanercept in Behçet's disease: a double blind, placebo controlled study. | journal=J Rheumatol | year= 2005 | volume= 32 | issue= 1 | pages= 98-105 | pmid=15630733 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15630733 }} </ref> | ||
*Interferon alfa-2a may also be an effective alternative treatment, particularly for patients with genital and oral ulcers<ref>{{cite journal | author=Alpsoy E, Durusoy C, Yilmaz E, Ozgurel Y, Ermis O, Yazar S | *[[Interferon alfa-2a]] may also be an effective alternative treatment, particularly for patients with [[Genital area|genital]] and [[Oral ulcer|oral ulcers]] as well as with [[ocular]] [[Lesion|lesions]].<ref name="pmid11939808">{{cite journal| author=Alpsoy E, Durusoy C, Yilmaz E, Ozgurel Y, Ermis O, Yazar S et al.| title=Interferon alfa-2a in the treatment of Behçet disease: a randomized placebo-controlled and double-blind study. | journal=Arch Dermatol | year= 2002 | volume= 138 | issue= 4 | pages= 467-71 | pmid=11939808 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11939808 }} </ref><ref name="pmid12642304">{{cite journal| author=Kötter I, Zierhut M, Eckstein AK, Vonthein R, Ness T, Günaydin I et al.| title=Human recombinant interferon alfa-2a for the treatment of Behçet's disease with sight threatening posterior or panuveitis. | journal=Br J Ophthalmol | year= 2003 | volume= 87 | issue= 4 | pages= 423-31 | pmid=12642304 | doi= | pmc=1771623 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12642304 }} </ref> | ||
*[[Azathioprine]], when used in combination with interferon alfa-2b also shows promise | *[[Azathioprine]], when used in combination with [[interferon alfa-2b]] also shows promise and [[colchicine]] may also be useful for treating some [[Genital ulcer|genital ulcers]], [[erythema nodosum]], and [[arthritis]].<ref>{{cite journal | author=Hamuryudan V, Ozyazgan Y, Fresko Y, Mat C, Yurdakul S, Yazici H | title=Interferon alfa combined with azathioprine for the uveitis of Behçet's disease: an open study | journal=Isr Med Assoc J | year=2002 | pages=928-30 | volume=4 | issue=11 Suppl | id=PMID 12455182}}</ref><ref>{{cite journal | author=Yurdakul S, Mat C, Tuzun Y, Ozyazgan Y, Hamuryudan V, Uysal O, Senocak M, Yazici H | title=A double-blind trial of colchicine in Behçet's syndrome | journal=Arthritis Rheum | year=2001 | pages=2686-92 | volume=44 | issue=11 | id=PMID 11710724}}</ref> | ||
*[[Thalidomide]] has been used due to its immune-modifying effect.<ref>{{cite journal | author=Hamuryudan V, Mat C, Saip S, Ozyazgan Y, Siva A, Yurdakul S, Zwingenberger K, Yazici H | title=Thalidomide in the treatment of the mucocutaneous lesions of the Behcet syndrome. | *[[Thalidomide]] has been used due to its [[Immunity (medical)|immune]]-modifying effect.<ref>{{cite journal | author=Hamuryudan V, Mat C, Saip S, Ozyazgan Y, Siva A, Yurdakul S, Zwingenberger K, Yazici H | title=Thalidomide in the treatment of the mucocutaneous lesions of the Behcet syndrome. | ||
A randomized, double-blind, placebo-controlled trial | journal=Ann Intern Med | year=1998 | pages=443-50 | volume=128 | issue=6 | id=PMID 9499327}}</ref> | A randomized, double-blind, placebo-controlled trial | journal=Ann Intern Med | year=1998 | pages=443-50 | volume=128 | issue=6 | id=PMID 9499327}}</ref> | ||
*[[Dapsone]] and [[rebamipide]] have been shown, in small studies, to have beneficial results for mucocutaneous lesions.<ref>{{cite journal | author=Matsuda T, Ohno S, Hirohata S, Miyanaga Y, Ujihara H, Inaba G, Nakamura S, Tanaka S, Kogure M, Mizushima Y | title=Efficacy of rebamipide as adjunctive therapy in the treatment of recurrent oral aphthous ulcers in patients with Behçet's disease: a randomised, double-blind, placebo-controlled study | journal=Drugs R D | year=2003 | pages=19-28 | volume=4 | issue=1 | id=PMID 12568631}}</ref><ref>{{cite journal | author=Sharquie KE, Najim RA, Abu-Raghif AR | title=Dapsone in Behçet's disease: a double-blind, placebo-controlled, cross-over study | journal=J Dermatol | year=2002 | pages=267-79 | volume=29 | issue=5 | id=PMID 12081158}}</ref> | *[[Dapsone]] and [[rebamipide]] have been shown, in small studies, to have beneficial results for [[Mucocutaneous zone|mucocutaneous]] [[Lesion|lesions]].<ref>{{cite journal | author=Matsuda T, Ohno S, Hirohata S, Miyanaga Y, Ujihara H, Inaba G, Nakamura S, Tanaka S, Kogure M, Mizushima Y | title=Efficacy of rebamipide as adjunctive therapy in the treatment of recurrent oral aphthous ulcers in patients with Behçet's disease: a randomised, double-blind, placebo-controlled study | journal=Drugs R D | year=2003 | pages=19-28 | volume=4 | issue=1 | id=PMID 12568631}}</ref><ref>{{cite journal | author=Sharquie KE, Najim RA, Abu-Raghif AR | title=Dapsone in Behçet's disease: a double-blind, placebo-controlled, cross-over study | journal=J Dermatol | year=2002 | pages=267-79 | volume=29 | issue=5 | id=PMID 12081158}}</ref> | ||
==References== | ==References== | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
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[[Category:Medicine]] | |||
[[Category:Up-To-date]] | |||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
[[Category:Rheumatology]] | [[Category:Rheumatology]] | ||
Latest revision as of 20:36, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]
Overview
Current treatment is aimed at easing the symptoms, reducing inflammation, and controlling the immune system. Anti-TNF therapy, such as infliximab, has shown promise in treating the uveitis associated with the disease. Another Anti-TNF agent, etanercept, may be useful in patients with mainly skin and mucosal symptoms. Interferon alfa-2a, azathioprine, colchicine, thalidomide, dapsone and rebamipide are among other agents that are used alternatives.
Medical Therapy
- Current treatment is aimed at easing the symptoms, reducing inflammation, and controlling the immune system.
- Anti-TNF therapy such as infliximab has shown promise in treating the uveitis associated with the disease.[1][2]
- Another Anti-TNF agent, etanercept, may be useful in patients with mainly skin and mucosal symptoms.[3]
- Interferon alfa-2a may also be an effective alternative treatment, particularly for patients with genital and oral ulcers as well as with ocular lesions.[4][5]
- Azathioprine, when used in combination with interferon alfa-2b also shows promise and colchicine may also be useful for treating some genital ulcers, erythema nodosum, and arthritis.[6][7]
- Thalidomide has been used due to its immune-modifying effect.[8]
- Dapsone and rebamipide have been shown, in small studies, to have beneficial results for mucocutaneous lesions.[9][10]
References
- ↑ Sfikakis PP, Theodossiadis PG, Katsiari CG, Kaklamanis P, Markomichelakis NN (2001). "Effect of infliximab on sight-threatening panuveitis in Behçet's disease". Lancet. 358 (9278): 295–6. PMID 11498218.
- ↑ Sfikakis PP (2002). "Behçet's disease: a new target for anti-tumour necrosis factor treatment". Ann Rheum Dis. 61 Suppl 2: ii51–3. PMC 1766720. PMID 12379622.
- ↑ Melikoglu M, Fresko I, Mat C, Ozyazgan Y, Gogus F, Yurdakul S; et al. (2005). "Short-term trial of etanercept in Behçet's disease: a double blind, placebo controlled study". J Rheumatol. 32 (1): 98–105. PMID 15630733.
- ↑ Alpsoy E, Durusoy C, Yilmaz E, Ozgurel Y, Ermis O, Yazar S; et al. (2002). "Interferon alfa-2a in the treatment of Behçet disease: a randomized placebo-controlled and double-blind study". Arch Dermatol. 138 (4): 467–71. PMID 11939808.
- ↑ Kötter I, Zierhut M, Eckstein AK, Vonthein R, Ness T, Günaydin I; et al. (2003). "Human recombinant interferon alfa-2a for the treatment of Behçet's disease with sight threatening posterior or panuveitis". Br J Ophthalmol. 87 (4): 423–31. PMC 1771623. PMID 12642304.
- ↑ Hamuryudan V, Ozyazgan Y, Fresko Y, Mat C, Yurdakul S, Yazici H (2002). "Interferon alfa combined with azathioprine for the uveitis of Behçet's disease: an open study". Isr Med Assoc J. 4 (11 Suppl): 928–30. PMID 12455182.
- ↑ Yurdakul S, Mat C, Tuzun Y, Ozyazgan Y, Hamuryudan V, Uysal O, Senocak M, Yazici H (2001). "A double-blind trial of colchicine in Behçet's syndrome". Arthritis Rheum. 44 (11): 2686–92. PMID 11710724.
- ↑ Hamuryudan V, Mat C, Saip S, Ozyazgan Y, Siva A, Yurdakul S, Zwingenberger K, Yazici H (1998). "Thalidomide in the treatment of the mucocutaneous lesions of the Behcet syndrome.
A randomized, double-blind, placebo-controlled trial". Ann Intern Med. 128 (6): 443–50. PMID 9499327. line feed character in
|title=at position 83 (help) - ↑ Matsuda T, Ohno S, Hirohata S, Miyanaga Y, Ujihara H, Inaba G, Nakamura S, Tanaka S, Kogure M, Mizushima Y (2003). "Efficacy of rebamipide as adjunctive therapy in the treatment of recurrent oral aphthous ulcers in patients with Behçet's disease: a randomised, double-blind, placebo-controlled study". Drugs R D. 4 (1): 19–28. PMID 12568631.
- ↑ Sharquie KE, Najim RA, Abu-Raghif AR (2002). "Dapsone in Behçet's disease: a double-blind, placebo-controlled, cross-over study". J Dermatol. 29 (5): 267–79. PMID 12081158.