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Infliximab treatment in refractory vascular Behcet’s disease: A single-center experience
Vascular ( IF 1.0 ) Pub Date : 2020-05-23 , DOI: 10.1177/1708538120927701
Demet Yalçın Kehribar 1 , Metin Ozgen 2
Affiliation  

Objective This study aims to investigate the efficacy and reliability of infliximab treatment in Behcet’s disease with vascular involvement. Methods This single-center retrospective study included a total of 18 patients diagnosed with Behcet’s disease with vascular involvement who were initiated infliximab treatment after exhibiting resistance to conventional immunosuppressive treatments. Results Seventeen patients achieved remission with infliximab treatment. While 18 patients were receiving a median of 50 (IQR: 20–61) mg/day equivalent of methylprednisolone before infliximab treatment, after infliximab treatment, only four patients were receiving 4 mg/day equivalent of methylprednisolone (p < 0.001). Only 4 patients were receiving oral anticoagulant treatment during infliximab treatment, and compared to the patients who were not receiving oral anticoagulants, there was no significant difference between the two groups according to occurrence of new vascular events. Conclusion Infliximab seems to be an effective and reliable treatment in Behcet’s disease with vascular involvement and may also allow reduced dosage or even the discontinuation of corticosteroids. The results of our study suggest that oral anticoagulant use is unnecessary in Behcet’s disease with vascular involvement. However, further long-term randomized controlled studies are needed to investigate the length of infliximab regimen, whether or not it should be discontinued, and if so, whether or not immunosuppressants should be given as maintenance after discontinuation.

中文翻译:

英夫利昔单抗治疗难治性血管性白塞病:单中心经验

目的本研究旨在探讨英夫利昔单抗治疗白塞病血管受累的疗效和可靠性。方法 这项单中心回顾性研究共纳入了 18 名诊断为血管受累的 Behcet 病患者,这些患者在对常规免疫抑制治疗表现出耐药性后开始接受英夫利昔单抗治疗。结果 17 名患者通过英夫利昔单抗治疗获得缓解。虽然 18 名患者在英夫利昔单抗治疗前接受了 50(IQR:20-61)mg/天的甲基强的松龙等效剂量,但在英夫利昔单抗治疗后,只有 4 位患者接受了 4 mg/天的甲基强的松龙等效剂量(p < 0.001)。英夫利昔单抗治疗期间仅有 4 名患者接受口服抗凝治疗,与未接受口服抗凝剂的患者相比,两组在新血管事件发生率方面无显着差异。结论 英夫利昔单抗似乎是一种有效且可靠的治疗白塞病血管受累的方法,并且还可以减少剂量甚至停用皮质类固醇。我们的研究结果表明,在血管受累的 Behcet 病中不需要口服抗凝剂。然而,需要进一步的长期随机对照研究来研究英夫利昔单抗方案的长度,是否应该停药,如果停药,是否应该在停药后给予免疫抑制剂作为维持治疗。根据新血管事件的发生率,两组之间没有显着差异。结论 英夫利昔单抗似乎是一种有效且可靠的治疗白塞病血管受累的方法,并且还可以减少剂量甚至停用皮质类固醇。我们的研究结果表明,在血管受累的 Behcet 病中不需要口服抗凝剂。然而,需要进一步的长期随机对照研究来研究英夫利昔单抗方案的长度,是否应该停药,如果停药,是否应该在停药后给予免疫抑制剂作为维持治疗。根据新血管事件的发生率,两组之间没有显着差异。结论 英夫利昔单抗似乎是一种有效且可靠的治疗白塞病血管受累的方法,并且还可以减少剂量甚至停用皮质类固醇。我们的研究结果表明,在血管受累的 Behcet 病中不需要口服抗凝剂。然而,需要进一步的长期随机对照研究来研究英夫利昔单抗方案的长度,是否应该停药,如果停药,是否应该在停药后给予免疫抑制剂作为维持治疗。结论 英夫利昔单抗似乎是一种有效且可靠的治疗白塞病血管受累的方法,并且还可以减少剂量甚至停用皮质类固醇。我们的研究结果表明,在血管受累的 Behcet 病中不需要口服抗凝剂。然而,需要进一步的长期随机对照研究来研究英夫利昔单抗方案的长度,是否应该停药,如果停药,是否应该在停药后给予免疫抑制剂作为维持治疗。结论 英夫利昔单抗似乎是一种有效且可靠的治疗白塞病血管受累的方法,并且还可以减少剂量甚至停用皮质类固醇。我们的研究结果表明,在血管受累的 Behcet 病中不需要口服抗凝剂。然而,需要进一步的长期随机对照研究来研究英夫利昔单抗方案的长度,是否应该停药,如果停药,是否应该在停药后给予免疫抑制剂作为维持治疗。
更新日期:2020-05-23
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