Infliximab is a plausible alternative for neurologic complications of Behcet disease

被引:49
|
作者
Zeydan, Burcu [1 ,3 ]
Uygunoglu, Ugur [1 ]
Saip, Sabahattin [1 ]
Demirci, Onat N. [1 ]
Seyahi, Emire [2 ]
Ugurlu, Serdal [2 ]
Hamuryudan, Vedat [2 ]
Siva, Aksel [1 ]
Kantarci, Orhun H. [3 ]
机构
[1] Istanbul Univ, Cerrahpasa Med Sch, Dept Neurol, Istanbul, Turkey
[2] Istanbul Univ, Cerrahpasa Med Sch, Dept Rheumatol, Istanbul, Turkey
[3] Mayo Clin, Coll Med, Dept Neurol, Rochester, MN 55905 USA
来源
关键词
EXTENSIVE TRANSVERSE MYELITIS; DAGGER-ETS DISEASE; CASE SERIES; RECOMMENDATIONS; MANAGEMENT; EFFICACY; PATIENT; BLOCKADE; THERAPY;
D O I
10.1212/NXI.0000000000000258
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: We evaluated the effectiveness of infliximab in patients with neuro-Behcet syndrome for whom other immunosuppressive medications had failed. Methods: Patients whose common immunosuppressive medications fail in recurrent neuro-Behcet syndrome need an alternative. We report our experience with the tumor necrosis factor alpha blocker infliximab for long-term treatment of neuro-Behcet syndrome. We recruited patients within a multidisciplinary referral practice of Behcet disease and prospectively followed everyone with a neurologic symptom(s). Patients (n=16) with >= 2 neurologic bouts (excluding purely progressive disease) while on another immunosuppressive treatment were switched to and successfully sustained on infliximab (5 mg/kg in weeks 0, 2, and 6, then once every 8 weeks; minimum follow-up duration >= 12 months). Infliximab was stopped within 2 months after initiation in one patient because of pulmonary and CNS tuberculosis. Results: Patients had stepwise worsening due to relapses in the Expanded Disability Status Scale modified for neuro-Behcet syndrome before switching to infliximab (median score of 5.0, range 2.0-7.0; median neuro-Behcet syndrome duration 29.1 months, range 5.0-180.7). Median duration of preinfliximab immunosuppressive medication use was 20.0 months (range 3.0-180.7). In all 15 patients, during infliximab treatment (median score 4.0, range 2.0-7.0; median duration 39.0 months, range 16.0-104.9 months), neurologic relapses were completely aborted and there was no further disability accumulation. Conclusion: We observed a significant beneficial effect of infliximab in neuro-Behcet syndrome.
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页数:9
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