Biological agents in the treatment of severe and/ or refractory neuro-Beh(c)et's disease
10.3760/cma.j.issn.1007-7480.2018.03.002
- VernacularTitle:生物制剂治疗重症和(或)难治性神经白塞病临床分析
- Author:
Dong YAN
1
,
2
;
Yuehua ZHANG
;
Jinjing LIU
;
Di WU
;
Linyi PENG
;
Li ZHANG
;
Nan JIANG
;
Shangzhu ZHANG
;
Li WANG
;
Yan ZHAO
;
Xiaofeng ZENG
;
Wenjie ZHENG
Author Information
1. 100730 中国医学科学院北京协和医院风湿免疫科
2. 苏州大学附属第二医院风湿免疫科
- Keywords:
Beh(c)et syndrome;
Biological agents;
Neuro-Beh(c)et's disease
- From:
Chinese Journal of Rheumatology
2018;22(3):148-153,封3
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the use of biological agents in Neuro-Beh(c)et's disease (NBD).Methods We retrospectively reviewed the clinical data of five NBD patients treated with biological agents who were in-patients at Peking Union Medical College Hospital between June 2009 and June 2016.The continuous variables were analyzed by t test.Results All five cases (4 male and 1 female) were severe and/or refractory patients with parenchymal involvement (pNBD).Their age at neurological onset was (31±12) years old.Four cases presented with multiple lesions.The brainstem,spinal cord,cerebral hemisphere and cerebellum involvement were presented in 4,3,3 and 2 patients,respectively.The Rankin score at the onset of NBD was (4.0±0.7).The biological agents were administrated when corticosteroids and immunosuppressant were ineffective.Three cases received tumor necrosis factor (TNF)-α inhibitors therapy,among whom one patient had gastrointestinal ulceration.One patient with refractory retinal vasculitis received interferon-α therapy.One patient treated with tocilizumab [interleukin (IL)-6R inhibitor] had high level IL-6 in the cerebrospinal fluid.All patients achievcd clinical improvements and the Rankin score significantly decreased to (2.2±0.8) when compared with the baseline (t=4.81,P＜0.01) after the treatment with biological agents.The corticosteroid dose was tapered in all cases and the numbers of immunosuppressants were reduced in most cases,indicating a potential steroid and immunosup-pressant-sparing effect.No serious adverse events were observed during the follow-up.Conclusion Neurological involvement is a severe complication of Behqet's disease.We can take appropriate biological agents such as TNF-α inhibitors or interferon-α into consideration when patients have severe/refractory pNBD.
