Biologic May Be a Viable Option for Patients with Behçet Disease

In a small open-label study, treatment with adalimumab (Humira) significantly improved arthritis, mucocutaneous manifestations, and interleukin-6 levels in all patients. However, less than half of patients reported significant reductions in pain.

“We assume that a subset of patient with insufficient improvement in joint tenderness and generalized pain, probably secondary to fibromyalgia, may require comprehensive pain management besides anti-inflammatory therapy,” the researchers wrote.
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The prospective study, which included 10 participants with active persistent Behçet arthritis who did not respond to disease-modifying anti-inflammatory drugs in Israel, had two phases. In the first phase, participants received adalimumab over 24 weeks, after which treatment stopped. Participants who relapsed within 12 weeks of adalimumab discontinuation had the option to enter a 3-year extension study and continue receiving the biologic agent.

After 24 weeks of treatment with adalimumab, significant improvements were observed in arthritis, interleukin-6 levels, disease activity visual analogue scales, and the Behçet Disease Current Activity Form scores. Oral and urogenital ulcers also resolved in all patients, according to the study. However, scores did not change on the Health Assessment Questionnaire or Functional Assessment of Chronic Illness Therapy Fatigue Scale. Significant pain reduction was reported by just 40% of patients.

Within 6 weeks of adalimumab discontinuation at the end of phase 1, 90% of patients relapsed, researchers reported. Of the seven patients who continued into phase 2, arthritis resolved in five patients, and two patients developed neutralizing antibodies to adalimumab after a year of treatment.

Adalimumab treatment was well tolerated, the study found.

—Jolynn Tumolo

Reference

Braun-Moscovici Y, Tavor Y, Markovits D, et al. The effects of adalimumab in Behçet disease patients on clinical manifestations and on pro-inflammatory cytokines milieu: Long-term follow-up. Isr Med Assoc J. 2020;22(5):289‐293.