Updated treatment strategies for intestinal Behçet's disease

• Published in: The Korean journal of internal medicine Vol. 33; no. 1; pp. 1 - 19
• Main Authors: Park, Yong Eun, Cheon, Jae Hee
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Association of Internal Medicine 01.01.2018; 대한내과학회
• Subjects: Adalimumab - therapeutic use; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Behcet Syndrome - therapy; Gastrointestinal Agents - therapeutic use; Humans; Induction Chemotherapy; Infliximab - therapeutic use; Intestinal Diseases - therapy; Maintenance Chemotherapy; Mesalamine - therapeutic use; Republic of Korea; Retrospective Studies; Review; 내과학; Republic of Korea; Intestinal Behcet disease; Tumor necrosis factor-alpha; Biological products; Infliximab; Adalimumab
• ISSN: 1226-3303; 2005-6648
• DOI: 10.3904/kjim.2017.377

Behçet's disease (BD) is a chronic, idiopathic, relapsing immune-mediated disease involving multiple organs, and is characterized by recurrent oral and genital ulcers, ocular disease, gastrointestinal ulcers, vascular diseases, and skin lesions. In particular, gastrointestinal involvement in BD is followed by severe complications, including massive bleeding, bowel perforation, and fistula, which can lead to significant morbidity and mortality. However, the management of intestinal BD has not yet been properly established. Intestinal BD patients with a severe clinical course experience frequent disease aggravations and often require recurrent corticosteroid and/or immunomodulatory therapies, or even surgery. However, a considerable number of patients with intestinal BD are often refractory to conventional therapies such as corticosteroids and immunomodulators. Recently, there has been a line of evidence suggesting that biologics such as infliximab and adalimumab are effective in treating intestinal BD. Moreover, new biologics targeting proteins other than tumor necrosis factor α are emerging and are under active investigation. Therefore, in this paper, we review the current therapeutic strategies and new clinical data for the treatment of intestinal BD.