TY - JOUR
T1 - Biological treatments in Behçet’s disease: beyond anti-TNF-therapy
AU - Caso, Francesco
AU - Costa, Luisa
AU - Rigante, Donato
AU - Lucherini, Orso Maria
AU - Caso, Paolo
AU - Bascherini, Vittoria
AU - Frediani, Bruno
AU - Cimaz, Rolando
AU - Marrani, Edoardo
AU - Nieves-Martín, Laura
AU - Atteno, Mariangela
AU - Raffaele, Carmela G. L.
AU - Tarantino, Giusyda
AU - Galeazzi, Mauro
AU - Punzi, Leonardo
AU - Cantarini, Luca
PY - 2014
Y1 - 2014
N2 - Behçet's disease (BD) is universally recognized as a multisystemic inflammatory disease of unknown etiology with chronic course and unpredictable exacerbations: its clinical spectrum varies from pure vasculitic manifestations with thrombotic complications to protean inflammatory involvement of multiple organs and tissues. Treatment has been revolutionized by the progressed knowledge in the pathogenetic mechanisms of BD, involving dysfunction and oversecretion of multiple proinflammatory molecules, chiefly tumor necrosis factor- (TNF-) α, interleukin- (IL-) 1β, and IL-6. However, although biological treatment with anti-TNF-α agents has been largely demonstrated to be effective in BD, not all patients are definite responders, and this beneficial response might drop off over time. Therefore, additional therapies for a subset of refractory patients with BD are inevitably needed. Different agents targeting various cytokines and their receptors or cell surface molecules have been studied: the IL-1 receptor has been targeted by anakinra, the IL-1 by canakinumab and gevokizumab, the IL-6 receptor by tocilizumab, the IL12/23 receptor by ustekinumab, and the B-lymphocyte antigen CD-20 by rituximab. The aim of this review is to summarize all current experiences and the most recent evidence regarding these novel approaches with biological drugs other than TNF-α blockers in BD, providing a valuable addition to the actually available therapeutic armamentarium.
AB - Behçet's disease (BD) is universally recognized as a multisystemic inflammatory disease of unknown etiology with chronic course and unpredictable exacerbations: its clinical spectrum varies from pure vasculitic manifestations with thrombotic complications to protean inflammatory involvement of multiple organs and tissues. Treatment has been revolutionized by the progressed knowledge in the pathogenetic mechanisms of BD, involving dysfunction and oversecretion of multiple proinflammatory molecules, chiefly tumor necrosis factor- (TNF-) α, interleukin- (IL-) 1β, and IL-6. However, although biological treatment with anti-TNF-α agents has been largely demonstrated to be effective in BD, not all patients are definite responders, and this beneficial response might drop off over time. Therefore, additional therapies for a subset of refractory patients with BD are inevitably needed. Different agents targeting various cytokines and their receptors or cell surface molecules have been studied: the IL-1 receptor has been targeted by anakinra, the IL-1 by canakinumab and gevokizumab, the IL-6 receptor by tocilizumab, the IL12/23 receptor by ustekinumab, and the B-lymphocyte antigen CD-20 by rituximab. The aim of this review is to summarize all current experiences and the most recent evidence regarding these novel approaches with biological drugs other than TNF-α blockers in BD, providing a valuable addition to the actually available therapeutic armamentarium.
KW - Behçet's disease
KW - Interleukin-1
KW - Behçet's disease
KW - Interleukin-1
UR - http://hdl.handle.net/10807/62927
U2 - 10.1155/2014/107421
DO - 10.1155/2014/107421
M3 - Article
SN - 1466-1861
VL - 2014
SP - N/A-N/A
JO - Mediators of Inflammation
JF - Mediators of Inflammation
ER -