Therapeutics and Clinical Risk Management (May 2009)
Managing Behçet’s disease: An update on current and emerging treatment options
Abstract
P LA van Daele, J H Kappen, P M van Hagen, J AM van LaarDepartment of Internal Medicine, Department of Immunology, Erasmus MC, ‘s Gravendijkwal 230, 3015 Ce Rotterdam, The NetherlandsAbstract: Behçet’s disease is an autoinflammatory vasculitis of unknown origin characterized by recurrent oral and genital ulcers, uveitis, arthritis and skin lesions. Additionally, involvement of the gastrointestinal tract, central nervous system and large vessels may occur. The disease is prevalent in countries along the ancient Silk Road from Eastern Asia to the Mediterranean Basin. Many treatment modalities are currently available. The choice of treatment depends on organ involvement and severity of disease. Topical treatment with corticosteroids is often sufficient for mucocutaneous involvement, however for more severe disease with vasculitis or neurological involvement a more aggressive approach is warranted. Newer drugs (biologicals) influencing cytokines and thereby T-cell function are promising with an acceptable side effect profile. Unfortunately, reimbursement of the costs of biologicals for rare disease is still a problem in various countries. In this report we discuss the current treatment modalities for Behçet’s disease.Keywords: Behçet’s disease, biologicals, treatment