Safety and efficacy of TNF inhibitors in patients with Behçet's disease: Retrospective study from eastern Turkey

Abstract

ObjectiveWe aimed to evaluate the clinical features, disease course and associated factors for outcome in severe/refractroy BD patients receiving TNF-i treatment. Material and methodsThis retrospective study was conducted by reviewing medical records from a tertiary referral center in Van province in Eastern Turkey. Data were obtained from the charts of patients followed up between June 2019 and June 2022. ResultsWe included 469 BD patients (59.3% male) whose 80 patients (17%) received TNF-i treatment into the study. Mean ± standard deviation (SD) of the patients was 36.7 ± 10.1 years and median (IQR) disease duration was 12 (12) years. IFX and ADA were initiated in 67.5% (n = 54) and 32.5% (n = 26) patients, respectively. Overall and first line retention rate of TNF-i were 84.7% and 92.6% for IFX and 83.3% and 80.8% for ADA, respectively. IFX was discontinued in 9 patients which were in 2 patients due to allergic reaction and tuberculosis, 3 patients for inefficacy, one patient for heart failure and one patient for orbital zona. Although, no serious advers event was observed with ADA, 5 patients switched to IFX due to inefficacy. Overall, 72 patients (90%) resumed TNF-i at the end of the study; TNF-i was discontinued in 3 patients (3.8%) due to severe advers events and in 5 patients (6.2%) prolonged remission. ConclusionIn our study, no case of death was observed in b-DMARD receiving patients. Most patients achieved attack-free and CS-free disease and retained on b-DMARD treatment. TNF inhibitors appear to be safe and effective in patients with severe/refractory Behçet's disease.