TY - JOUR
T1 - Infliximab is a plausible alternative for neurologic complications of Behçet disease
AU - Zeydan, Burcu
AU - Uygunoglu, Ugur
AU - Saip, Sabahattin
AU - Demirci, Onat N.
AU - Seyahi, Emire
AU - Ugurlu, Serdal
AU - Hamuryudan, Vedat
AU - Siva, Aksel
AU - Kantarci, Orhun H.
N1 - Funding Information:
Dr. Zeydan’s fellowship position in the Department of Neurology, Mayo Clinic, Rochester, MN, is partially supported by an unrestricted grant from the Turkish Neurological Society.
Funding Information:
B. Zeydan received research support from the Turkish Neurologic Society. U. Uygunoglu is on the editorial board for the Turkish Journal of Neurology, received research support from The Scientific and Technological Research Council of Turkey. S. Saip, O.N. Demirci, E. Seyahi, and S. Ugurlu report no disclosures. V. Hamuryudan received speaker honoraria from BMS, MSD, Pfizer, AbbVie, Amgen, UCB, is associate editor for Letter to Editor Rheumatology. A. Siva received travel funding from Merck Serono, Biogen Idec/Gen Pharma of Turkey, Novartis, Teva, is on the editorial board for Journal of Neurologic Sciences, Journal of Headache and Pain, Turkish Neurologic Journal, Turkish Pain Journal, Brazilian Journal of Multiple Sclerosis, receives consulting fees from Biogen Idec, Novartis, Teva, Genzyme, Roche, gives educational presentations at programs and symposia prepared by EXCEMED, received research grants from The Scientific and Technological Research Council of Turkey. O.H. Kantarci’s institution received speaker honoraria from Novartis Pharmaceutical, Biogen, he performed a grant review for the National Multiple Sclerosis Society, received research support from the European Regional Development Fund, National Multiple Sclerosis Society, Mayo Foundation, Hilton Foundation, his spouse serves on the data safety monitoring board of Takeda Global Research and Development Center, INC, on the data monitoring board for Pfizer Inc., Janssen Alzheimer Immunotherapy, is funding by NIH and Minnesota Partnership for Biotechnology and Medical Genomics. Go to Neurology.org/nn for full disclosure forms.
Publisher Copyright:
© 2016 American Academy of Neurology.
PY - 2016
Y1 - 2016
N2 - Objective: We evaluated the effectiveness of infliximab in patients with neuro-Behçet syndrome for whom other immunosuppressive medications had failed. Methods: Patients whose common immunosuppressive medications fail in recurrent neuro-Behçet syndrome need an alternative. We report our experience with the tumor necrosis factor a blocker infliximab for long-term treatment of neuro-Behçet syndrome. We recruited patients within a multidisciplinary referral practice of Behçet disease and prospectively followed everyone with a neurologic symptom(s). Patients (n 5 16) with $2 neurologic bouts (excluding purely progressive disease) while on another immunosuppressive treatment were switched to and successfully sustained on infliximab (5 mg/kg in weeks 0, 2, and 6, then once every 8 weeks; minimum follow-up duration $12 months). Infliximab was stopped within 2 months after initiation in one patient because of pulmonary and CNS tuberculosis. Results: Patients had stepwise worsening due to relapses in the Expanded Disability Status Scale modified for neuro-Behçet syndrome before switching to infliximab (median score of 5.0, range 2.0–7.0; median neuro-Behçet syndrome duration 29.1 months, range 5.0–180.7). Median duration of preinfliximab immunosuppressive medication use was 20.0 months (range 3.0–180.7). In all 15 patients, during infliximab treatment (median score 4.0, range 2.0–7.0; median duration 39.0 months, range 16.0–104.9 months), neurologic relapses were completely aborted and there was no further disability accumulation. Conclusion: We observed a significant beneficial effect of infliximab in neuro-Behçet syndrome.
AB - Objective: We evaluated the effectiveness of infliximab in patients with neuro-Behçet syndrome for whom other immunosuppressive medications had failed. Methods: Patients whose common immunosuppressive medications fail in recurrent neuro-Behçet syndrome need an alternative. We report our experience with the tumor necrosis factor a blocker infliximab for long-term treatment of neuro-Behçet syndrome. We recruited patients within a multidisciplinary referral practice of Behçet disease and prospectively followed everyone with a neurologic symptom(s). Patients (n 5 16) with $2 neurologic bouts (excluding purely progressive disease) while on another immunosuppressive treatment were switched to and successfully sustained on infliximab (5 mg/kg in weeks 0, 2, and 6, then once every 8 weeks; minimum follow-up duration $12 months). Infliximab was stopped within 2 months after initiation in one patient because of pulmonary and CNS tuberculosis. Results: Patients had stepwise worsening due to relapses in the Expanded Disability Status Scale modified for neuro-Behçet syndrome before switching to infliximab (median score of 5.0, range 2.0–7.0; median neuro-Behçet syndrome duration 29.1 months, range 5.0–180.7). Median duration of preinfliximab immunosuppressive medication use was 20.0 months (range 3.0–180.7). In all 15 patients, during infliximab treatment (median score 4.0, range 2.0–7.0; median duration 39.0 months, range 16.0–104.9 months), neurologic relapses were completely aborted and there was no further disability accumulation. Conclusion: We observed a significant beneficial effect of infliximab in neuro-Behçet syndrome.
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U2 - 10.1212/NXI.0000000000000258
DO - 10.1212/NXI.0000000000000258
M3 - Article
AN - SCOPUS:85020291481
VL - 3
JO - Neurology: Neuroimmunology and NeuroInflammation
JF - Neurology: Neuroimmunology and NeuroInflammation
SN - 2332-7812
IS - 5
M1 - e258
ER -