Use of biotherapy in the management of Behcet's disease in a department of internal medicine

Background. - Behcet's disease (BD) is a recurrent multisystemic disease responsible for occlusive vasculitis with arterial, venous and capillary involvement. The aim of this study was to determine the frequency and the features associated with the use of biotherapy in the management of patients followed in our department for BD. Methods. - This is a retrospective study of patients medical records followed for BD in a department of internal medicine from January 2005 to August 2018. Results. -A total of 41 patients were included with a mean age at diagnosis of 42.5 f 12.1 years (range 16 to 63) and a sex ratio men/women of 1.05. Oral and/or genital aphtosis was present in 70.7% of the patients. Other lesions were: ocular (78.0%), articular (46.3%), cutaneous (41.5%), central neurological (34.1%), vascular (26.8%), digestive (7.3%), pericardial (2.4%) and epididymal (2.4%). A biotherapy, interferon a and monoclonal antibodies, was used in 15 patients (36.6%), after failure of conventional treatments. The monoclonal antibodies were anti-TNF alpha (infliximab, adalimumab, certolizumab and golimumab) except in one patient for whom ustekinumab was used. Biotherapy was used in 46.9% of the patients with ocular involvement and never used in those patients without ocular involvement (P= 0.01). Conclusion. - Biotherapy is effective and represents a solution to the failures of conventional treatments in severe forms of Behget's disease with ocular involvement. (C) 2019 Socike Nationale Francaise de Medecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.