Real-world efficacy of adalimumab and infliximab for refractory intestinal Behçet’s disease

Abstract Background Anti-tumor necrosisfactor-α agents are important for managing refractory intestinal Behcet’s disease. Few studies have reported the efficacy of anti-tumor necrosisfactor-α monoclonal antibodies for intestinal Behcet’s diseasedue to its rarity. Aims The aim was to examine the efficacy of anti-tumor necrosisfactor-α antibodies for intestinal Behcet’s diseasein real-world practice. Methods This was a retrospective review of medical records at 4 hospitals in Japan. Global gastrointestinal symptom and endoscopic assessment scores were analyzed in intestinal Behcet’s diseasepatients given anti-tumor necrosisfactor-α agents at 3 and 12 months after the start of therapy. Results Of 53 intestinal Behcet’s diseasepatients, 22 received anti-tumor necrosisfactor-α monoclonal antibody treatment. At the first line, 14 were given adalimumab, and 8 were given infliximab. After 3 and 12 months of treatment, 7 and 11 patients showed complete response of gastrointestinal symptom scores, respectively, and 5 and 9 showed complete remission of the endoscopic assessment score, respectively. Three patients switched anti-tumor necrosisfactor-α agents. Conclusion Anti-tumor necrosisfactor-α monoclonal antibodies are effective for refractory intestinal Behcet’s diseasein real-world situations. Switching anti-tumor necrosisfactor-α agents may be useful for failure of first-line anti-tumor necrosisfactor-α therapy in some refractory cases.