Related Experiment Videos

New Evidence-Based Treatment Approach in Behçet's Disease

Erkan Alpsoy1

  • 1Department of Dermatology and Venerology, Akdeniz University School of Medicine, 07059 Antalya, Turkey.

Insights

Behçet's disease (BD) is a chronic vasculitis affecting multiple organs. This paper outlines current therapeutic approaches and presents an evidence-based algorithm to guide treatment decisions, aiming to prevent irreversible organ damage.

Area of Science:

  • Rheumatology
  • Immunology
  • Internal Medicine

Background:

  • Behçet's disease (BD) is a chronic, relapsing systemic vasculitis of unknown origin.
  • Characterized by mucocutaneous lesions and multi-organ involvement (ocular, vascular, articular, neurologic, etc.).
  • Prevalence is higher along the Silk Route (Eastern Asia to Mediterranean) compared to Western countries.

Purpose of the Study:

  • To outline the current state of knowledge regarding therapeutic approaches for Behçet's disease.
  • To provide a rational framework for selecting appropriate therapies.
  • To develop a stepwise, symptom-based, evidence-based algorithmic approach for BD treatment.

Main Methods:

  • Review of current knowledge on therapeutic approaches for Behçet's disease.
  • Development of a stepwise, symptom-based, evidence-based treatment algorithm.
  • Focus on immunomodulatory and immunosuppressive agents for managing inflammatory attacks.

Main Results:

  • The paper outlines current therapeutic strategies for Behçet's disease.
  • An evidence-based algorithmic approach for treatment selection has been developed.
  • The algorithm aims to guide clinicians in managing the diverse manifestations of BD.

Conclusions:

  • Effective management of Behçet's disease requires close monitoring and timely, appropriate treatment.
  • The primary goal of treatment is to prevent irreversible organ damage.
  • The developed algorithmic approach facilitates rational, evidence-based therapeutic decision-making in BD.

Related Concept Videos

Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy01:16

Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy

Helicobacter pylori, a resilient gram-negative bacterium, can thrive in the stomach's harsh, acidic environment. Infection with H. pylori leads to a cascade of events within the stomach lining. One of the critical disruptions caused by this bacterium is the interference with somatostatin production, a hormone responsible for regulating acid secretion. This interference tips the balance, escalating acid secretion and diminishing bicarbonate levels. This imbalance compromises the defensive...