Infliximab for vascular involvement in Behçet's syndrome

Area of Science:

• Rheumatology
• Immunology
• Vascular Medicine

Background:

• Vascular involvement significantly contributes to morbidity and mortality in Behçet's syndrome (BS).
• Existing immunosuppressive therapies may not always be sufficient for managing vascular complications in BS.
• The efficacy and safety of infliximab (IFX) in this specific patient population require further investigation.

Purpose of the Study:

• To evaluate the efficacy and safety of infliximab (IFX) in Behçet's syndrome (BS) patients with vascular involvement.
• To determine remission rates and identify factors influencing treatment outcomes.
• To assess adverse events associated with IFX therapy in this cohort.

Main Methods:

• Retrospective review of 127 Behçet's syndrome patients with vascular involvement treated with infliximab (2004-2022).
• Primary endpoint: remission at Month 6, defined by clinical and imaging criteria, and CRP levels.
• Relapse defined as new or recurrent vascular lesions; safety assessed through adverse events and mortality.

Main Results:

• A 73% remission rate was observed at Month 6 and 63% at Month 12.
• Higher remission rates were noted in patients with pulmonary artery involvement and venous thrombosis compared to others.
• Four deaths occurred, and 14 patients discontinued IFX due to adverse events.

Conclusions:

• Infliximab demonstrates significant efficacy in managing vascular involvement in Behçet's syndrome patients.
• Treatment appears effective even in patients refractory to conventional immunosuppressives and glucocorticoids.
• IFX offers a valuable therapeutic option for refractory vascular Behçet's syndrome, though safety monitoring is crucial.