Terapias innovadoras para el manejo de la enfermedad de Behçet refractaria

Resumo

Behçet's disease (BD) is a chronic inflammatory autoimmune disease, within the group of variable-vessel vasculitis, characterized by the presence of recurrent oral ulcers with systemic manifestations, including ocular, cutaneous, gastrointestinal, neurological, vascular and/or joint involvement. Its prevalence is higher in the Mediterranean countries along the ancient “Silk Road”. The relapsing-remitting nature of BD and the different organ involvement, as well as the differences in the course of the disease by sex, age and race, require individualized treatments. Unfortunately, there are patients who do not respond to or do not tolerate conventional immunosuppressive therapies. The studies carried out in this Thesis conclude that the use of biological anti-TNF agents, both infliximab and adalimumab, is effective in patients with BD and severe/ refractory uveitis. On the other hand, apremilast could be beneficial to treat orogenital ulcers that do not respond to conventional treatment, even in combination with other immunosuppressants. Finally, tocilizumab is an effective and safe alternative in patients with ocular and neurological phenotypes, especially in the most complicated cases.