Materiały źródłowe

• #1 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  There’s no cure for Behcet disease. If you have a mild form, your healthcare professional might suggest medicines to manage the pain and swelling of flares. You might not need medicine between flares. For some people, symptoms get better over time. […] For worse symptoms, you might take medicines to manage Behcet disease throughout your body. Plus you might take medicines for flares. […] Medicines to manage symptoms during flares might include: Skin creams, gels and ointments. These products, called topical medicines, are corticosteroid medicines that you put on skin and genital sores. Mouth rinses. Special mouthwashes that have corticosteroids and other agents might reduce the pain of mouth sores. Eye drops. For mild swelling and irritation, eye drops that have corticosteroids or other medicines might help.

• #2 Behcet’s Disease Recovery & Support | NYU Langone Health

  https://nyulangone.org/conditions/behcets-disease/support

  There is no cure for Behcets disease, but treatments can keep symptoms under control. Therapies are most effective when started early and monitored regularly. […] The goal of treatment with medication is to get you into remission. That can take several months to years. […] Some people, however, need long-term medication to control the symptoms of Behets disease. […] Its important for people with severe symptoms to continue seeing a rheumatologist after treatment is completed. […] If Behets disease does flare up, the experts at NYU Langone can immediately treat you and help alleviate your symptoms.

• #3 Treatment of Behçet syndrome – UpToDate

  https://www.uptodate.com/contents/treatment-of-behcet-syndrome/print

  Treatment of Behçet syndrome will be reviewed here. […] The goal of treatment is to promptly suppress inflammatory exacerbations and recurrences to prevent irreversible organ damage.

• #4 Treatment of Behçet’s Disease: An Algorithmic Multidisciplinary Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8115406/

  Behet’s disease (BD) is a chronic, relapsing inflammatory, multisystem disease of unknown etiology. […] Although the number of effective drugs used in the disease’s treatment has increased in recent years, BD is still associated with severe morbidity because of mainly mucocutaneous, articular and ocular symptoms and an increased mortality because of large vessel, neurological, gastrointestinal and cardiac involvement. […] The primary goal of treatment should be the prevention of irreversible organ damage. Therefore, early diagnosis and appropriate treatment and close follow-up are mandatory to reduce the morbidity and mortality of the disease. Treatment varies depending on the organ involved and the severity of the involvement. […] For all these reasons, the treatment should be personalized and arranged with a multidisciplinary approach according to the organs involved. Treatment is mainly based on suppression of the inflammatory attacks of the disease using local and systemic immunomodulatory and immunosuppressive drugs.

• #5 Treatment of Behçet’s Disease: An Algorithmic Multidisciplinary Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8115406/

  In this review, we propose a symptom-based, algorithmic treatment approach. […] Treatment varies depending on involved organ/s, the severity and duration of involvement, the frequency of attacks, gender and patient’s age. At present, no specific recommendations based on gender or age exist for all the manifestations of BD; however, age and early disease can influence the treatment of ocular involvement. […] Nevertheless, the primary goal of treatment should be rapidly to suppress and prevent new inflammatory attacks to avoid irreversible organ damage, especially in the early, active stages of BD. […] In acute and severe attacks of mucocutaneous lesions (e.g., major OU, GU, and/or EN-like lesions), corticosteroids (prednisolone, initial dose 40-60 mg daily for 24 weeks, tapered over the ensuing 4-6 weeks) can be used as an effective treatment.

• #6 Treatment of Behçet’s Disease: An Algorithmic Multidisciplinary Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8115406/

  Behet’s disease (BD) is a chronic, relapsing inflammatory, multisystem disease of unknown etiology. […] Although the number of effective drugs used in the disease’s treatment has increased in recent years, BD is still associated with severe morbidity because of mainly mucocutaneous, articular and ocular symptoms and an increased mortality because of large vessel, neurological, gastrointestinal and cardiac involvement. […] The primary goal of treatment should be the prevention of irreversible organ damage. Therefore, early diagnosis and appropriate treatment and close follow-up are mandatory to reduce the morbidity and mortality of the disease. Treatment varies depending on the organ involved and the severity of the involvement. […] For all these reasons, the treatment should be personalized and arranged with a multidisciplinary approach according to the organs involved. Treatment is mainly based on suppression of the inflammatory attacks of the disease using local and systemic immunomodulatory and immunosuppressive drugs.

• #7 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  There’s no cure for Behcet disease. If you have a mild form, your healthcare professional might suggest medicines to manage the pain and swelling of flares. You might not need medicine between flares. For some people, symptoms get better over time. […] For worse symptoms, you might take medicines to manage Behcet disease throughout your body. Plus you might take medicines for flares. […] Medicines to manage symptoms during flares might include: Skin creams, gels and ointments. These products, called topical medicines, are corticosteroid medicines that you put on skin and genital sores. Mouth rinses. Special mouthwashes that have corticosteroids and other agents might reduce the pain of mouth sores. Eye drops. For mild swelling and irritation, eye drops that have corticosteroids or other medicines might help.

• #8 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  There’s no cure for Behcet disease. If you have a mild form, your healthcare professional might suggest medicines to manage the pain and swelling of flares. You might not need medicine between flares. For some people, symptoms get better over time. […] For worse symptoms, you might take medicines to manage Behcet disease throughout your body. Plus you might take medicines for flares. […] Medicines to manage symptoms during flares might include: Skin creams, gels and ointments. These products, called topical medicines, are corticosteroid medicines that you put on skin and genital sores. Mouth rinses. Special mouthwashes that have corticosteroids and other agents might reduce the pain of mouth sores. Eye drops. For mild swelling and irritation, eye drops that have corticosteroids or other medicines might help.

• #9 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  There’s no cure for Behcet disease. If you have a mild form, your healthcare professional might suggest medicines to manage the pain and swelling of flares. You might not need medicine between flares. For some people, symptoms get better over time. […] For worse symptoms, you might take medicines to manage Behcet disease throughout your body. Plus you might take medicines for flares. […] Medicines to manage symptoms during flares might include: Skin creams, gels and ointments. These products, called topical medicines, are corticosteroid medicines that you put on skin and genital sores. Mouth rinses. Special mouthwashes that have corticosteroids and other agents might reduce the pain of mouth sores. Eye drops. For mild swelling and irritation, eye drops that have corticosteroids or other medicines might help.

• #10 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  There’s no cure for Behcet disease. If you have a mild form, your healthcare professional might suggest medicines to manage the pain and swelling of flares. You might not need medicine between flares. For some people, symptoms get better over time. […] For worse symptoms, you might take medicines to manage Behcet disease throughout your body. Plus you might take medicines for flares. […] Medicines to manage symptoms during flares might include: Skin creams, gels and ointments. These products, called topical medicines, are corticosteroid medicines that you put on skin and genital sores. Mouth rinses. Special mouthwashes that have corticosteroids and other agents might reduce the pain of mouth sores. Eye drops. For mild swelling and irritation, eye drops that have corticosteroids or other medicines might help.

• #11 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  There’s no cure for Behcet disease. If you have a mild form, your healthcare professional might suggest medicines to manage the pain and swelling of flares. You might not need medicine between flares. For some people, symptoms get better over time. […] For worse symptoms, you might take medicines to manage Behcet disease throughout your body. Plus you might take medicines for flares. […] Medicines to manage symptoms during flares might include: Skin creams, gels and ointments. These products, called topical medicines, are corticosteroid medicines that you put on skin and genital sores. Mouth rinses. Special mouthwashes that have corticosteroids and other agents might reduce the pain of mouth sores. Eye drops. For mild swelling and irritation, eye drops that have corticosteroids or other medicines might help.

• #12 Behçet disease: Background, Treatment and More

  https://dermnetnz.org/topics/behcet-disease

  Behet disease treatment should be tailored to each individual patient based on clinical manifestations and extent of disease an MDT approach is required. Behet disease typically has a relapsing-remitting course, and treatments should aim to suppress any inflammatory exacerbations and prevent irreversible organ damage, particularly in the initial phase of disease. […] Ocular, vascular, and neurological manifestations are often more serious and require more aggressive treatment. […] Topical treatments include: corticosteroids applied as creams, gels, or mouth rinses, pimecrolimus as an alternative to topical steroids, sucralfate, antibiotics such as tetracyclines, antiseptics chlorhexidine mouthwash, hydroxypropyl cellulose, diclofenac, lidocaine. […] Systemic treatments for mucosal disease include: colchicine, glucocorticoids, apremilast, azathioprine, TNF-alpha inhibitors, ciclosporin, interferon alpha-21 and interferon alpha-2b, thalidomide, methotrexate, roflumilast, secukinumab, ustekinumab.

• #13 Behçet disease: Background, Treatment and More

  https://dermnetnz.org/topics/behcet-disease

  Behet disease treatment should be tailored to each individual patient based on clinical manifestations and extent of disease an MDT approach is required. Behet disease typically has a relapsing-remitting course, and treatments should aim to suppress any inflammatory exacerbations and prevent irreversible organ damage, particularly in the initial phase of disease. […] Ocular, vascular, and neurological manifestations are often more serious and require more aggressive treatment. […] Topical treatments include: corticosteroids applied as creams, gels, or mouth rinses, pimecrolimus as an alternative to topical steroids, sucralfate, antibiotics such as tetracyclines, antiseptics chlorhexidine mouthwash, hydroxypropyl cellulose, diclofenac, lidocaine. […] Systemic treatments for mucosal disease include: colchicine, glucocorticoids, apremilast, azathioprine, TNF-alpha inhibitors, ciclosporin, interferon alpha-21 and interferon alpha-2b, thalidomide, methotrexate, roflumilast, secukinumab, ustekinumab.

• #14 Behçet disease: Background, Treatment and More

  https://dermnetnz.org/topics/behcet-disease

  Behet disease treatment should be tailored to each individual patient based on clinical manifestations and extent of disease an MDT approach is required. Behet disease typically has a relapsing-remitting course, and treatments should aim to suppress any inflammatory exacerbations and prevent irreversible organ damage, particularly in the initial phase of disease. […] Ocular, vascular, and neurological manifestations are often more serious and require more aggressive treatment. […] Topical treatments include: corticosteroids applied as creams, gels, or mouth rinses, pimecrolimus as an alternative to topical steroids, sucralfate, antibiotics such as tetracyclines, antiseptics chlorhexidine mouthwash, hydroxypropyl cellulose, diclofenac, lidocaine. […] Systemic treatments for mucosal disease include: colchicine, glucocorticoids, apremilast, azathioprine, TNF-alpha inhibitors, ciclosporin, interferon alpha-21 and interferon alpha-2b, thalidomide, methotrexate, roflumilast, secukinumab, ustekinumab.

• #15 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  If topical medicines don’t help, you might take a medicine by mouth called colchicine (Colcrys, Mitigare, others). This is for mouth and genital sores that come back. Colchicine also might ease joint swelling. […] More recently, the U.S. Food and Drug Administration approved apremilast (Otezla) for the treatment of mouth sores caused by Behcet disease. Side effects may include weight loss and depression. […] If you have more-serious Behcet disease, you may need treatments to lessen damage from the disease between flares. Your healthcare professional might prescribe: Corticosteroids to manage swelling and irritation, called inflammation. Corticosteroids, such as prednisone (Rayos), ease the inflammation caused by Behcet disease. Healthcare professionals often prescribe corticosteroids with another medicine to make the immune system less active. Side effects of corticosteroids include weight gain, heartburn, high blood pressure and bone thinning, called osteoporosis.

• #16 French recommendations for the management of Behçet’s disease | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-020-01620-4

  The use of anticoagulants in treating vascular involvement is disputed but remains recommended; inflammation of the vascular walls is the main cause of Behets disease-related thrombosis. […] In its serious and/or complicated forms, Behets disease is categorized as a life-long disorder, with waiver of co-pay (care at 100%). […] Therapeutic education is indispensable to optimize the care and compliance of the patient with the therapeutic project. […] Colchicine is the first-line treatment of mucocutaneous and articular manifestations. […] Reduction (or cessation) of immunosuppressant or immunomodulating treatment can be considered, except in exceptional cases, only after at least 2 years of remission within the framework of severe Behets disease (ophthalmological, digestive, neurological, cardiovascular, and pulmonary damage).

• #17 French recommendations for the management of Behçet’s disease | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-020-01620-4

  Behets disease (BD) is a systemic variable vessel vasculitis that involves the skin, mucosa, joints, eyes, arteries, veins, nervous system and gastrointestinal system, presenting with remissions and exacerbations. […] Several new therapeutic modalities with different mechanisms of action have been studied in patients with BD. A substantial amount of new data have been published on the management of BD, especially with biologics, over the last years. […] The drug treatments for Behets disease essentially depend on the clinical manifestations and target the abatement of inflammation. […] Colchicine is the first-choice treatment of mucocutaneous and articular involvement. The most serious, ocular, vascular, or neurological involvements require immunomodulating treatment, most often associating systemic corticosteroid therapy with immunosuppressants and biotherapy (anti-TNF), depending on the indication.

• #18 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  If topical medicines don’t help, you might take a medicine by mouth called colchicine (Colcrys, Mitigare, others). This is for mouth and genital sores that come back. Colchicine also might ease joint swelling. […] More recently, the U.S. Food and Drug Administration approved apremilast (Otezla) for the treatment of mouth sores caused by Behcet disease. Side effects may include weight loss and depression. […] If you have more-serious Behcet disease, you may need treatments to lessen damage from the disease between flares. Your healthcare professional might prescribe: Corticosteroids to manage swelling and irritation, called inflammation. Corticosteroids, such as prednisone (Rayos), ease the inflammation caused by Behcet disease. Healthcare professionals often prescribe corticosteroids with another medicine to make the immune system less active. Side effects of corticosteroids include weight gain, heartburn, high blood pressure and bone thinning, called osteoporosis.

• #19 Treatment of Behcet’s Disease

  https://www.behcets.com/treatment

  Apremilast (Otezla), an oral selective phosphodiesterase 4 (PDE4) inhibitor, is the first and only approved treatment by the US Food and Drug Administration (FDA) for oral ulcers associated with Behcet’s Disease. […] Treatment of Behcet’s Disease typically focuses on reducing discomfort and preventing serious complications. […] Patients can control symptoms of Behcet’s Disease with proper medication, rest, exercise, and a healthy lifestyle. The goal of treatment is to reduce discomfort and prevent serious complications. […] Topical medication is applied directly to the ulcers and skin lesions in order to relieve pain and discomfort. […] TNF inhibitors (anti tumor necrosis factor drugs) are a class of drugs used in the United States for more than 15 years and used worldwide to treat inflammatory conditions.

• #20 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  If topical medicines don’t help, you might take a medicine by mouth called colchicine (Colcrys, Mitigare, others). This is for mouth and genital sores that come back. Colchicine also might ease joint swelling. […] More recently, the U.S. Food and Drug Administration approved apremilast (Otezla) for the treatment of mouth sores caused by Behcet disease. Side effects may include weight loss and depression. […] If you have more-serious Behcet disease, you may need treatments to lessen damage from the disease between flares. Your healthcare professional might prescribe: Corticosteroids to manage swelling and irritation, called inflammation. Corticosteroids, such as prednisone (Rayos), ease the inflammation caused by Behcet disease. Healthcare professionals often prescribe corticosteroids with another medicine to make the immune system less active. Side effects of corticosteroids include weight gain, heartburn, high blood pressure and bone thinning, called osteoporosis.

• #21 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  If topical medicines don’t help, you might take a medicine by mouth called colchicine (Colcrys, Mitigare, others). This is for mouth and genital sores that come back. Colchicine also might ease joint swelling. […] More recently, the U.S. Food and Drug Administration approved apremilast (Otezla) for the treatment of mouth sores caused by Behcet disease. Side effects may include weight loss and depression. […] If you have more-serious Behcet disease, you may need treatments to lessen damage from the disease between flares. Your healthcare professional might prescribe: Corticosteroids to manage swelling and irritation, called inflammation. Corticosteroids, such as prednisone (Rayos), ease the inflammation caused by Behcet disease. Healthcare professionals often prescribe corticosteroids with another medicine to make the immune system less active. Side effects of corticosteroids include weight gain, heartburn, high blood pressure and bone thinning, called osteoporosis.

• #22 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  If topical medicines don’t help, you might take a medicine by mouth called colchicine (Colcrys, Mitigare, others). This is for mouth and genital sores that come back. Colchicine also might ease joint swelling. […] More recently, the U.S. Food and Drug Administration approved apremilast (Otezla) for the treatment of mouth sores caused by Behcet disease. Side effects may include weight loss and depression. […] If you have more-serious Behcet disease, you may need treatments to lessen damage from the disease between flares. Your healthcare professional might prescribe: Corticosteroids to manage swelling and irritation, called inflammation. Corticosteroids, such as prednisone (Rayos), ease the inflammation caused by Behcet disease. Healthcare professionals often prescribe corticosteroids with another medicine to make the immune system less active. Side effects of corticosteroids include weight gain, heartburn, high blood pressure and bone thinning, called osteoporosis.

• #23 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  Medicines that make the immune system less active. Medicines that keep the immune system from attacking healthy tissues include azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral, others) and cyclophosphamide (Cytoxan). These medicines can increase the risk of infection. They also can affect the liver and kidneys and cause low blood counts and high blood pressure. […] Medicines that change how the immune system responds. Interferon alfa-2b (Intron A) may be used alone or with other medicines to help manage skin sores, joint pain and eye irritation in people with Behcet disease. Side effects include flu-like symptoms, such as muscle pain and fatigue. […] Medicines that block a substance called tumor necrosis factor can treat some of the symptoms of Behcet disease. People who have worse symptoms or symptoms that resist treatment might take one of these medicines. Medicines include infliximab (Remicade) and adalimumab (Humira). Side effects might include headache, skin rash and a higher risk of infections.

• #24 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  Medicines that make the immune system less active. Medicines that keep the immune system from attacking healthy tissues include azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral, others) and cyclophosphamide (Cytoxan). These medicines can increase the risk of infection. They also can affect the liver and kidneys and cause low blood counts and high blood pressure. […] Medicines that change how the immune system responds. Interferon alfa-2b (Intron A) may be used alone or with other medicines to help manage skin sores, joint pain and eye irritation in people with Behcet disease. Side effects include flu-like symptoms, such as muscle pain and fatigue. […] Medicines that block a substance called tumor necrosis factor can treat some of the symptoms of Behcet disease. People who have worse symptoms or symptoms that resist treatment might take one of these medicines. Medicines include infliximab (Remicade) and adalimumab (Humira). Side effects might include headache, skin rash and a higher risk of infections.

• #25 Behcet disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/behcet-disease/diagnosis-treatment/drc-20351331

  Medicines that make the immune system less active. Medicines that keep the immune system from attacking healthy tissues include azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral, others) and cyclophosphamide (Cytoxan). These medicines can increase the risk of infection. They also can affect the liver and kidneys and cause low blood counts and high blood pressure. […] Medicines that change how the immune system responds. Interferon alfa-2b (Intron A) may be used alone or with other medicines to help manage skin sores, joint pain and eye irritation in people with Behcet disease. Side effects include flu-like symptoms, such as muscle pain and fatigue. […] Medicines that block a substance called tumor necrosis factor can treat some of the symptoms of Behcet disease. People who have worse symptoms or symptoms that resist treatment might take one of these medicines. Medicines include infliximab (Remicade) and adalimumab (Humira). Side effects might include headache, skin rash and a higher risk of infections.

• #26 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  The goals of therapy in Behet disease are to suppress inflammation and reduce the frequency and severity of recurrences. To be effective, treatment must be started early. The sites and extent of involvement and the severity of disease determine the choice of medication. […] The treatment approach depends on the individual patient, severity of disease, and major organ involvement. The European League Against Rheumatism (EULAR) recommendations for the management of Behet disease, which were developed in 2008 and updated in 2018, aid in the management of different aspects of Behet disease. […] As disease activity subsides, taper medications to the lowest dose that effectively controls disease activity. Inpatient care is based on individual organ-system involvement. Individualize the transfer situation for each patient based on the specifics of organ-system involvement.

• #27 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  For oral and genital ulcerations, topical corticosteroids or sucralfate solution are first-line therapy for mild isolated ulcerations. […] Colchicine has also been used to prevent mucocutaneous relapse. […] For severe mucocutaneous lesions, systemic corticosteroids, azathioprine, pentoxifylline, dapsone, interferon-alfa, colchicine, and thalidomide have demonstrated benefit. […] Apremilast is a second-line treatment for oral ulcers associated with Behet disease. […] A study that compared TNF- inhibitors and apremilast for the treatment of refractory oral ulcers showed that both are equally effective. […] For ocular disease, azathioprine is widely accepted as the initial agent. For severe eye disease (significant drop in visual acuity, retinal vasculitis, or macular involvement), either cyclosporine or infliximab may be used in combination with azathioprine and corticosteroids. […] An expert panel has recommended considering infliximab and adalimumab as first-line immunomodulatory agents for the treatment of ocular manifestations.

• #28 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  For oral and genital ulcerations, topical corticosteroids or sucralfate solution are first-line therapy for mild isolated ulcerations. […] Colchicine has also been used to prevent mucocutaneous relapse. […] For severe mucocutaneous lesions, systemic corticosteroids, azathioprine, pentoxifylline, dapsone, interferon-alfa, colchicine, and thalidomide have demonstrated benefit. […] Apremilast is a second-line treatment for oral ulcers associated with Behet disease. […] A study that compared TNF- inhibitors and apremilast for the treatment of refractory oral ulcers showed that both are equally effective. […] For ocular disease, azathioprine is widely accepted as the initial agent. For severe eye disease (significant drop in visual acuity, retinal vasculitis, or macular involvement), either cyclosporine or infliximab may be used in combination with azathioprine and corticosteroids. […] An expert panel has recommended considering infliximab and adalimumab as first-line immunomodulatory agents for the treatment of ocular manifestations.

• #29 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  For oral and genital ulcerations, topical corticosteroids or sucralfate solution are first-line therapy for mild isolated ulcerations. […] Colchicine has also been used to prevent mucocutaneous relapse. […] For severe mucocutaneous lesions, systemic corticosteroids, azathioprine, pentoxifylline, dapsone, interferon-alfa, colchicine, and thalidomide have demonstrated benefit. […] Apremilast is a second-line treatment for oral ulcers associated with Behet disease. […] A study that compared TNF- inhibitors and apremilast for the treatment of refractory oral ulcers showed that both are equally effective. […] For ocular disease, azathioprine is widely accepted as the initial agent. For severe eye disease (significant drop in visual acuity, retinal vasculitis, or macular involvement), either cyclosporine or infliximab may be used in combination with azathioprine and corticosteroids. […] An expert panel has recommended considering infliximab and adalimumab as first-line immunomodulatory agents for the treatment of ocular manifestations.

• #30 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  Interferon-alfa, alone or in combination with corticosteroids, can be a second choice in severe ocular Behet disease. It is used primarily in Europe. A retrospective study of a large case series from Germany reported long-lasting remission and improved visual prognosis in patients with severe ocular Behet disease treated with alpha interferon. […] For gastrointestinal lesions, treatment alternatives based on expert opinion are as follows: Minosalicylate (5-ASA) derivatives (eg, sulfasalazine or mesalamine), systemic corticosteroids, azathioprine, tumor necrosis factor (TNF-) antagonists, thalidomide. […] Arthritis may respond to prednisone, local corticosteroid injections, nonsteroidal anti-inflammatory drugs (NSAIDs), and colchicine. Interferon-alfa, azathioprine, and TNF- blockers may be tried in rare cases of patients with resistant, prolonged, and disabling attacks.

• #31 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  Interferon-alfa, alone or in combination with corticosteroids, can be a second choice in severe ocular Behet disease. It is used primarily in Europe. A retrospective study of a large case series from Germany reported long-lasting remission and improved visual prognosis in patients with severe ocular Behet disease treated with alpha interferon. […] For gastrointestinal lesions, treatment alternatives based on expert opinion are as follows: Minosalicylate (5-ASA) derivatives (eg, sulfasalazine or mesalamine), systemic corticosteroids, azathioprine, tumor necrosis factor (TNF-) antagonists, thalidomide. […] Arthritis may respond to prednisone, local corticosteroid injections, nonsteroidal anti-inflammatory drugs (NSAIDs), and colchicine. Interferon-alfa, azathioprine, and TNF- blockers may be tried in rare cases of patients with resistant, prolonged, and disabling attacks.

• #32 Treatment of Behçet’s Disease: An Algorithmic Multidisciplinary Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8115406/

  In patients unresponsive to colchicine monotherapy, the addition of benzathine penicillin may be beneficial. […] In patients with severe clinical presentation or poor prognostic factors, anti-TNF- agents or cyclophosphamide can be considered as a first-line therapy. […] In patients with refractory venous thrombosis, anti-TNF-alpha agents, alone or in combination with traditional DMARDs, or interferon-alpha, can be considered. […] The treatment of vascular BD manifestations differs according to the involved district, and to the specific type of event. […] The pharmacological treatment of gastrointestinal involvement varies according to its severity. While milder cases should be initially treated with 5-amino salicylate derivatives (e.g., sulfasalazine, mesalamine), azathioprine should be considered in unresponsive or more severe cases. […] Because of the high incidence of vital organ involvement, regular follow-up and appropriate management of BD is mandatory.

• #33 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  Interferon-alfa, alone or in combination with corticosteroids, can be a second choice in severe ocular Behet disease. It is used primarily in Europe. A retrospective study of a large case series from Germany reported long-lasting remission and improved visual prognosis in patients with severe ocular Behet disease treated with alpha interferon. […] For gastrointestinal lesions, treatment alternatives based on expert opinion are as follows: Minosalicylate (5-ASA) derivatives (eg, sulfasalazine or mesalamine), systemic corticosteroids, azathioprine, tumor necrosis factor (TNF-) antagonists, thalidomide. […] Arthritis may respond to prednisone, local corticosteroid injections, nonsteroidal anti-inflammatory drugs (NSAIDs), and colchicine. Interferon-alfa, azathioprine, and TNF- blockers may be tried in rare cases of patients with resistant, prolonged, and disabling attacks.

• #34 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  Central nervous system (CNS) disease is usually treated with systemic corticosteroids, interferon-alfa, azathioprine, cyclophosphamide, methotrexate, and TNF- antagonists. […] Treatment of major-vessel disease with thrombotic events is with systemic anticoagulation in addition to corticosteroids, azathioprine, cyclophosphamide, or cyclosporine. Pulmonary arterial aneurysms are treated with cyclophosphamide and corticosteroids. […] TNF- antagonists are increasingly used and have become standard treatment of Behet disease that is inadequately controlled by standard immunosuppressive regimens. […] Infliximab has been most widely studied, but adalimumab has proved successful in cases refractory to both conventional therapy and infliximab. […] Etanercept is the only TNF inhibitor with data from a short-term randomized controlled study demonstrating efficacy in suppressing most of the mucocutaneous manifestations of Behet disease.

• #35 Advances in the Treatment of Behcet’s Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8136102/

  Azathioprine or cyclosporine A are traditionally first-line treatment options for the treatment of ocular involvement since their efficacy for protecting visual acuity and preventing uveitis relapses were confirmed in RCTs. […] TNF inhibitors seem to be effective treatment options in all types of refractory vascular involvement of BD. […] According to EULAR 2018 recommendations, GCs and ISs such as azathioprine, cyclophosphamide, or cyclosporine A are recommended for the management of acute deep venous thrombosis (DVT) in BD. […] According to EULAR 2018 recommendations, azathioprine and daily IV GC pulses (up to 7 day) are usually prescribed as first-line treatment of an acute attack of parenchymal involvement. […] Treatment approaches for the management of gastrointestinal disease in BD are based on retrospective observational studies or extrapolations from studies on inflammatory bowel disease since there are no controlled trials.

• #36 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  Central nervous system (CNS) disease is usually treated with systemic corticosteroids, interferon-alfa, azathioprine, cyclophosphamide, methotrexate, and TNF- antagonists. […] Treatment of major-vessel disease with thrombotic events is with systemic anticoagulation in addition to corticosteroids, azathioprine, cyclophosphamide, or cyclosporine. Pulmonary arterial aneurysms are treated with cyclophosphamide and corticosteroids. […] TNF- antagonists are increasingly used and have become standard treatment of Behet disease that is inadequately controlled by standard immunosuppressive regimens. […] Infliximab has been most widely studied, but adalimumab has proved successful in cases refractory to both conventional therapy and infliximab. […] Etanercept is the only TNF inhibitor with data from a short-term randomized controlled study demonstrating efficacy in suppressing most of the mucocutaneous manifestations of Behet disease.

• #37 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  Central nervous system (CNS) disease is usually treated with systemic corticosteroids, interferon-alfa, azathioprine, cyclophosphamide, methotrexate, and TNF- antagonists. […] Treatment of major-vessel disease with thrombotic events is with systemic anticoagulation in addition to corticosteroids, azathioprine, cyclophosphamide, or cyclosporine. Pulmonary arterial aneurysms are treated with cyclophosphamide and corticosteroids. […] TNF- antagonists are increasingly used and have become standard treatment of Behet disease that is inadequately controlled by standard immunosuppressive regimens. […] Infliximab has been most widely studied, but adalimumab has proved successful in cases refractory to both conventional therapy and infliximab. […] Etanercept is the only TNF inhibitor with data from a short-term randomized controlled study demonstrating efficacy in suppressing most of the mucocutaneous manifestations of Behet disease.

• #38 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  Central nervous system (CNS) disease is usually treated with systemic corticosteroids, interferon-alfa, azathioprine, cyclophosphamide, methotrexate, and TNF- antagonists. […] Treatment of major-vessel disease with thrombotic events is with systemic anticoagulation in addition to corticosteroids, azathioprine, cyclophosphamide, or cyclosporine. Pulmonary arterial aneurysms are treated with cyclophosphamide and corticosteroids. […] TNF- antagonists are increasingly used and have become standard treatment of Behet disease that is inadequately controlled by standard immunosuppressive regimens. […] Infliximab has been most widely studied, but adalimumab has proved successful in cases refractory to both conventional therapy and infliximab. […] Etanercept is the only TNF inhibitor with data from a short-term randomized controlled study demonstrating efficacy in suppressing most of the mucocutaneous manifestations of Behet disease.

• #39 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  Central nervous system (CNS) disease is usually treated with systemic corticosteroids, interferon-alfa, azathioprine, cyclophosphamide, methotrexate, and TNF- antagonists. […] Treatment of major-vessel disease with thrombotic events is with systemic anticoagulation in addition to corticosteroids, azathioprine, cyclophosphamide, or cyclosporine. Pulmonary arterial aneurysms are treated with cyclophosphamide and corticosteroids. […] TNF- antagonists are increasingly used and have become standard treatment of Behet disease that is inadequately controlled by standard immunosuppressive regimens. […] Infliximab has been most widely studied, but adalimumab has proved successful in cases refractory to both conventional therapy and infliximab. […] Etanercept is the only TNF inhibitor with data from a short-term randomized controlled study demonstrating efficacy in suppressing most of the mucocutaneous manifestations of Behet disease.

• #40 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  In a multicenter study of the use of TNF- antagonists (mainly infliximab and adalimumab) for treatment of severe and/or refractory Behet’s disease in 124 patients, clinical response rates with particular organ involvement were as follows: Ocular – 96.3%, Mucocutaneous – 88%, Joint – 70%, GI – 77.8%, CNS – 92.3%, Cardiovascular – 66.7%. […] Infliximab was reported to successfully treat a case of Behet disease in pregnancy. […] Other therapies with data from case reports or small pilot studies include the following, among others: Rituximab, Alemtuzumab, Golimumab. […] An open-label multicenter study compared the efficacy of infliximab versus adalimumab as a firstline treatment in 177 patients with refractory uveitis due to Behet disease. After 1 year of therapy, both treatment groups showed improvement. However, the patients receiving adalimumab had significantly better outcomes in some parameters, including improvement in anterior chamber inflammation, improvement in vitritis, and best-corrected visual acuity.

• #41 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  In a multicenter study of the use of TNF- antagonists (mainly infliximab and adalimumab) for treatment of severe and/or refractory Behet’s disease in 124 patients, clinical response rates with particular organ involvement were as follows: Ocular – 96.3%, Mucocutaneous – 88%, Joint – 70%, GI – 77.8%, CNS – 92.3%, Cardiovascular – 66.7%. […] Infliximab was reported to successfully treat a case of Behet disease in pregnancy. […] Other therapies with data from case reports or small pilot studies include the following, among others: Rituximab, Alemtuzumab, Golimumab. […] An open-label multicenter study compared the efficacy of infliximab versus adalimumab as a firstline treatment in 177 patients with refractory uveitis due to Behet disease. After 1 year of therapy, both treatment groups showed improvement. However, the patients receiving adalimumab had significantly better outcomes in some parameters, including improvement in anterior chamber inflammation, improvement in vitritis, and best-corrected visual acuity.

• #42 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  In a multicenter study of the use of TNF- antagonists (mainly infliximab and adalimumab) for treatment of severe and/or refractory Behet’s disease in 124 patients, clinical response rates with particular organ involvement were as follows: Ocular – 96.3%, Mucocutaneous – 88%, Joint – 70%, GI – 77.8%, CNS – 92.3%, Cardiovascular – 66.7%. […] Infliximab was reported to successfully treat a case of Behet disease in pregnancy. […] Other therapies with data from case reports or small pilot studies include the following, among others: Rituximab, Alemtuzumab, Golimumab. […] An open-label multicenter study compared the efficacy of infliximab versus adalimumab as a firstline treatment in 177 patients with refractory uveitis due to Behet disease. After 1 year of therapy, both treatment groups showed improvement. However, the patients receiving adalimumab had significantly better outcomes in some parameters, including improvement in anterior chamber inflammation, improvement in vitritis, and best-corrected visual acuity.

• #43 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  Apremilast, an oral phosphodiesterase-4 inhibitor initially approved for the treatment of psoriasis and psoriatic arthritis, was approved for treatment of oral ulcers associated with Behet disease in 2019. […] In a phase III trial, patients taking apremilast had significantly fewer oral ulcers than individuals receiving a placebo. However, 79% of those taking apremilast experienced adverse events, which included diarrhea, nausea, headache, and upper respiratory tract infection. […] The role of antiinterleukin-17 in Behet disease is not known. Two small retrospective studies suggest improvement in mucocutaneous and articular symptoms with secukinumab. […] However, paradoxical Behet disease has been associated with interleukin-17 inhibitors.

• #44 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  Apremilast, an oral phosphodiesterase-4 inhibitor initially approved for the treatment of psoriasis and psoriatic arthritis, was approved for treatment of oral ulcers associated with Behet disease in 2019. […] In a phase III trial, patients taking apremilast had significantly fewer oral ulcers than individuals receiving a placebo. However, 79% of those taking apremilast experienced adverse events, which included diarrhea, nausea, headache, and upper respiratory tract infection. […] The role of antiinterleukin-17 in Behet disease is not known. Two small retrospective studies suggest improvement in mucocutaneous and articular symptoms with secukinumab. […] However, paradoxical Behet disease has been associated with interleukin-17 inhibitors.

• #45 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  Apremilast, an oral phosphodiesterase-4 inhibitor initially approved for the treatment of psoriasis and psoriatic arthritis, was approved for treatment of oral ulcers associated with Behet disease in 2019. […] In a phase III trial, patients taking apremilast had significantly fewer oral ulcers than individuals receiving a placebo. However, 79% of those taking apremilast experienced adverse events, which included diarrhea, nausea, headache, and upper respiratory tract infection. […] The role of antiinterleukin-17 in Behet disease is not known. Two small retrospective studies suggest improvement in mucocutaneous and articular symptoms with secukinumab. […] However, paradoxical Behet disease has been associated with interleukin-17 inhibitors.

• #46 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  Apremilast, an oral phosphodiesterase-4 inhibitor initially approved for the treatment of psoriasis and psoriatic arthritis, was approved for treatment of oral ulcers associated with Behet disease in 2019. […] In a phase III trial, patients taking apremilast had significantly fewer oral ulcers than individuals receiving a placebo. However, 79% of those taking apremilast experienced adverse events, which included diarrhea, nausea, headache, and upper respiratory tract infection. […] The role of antiinterleukin-17 in Behet disease is not known. Two small retrospective studies suggest improvement in mucocutaneous and articular symptoms with secukinumab. […] However, paradoxical Behet disease has been associated with interleukin-17 inhibitors.

• #47 Behcet’s Syndrome – Vasculitis UK

  https://www.vasculitis.org.uk/about-vasculitis/behcets-disease

  Lifestyle modifications to reduce stress should be considered as many people report that stress exacerbates Behets. It is often worthwhile checking for and correcting vitamin D deficiency, as vitamin D has many immune-modulating effects and is often at surprisingly low levels in people from Northern Europe. […] For the vast majority of people with Behets, a normal life span is expected. For those with severe eye inflammation, progressive loss of vision was previously a major complication. However, with improving treatments, visual loss is now uncommon. People with purely skin/ulcers/joint disease have a very good prognosis. […] Treatment is based on immunosuppression with agents including steroids, azathioprine, and biologic agents.

• #48 Behcet’s Disease Signs & Symptoms | Rush

  https://www.rush.edu/conditions/behcets-disease

  Behcet’s disease is treatable but not curable. Symptoms may disappear (go into remission) and come back (flare). Your Rush rheumatologist will work with you to develop a personalized plan to reduce your pain, and prevent flares and complications. With effective treatment, flares typically become less frequent. […] Your treatment at Rush might include the following medications: Corticosteroids to reduce pain and inflammation, Immunosuppressive medicine to control the immune system, reduce inflammation and prevent flares, Eye drops for inflammation in the eyes, Topical steroids to treat rashes and other skin symptoms. […] Getting a lot of rest when your symptoms are flaring may help. During periods of remission, moderate exercise, such as swimming or walking, can help prevent flares. […] Behcets disease affects several organ systems. Other specialists may be consulted during your diagnosis, including some of the following: Ophthalmologists to identify and treat complications from eye inflammation, Dermatologists to address mouth or skin lesions, Gynecologists to treat womens genital sores, Urologists to treat mens genital sores, Gastroenterologists to identify and manage digestive problems.

• #49 Behcet’s Syndrome – Vasculitis UK

  https://www.vasculitis.org.uk/about-vasculitis/behcets-disease

  Lifestyle modifications to reduce stress should be considered as many people report that stress exacerbates Behets. It is often worthwhile checking for and correcting vitamin D deficiency, as vitamin D has many immune-modulating effects and is often at surprisingly low levels in people from Northern Europe. […] For the vast majority of people with Behets, a normal life span is expected. For those with severe eye inflammation, progressive loss of vision was previously a major complication. However, with improving treatments, visual loss is now uncommon. People with purely skin/ulcers/joint disease have a very good prognosis. […] Treatment is based on immunosuppression with agents including steroids, azathioprine, and biologic agents.

• #50 Behcet’s Syndrome – Vasculitis UK

  https://www.vasculitis.org.uk/about-vasculitis/behcets-disease

  Lifestyle modifications to reduce stress should be considered as many people report that stress exacerbates Behets. It is often worthwhile checking for and correcting vitamin D deficiency, as vitamin D has many immune-modulating effects and is often at surprisingly low levels in people from Northern Europe. […] For the vast majority of people with Behets, a normal life span is expected. For those with severe eye inflammation, progressive loss of vision was previously a major complication. However, with improving treatments, visual loss is now uncommon. People with purely skin/ulcers/joint disease have a very good prognosis. […] Treatment is based on immunosuppression with agents including steroids, azathioprine, and biologic agents.

• #51 Behcet’s Syndrome – Vasculitis UK

  https://www.vasculitis.org.uk/about-vasculitis/behcets-disease

  Lifestyle modifications to reduce stress should be considered as many people report that stress exacerbates Behets. It is often worthwhile checking for and correcting vitamin D deficiency, as vitamin D has many immune-modulating effects and is often at surprisingly low levels in people from Northern Europe. […] For the vast majority of people with Behets, a normal life span is expected. For those with severe eye inflammation, progressive loss of vision was previously a major complication. However, with improving treatments, visual loss is now uncommon. People with purely skin/ulcers/joint disease have a very good prognosis. […] Treatment is based on immunosuppression with agents including steroids, azathioprine, and biologic agents.

• #52 Advances in the Treatment of Behcet’s Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8136102/

  Most mild forms of major organ involvement are sufficiently controlled by conventional ISs (cISs) such as GCs, azathioprine, cyclosporine A, and mycophenolate mofetil (MMF). […] Although randomized-controlled trials (RCT) are lacking, many biologic agents targeting proinflammatory cytokines, such tumor necrosis factor alpha (TNF), IL-1, IL-6, IL-12, and IL-17 licensed for other rheumatological disorders, became part of the treatment choices in BD. […] A recent controversial issue of biologic use is the optimization of advanced therapies in BD before discontinuation. […] Recently, biosimilars are also used in BD patients. […] Our expert-opinion approach to the management of different organ manifestations in BD is summarized in Table 2. […] Behcets disease usually starts with mucocutaneous manifestations which have a limited impact on vital organ functions and general quality of life (QoL).

• #53 Behcet Disease Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/329099-treatment

  The goals of therapy in Behet disease are to suppress inflammation and reduce the frequency and severity of recurrences. To be effective, treatment must be started early. The sites and extent of involvement and the severity of disease determine the choice of medication. […] The treatment approach depends on the individual patient, severity of disease, and major organ involvement. The European League Against Rheumatism (EULAR) recommendations for the management of Behet disease, which were developed in 2008 and updated in 2018, aid in the management of different aspects of Behet disease. […] As disease activity subsides, taper medications to the lowest dose that effectively controls disease activity. Inpatient care is based on individual organ-system involvement. Individualize the transfer situation for each patient based on the specifics of organ-system involvement.

• #54 French recommendations for the management of Behçet’s disease | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-020-01620-4

  The use of anticoagulants in treating vascular involvement is disputed but remains recommended; inflammation of the vascular walls is the main cause of Behets disease-related thrombosis. […] In its serious and/or complicated forms, Behets disease is categorized as a life-long disorder, with waiver of co-pay (care at 100%). […] Therapeutic education is indispensable to optimize the care and compliance of the patient with the therapeutic project. […] Colchicine is the first-line treatment of mucocutaneous and articular manifestations. […] Reduction (or cessation) of immunosuppressant or immunomodulating treatment can be considered, except in exceptional cases, only after at least 2 years of remission within the framework of severe Behets disease (ophthalmological, digestive, neurological, cardiovascular, and pulmonary damage).

• #55 Behçet’s Disease, Pathogenesis, Clinical Features, and Treatment Approaches: A Comprehensive Review

  https://www.mdpi.com/1648-9144/60/4/562

  Regular follow-ups are essential to track the course of the disease and the effectiveness of treatment, in addition to pharmacological interventions. For the best treatment of Behçet’s illness, rheumatologists, dermatologists, ophthalmologists, and other specialists must work together in multidisciplinary care.

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