Successful combination therapy using adalimumab and 5-aminosalicylic acid for a resistant case of intestinal Behçet's disease.

Abstract:

:Behçet's disease (BD) is a recurrent, multisystemic, inflammatory blood vessel disorder that can result in mouth, genital, and skin ulcers; arthritis; and eye and intestinal inflammation. We describe a 21-year-old Korean female patient with intestinal BD refractory to conventional medical treatment and biologic drugs. The patient was initially treated with high-dose steroids and sulfasalazine. Two months later, a skin rash occurred as a side effect of sulfasalazine. Therefore, infliximab (IFX) was administered, and disease activity decreased. However, IFX also induced a skin rash; hence, the patient was switched to adalimumab. After 12 months, the patient experienced a relapse of intestinal BD. Hence, treatment was initiated using a combination of methotrexate and adalimumab; however, this treatment was ineffective. Methotrexate was discontinued and replaced with 5‑aminosalicylic acid while maintaining adalimumab, and no recurrence has been observed to date. We report this novel strategy involving the use of anti-tumor necrosis factor‑α agents for patients with resistant BD; however, further large cohort studies are required to verify its usefulness.

journal_name

Z Rheumatol

authors

Kim HJ,Kim KT,Lee SG,Kim Y

doi

10.1007/s00393-020-00816-0

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

702-706

issue

7

eissn

0340-1855

issn

1435-1250

pii

10.1007/s00393-020-00816-0

journal_volume

79

pub_type

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