Abstract
Behçet's disease (BD) is a multi-systemic disorder of unknown etiology characterized by relapsing oral-genital ulcers, uveitis, and involvement of the articular, gastrointestinal, neurologic, and vascular systems. Although the primum movens of this condition remains unknown, a tangled plot combining autoimmune and autoinflammatory pathways has been hypothesized to explain its start and recurrence. In-depth analysis of BD pathogenetic mechanisms, involving dysfunction of multiple proinflammatory molecules, has opened new modalities of treatment: different agents targeting interleukin-1 have been studied in recent years to manage the most difficult and multi-resistant cases of BD. Growing experience with anakinra, canakinumab and gevokizumab is discussed in this review, highlighting the relative efficacy of each drug upon the protean BD clinical manifestations. Safety and tolerability of interleukin-1 antagonists in different doses have been confirmed by numerous observational studies on both large and small cohorts of patients with BD. In particular, the potential for Mycobacterium tuberculosis reactivation and tuberculosis development appears to be significantly lower with interleukin-1 blockers compared to tumor necrosis factor-α inhibitors, thus increasing the beneficial profile of this approach.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1-9 |
| Number of pages | 9 |
| Journal | Autoimmunity Reviews |
| Volume | 14 |
| Issue number | 1 |
| DOIs | |
| State | Published - 2015 |
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Keywords
- Anakinra
- Behçet's disease
- Canakinumab
- Gevokizumab
- Interleukin-1
- Tuberculosis
ASJC Scopus subject areas
- Immunology
- Immunology and Allergy
- Medicine(all)
Cite this
Effectiveness and tuberculosis-related safety profile of interleukin-1 blocking agents in the management of Behçet's disease. / Cantarini, Luca; Lopalco, Giuseppe; Caso, Francesco; Costa, Luisa; Iannone, Florenzo; Lapadula, Giovanni; Anelli, Maria Grazia; Franceschini, Rossella; Menicacci, Cristina; Galeazzi, Mauro; Selmi, Carlo; Rigante, Donato.
In: Autoimmunity Reviews, Vol. 14, No. 1, 2015, p. 1-9.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Effectiveness and tuberculosis-related safety profile of interleukin-1 blocking agents in the management of Behçet's disease
AU - Cantarini, Luca
AU - Lopalco, Giuseppe
AU - Caso, Francesco
AU - Costa, Luisa
AU - Iannone, Florenzo
AU - Lapadula, Giovanni
AU - Anelli, Maria Grazia
AU - Franceschini, Rossella
AU - Menicacci, Cristina
AU - Galeazzi, Mauro
AU - Selmi, Carlo
AU - Rigante, Donato
PY - 2015
Y1 - 2015
N2 - Behçet's disease (BD) is a multi-systemic disorder of unknown etiology characterized by relapsing oral-genital ulcers, uveitis, and involvement of the articular, gastrointestinal, neurologic, and vascular systems. Although the primum movens of this condition remains unknown, a tangled plot combining autoimmune and autoinflammatory pathways has been hypothesized to explain its start and recurrence. In-depth analysis of BD pathogenetic mechanisms, involving dysfunction of multiple proinflammatory molecules, has opened new modalities of treatment: different agents targeting interleukin-1 have been studied in recent years to manage the most difficult and multi-resistant cases of BD. Growing experience with anakinra, canakinumab and gevokizumab is discussed in this review, highlighting the relative efficacy of each drug upon the protean BD clinical manifestations. Safety and tolerability of interleukin-1 antagonists in different doses have been confirmed by numerous observational studies on both large and small cohorts of patients with BD. In particular, the potential for Mycobacterium tuberculosis reactivation and tuberculosis development appears to be significantly lower with interleukin-1 blockers compared to tumor necrosis factor-α inhibitors, thus increasing the beneficial profile of this approach.
AB - Behçet's disease (BD) is a multi-systemic disorder of unknown etiology characterized by relapsing oral-genital ulcers, uveitis, and involvement of the articular, gastrointestinal, neurologic, and vascular systems. Although the primum movens of this condition remains unknown, a tangled plot combining autoimmune and autoinflammatory pathways has been hypothesized to explain its start and recurrence. In-depth analysis of BD pathogenetic mechanisms, involving dysfunction of multiple proinflammatory molecules, has opened new modalities of treatment: different agents targeting interleukin-1 have been studied in recent years to manage the most difficult and multi-resistant cases of BD. Growing experience with anakinra, canakinumab and gevokizumab is discussed in this review, highlighting the relative efficacy of each drug upon the protean BD clinical manifestations. Safety and tolerability of interleukin-1 antagonists in different doses have been confirmed by numerous observational studies on both large and small cohorts of patients with BD. In particular, the potential for Mycobacterium tuberculosis reactivation and tuberculosis development appears to be significantly lower with interleukin-1 blockers compared to tumor necrosis factor-α inhibitors, thus increasing the beneficial profile of this approach.
KW - Anakinra
KW - Behçet's disease
KW - Canakinumab
KW - Gevokizumab
KW - Interleukin-1
KW - Tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=84924272779&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924272779&partnerID=8YFLogxK
U2 - 10.1016/j.autrev.2014.08.008
DO - 10.1016/j.autrev.2014.08.008
M3 - Article
C2 - 25151975
AN - SCOPUS:84924272779
VL - 14
SP - 1
EP - 9
JO - Autoimmunity Reviews
JF - Autoimmunity Reviews
SN - 1568-9972
IS - 1
ER -