IL-17 Inhibitor Associated With Treatment Response in Refractory Behçet Disease

Secukinumab (Cosentyx) was found to be an effective treatment option for patients with a refractory mucosal and articular phenotype of Behçet syndrome in a recent retrospective study.

The multicenter retrospective study included 15 participants with a mucosal and articular phenotype of Behçet syndrome who fulfilled the International Criteria for Behçet Disease and refractory to treatment with colchicine, disease-modifying antirheumatic drugs, and at least 1 anti-tumor necrosis factor-α agent. Six participants with polyarticular involvement were treated with 300 mg of secukinumab per month, and 9 received 150 mg per month. Participants were followed for a minimum of 6 months.

In addition, the researchers allowed a dose increase from 150 to 300 mg per month and shortening of administration frequency for poor disease control. The researchers based their evaluation of treatment response on the number of oral ulcers in the previous 28 days and Disease Activity Score-28 for articular manifestations.
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After 3 months of follow-up, 9 participants (66.7%) had achieved either a complete or partial response, the researchers wrote. They found the proportion of participants achieving a response had increased further to 86.7% at 6 months, 76.9% at 12 months, 90% at 18 months, and 100% at 24 months.

In addition, the researchers found all participants who started secukinumab at 300 mg per month had achieved complete response by month 6, and 7 participants (46.7%) could only achieve a response after switching to a higher dosage.

“Our study suggests that secukinumab at a dose of 150 and 300 mg per month is safe and effective for the long-term treatment of patients with Behçet’s syndrome with a mucosal and articular phenotype refractory to previous treatments,” the researchers concluded. “Notably, secukinumab 300 mg/month resulted in superior complete mucosal and articular responses with no serious or dose-related adverse effects.”

Reference

Fagni F, Bettiol A, Talarico R, et al. Long-term effectiveness and safety of secukinumab for treatment of refractory mucosal and articular Behçet's phenotype: a multicentre study [published online ahead of print May 7, 2020]. Ann Rheum Dis. doi:10.1136/annrheumdis-2020-217108