Resumen de Anti-TNF switching for treatment of neuro-Behçet's disease
Juan Manuel Rodríguez Camacho, Francesc Company Bezares, Juan González Moreno
Adalimumab and infliximab are anti-TNF drugs which have been used off-label for the treatment of refractory neuro-Behçet's disease. We present the case of a 48-year-old woman with a diagnosis of neuro-Behçet's disease who started treatment with classical immunosuppressants. Because of progressive clinical worsening of the disease and the onset of Cushing's syndrome associated with the long-term use of corticosteroids, treatment with infliximab was initiated. However, given the poor clinical outcome after six cycles of treatment with infliximab, switching to adalimumab was attempted. After one year of treatment with adalimumab, clinical improvement and radiological stability of the illness were achieved. The dose of corticosteroids was significantly decreased and no hospital admissions or intravenous treatment were required to control the exacerbations of the disease. In conclusion, this case shows that adalimumab can be considered as a possible alternative for the treatment of Behçet's disease with neurological manifestations after failure of infliximab
