J Rheum Dis.  2012 Dec;19(6):355-358. 10.4078/jrd.2012.19.6.355.

Switching to Etanercept in Intestinal Behcet's Disease Complicated by Secondary Non-response to Anti-TNF-alpha Antibodies

• Lee S
• Kim TO
• Park CS
• Kim HK
• Kim SH

• KMID: 2223064
• DOI: http://doi.org/10.4078/jrd.2012.19.6.355

Abstract

The efficacy of anti-TNF-alpha antibodies including infliximab and adalimumab for refractory intestinal Behcet's disease has recently been demonstrated in a series of case reports. The efficacy of switching to a different kind of anti-TNF-alpha agent in the face of refractoriness to one kind of anti-TNF-alpha agent, a common practice of proven efficacy in rheumatoid arthritis, has yet not been reported for intestinal Behcet's disease. In the present study, we report a case of 52-year-old female patient with intestinal Behcet's disease, who lost initial good response to infliximab, and was refractory to subsequent administrations of adalimumab. Her recent relapse of intestinal lesions could be successfully treated with etanercept. This case suggests that switching to etanercept might be a reasonable therapeutic option in case of intestinal Behcet's disease with secondary non-response to anti-TNF-alpha antibodies that is most likely to be mediated by anti-drug antibody.

Keyword

Behcet's disease; Intestinal; Etanercept

MeSH Terms

Antibodies
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Arthritis, Rheumatoid
Female
Humans
Immunoglobulin G
Receptors, Tumor Necrosis Factor
Recurrence
Adalimumab
Infliximab
Etanercept
Antibodies
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Immunoglobulin G
Receptors, Tumor Necrosis Factor

Figure

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  Figure 1 (A, B) Findings on colonofiberscopy before the administration of etanercept. The presence of ulcer with mucosal edema narrowing the lumen of terminal ileum. (C, D) Three months after starting the treatment with etanercept. Complete resolution of previously seen lesions can be seen.

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