The Effectiveness of the Anti-tumor Necrosis Factor Therapy Infliximab in Neuro-Behçet's Disease: a Systematic Review and Meta-analysis

Overview

Journal J Int Med Res

Publisher Sage Publications

Specialty General Medicine

Date 2023 May 19

PMID 37203384

Authors

Reem Hamdy A Mohammed

Yohannes W Woldeamanuel

Affiliations

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Abstract

Objective: To study the effectiveness of infliximab for the treatment of refractory central neuro-Behçet's disease.

Methods: In this systematic review and meta-analysis, the research question was designed using the 'Population, Intervention, Comparator, and Outcomes' (PICO) model and the search methodology was developed according to the PRISMA statement. The study was registered on PROSPERO. Web of Science, PubMed, and Cochrane Library databases were searched for articles published in English between January 2000 and January 2020. Data were analysed using Meta-Essentials software, version 10.12. Treatment effect size was determined by a random effects model. Interstudy heterogeneity was explored using I statistics. Cumulative meta-analysis was conducted to assess the temporal trend for accumulating evidence.

Results: Twenty-one studies, comprising 64 patients (mean age, 38 .21 years and mean disease duration, 84.76 months) were included. Effect-size analysis showed that 93.7% of the treated patients in the analysis were responders to infliximab therapy (95% confidence interval 0.88, 0.993). There was no significant inter-study heterogeneity (I = 0%). Cumulative analysis showed accumulating evidence favoring increasing effectiveness over the last 20 years.

Conclusion: Infliximab showed considerable therapeutic effectiveness in the treatment of refractory neuro-Behçet's disease.

Citing Articles

Real-World Safety and Effectiveness of Infliximab in 255 Patients with Intestinal, Neurological, and Vascular Behçet's Disease: A Post-Marketing Surveillance.

Hibi T, Hirohata S, Hisamatsu T, Kikuchi H, Takeno M, Sato N Adv Ther. 2024; 41(12):4476-4497.

PMID: 39412631 PMC: 11550226. DOI: 10.1007/s12325-024-02993-9.

Long-term outcomes of infliximab treatment in neuro-Behcet syndrome: A single-center retrospective study.

Rabia K, Gizem G, Furkan S, Sanja G, Nihan C, Yavuz P Clin Rheumatol. 2024; 43(10):3213-3221.

PMID: 39182213 DOI: 10.1007/s10067-024-07118-9.

References

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009; 151(4):264-9, W64. DOI: 10.7326/0003-4819-151-4-200908180-00135. View

Baresic M, Reihl M, Habek M, Vukojevic N, Anic B . Improvement of neurological and ocular symptoms of Behçet's disease after the introduction of infliximab. Rheumatol Int. 2018; 38(7):1301-1306. DOI: 10.1007/s00296-018-4054-9. View

Ohno S, Ohguchi M, Hirose S, Matsuda H, Wakisaka A, Aizawa M . Close association of HLA-Bw51 with Behçet's disease. Arch Ophthalmol. 1982; 100(9):1455-8. DOI: 10.1001/archopht.1982.01030040433013. View

Schardt C, Adams M, Owens T, Keitz S, Fontelo P . Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak. 2007; 7:16. PMC: 1904193. DOI: 10.1186/1472-6947-7-16. View

Matsui T, Ishida T, Tono T, Yoshida T, Sato S, Hirohata S . An attack of acute neuro-Behçet's disease during the course of chronic progressive neuro-Behçet's disease: report of two cases. Mod Rheumatol. 2010; 20(6):621-6. DOI: 10.1007/s10165-010-0332-4. View

Hibi T, Hirohata S, Kikuchi H, Tateishi U, Sato N, Ozaki K . Infliximab therapy for intestinal, neurological, and vascular involvement in Behcet disease: Efficacy, safety, and pharmacokinetics in a multicenter, prospective, open-label, single-arm phase 3 study. Medicine (Baltimore). 2016; 95(24):e3863. PMC: 4998455. DOI: 10.1097/MD.0000000000003863. View

Ribi C, Sztajzel R, Delavelle J, Chizzolini C . Efficacy of TNF {alpha} blockade in cyclophosphamide resistant neuro-Behçet disease. J Neurol Neurosurg Psychiatry. 2005; 76(12):1733-5. PMC: 1739470. DOI: 10.1136/jnnp.2004.055434. View

Hatemi G, Silman A, Bang D, Bodaghi B, Chamberlain A, Gul A . EULAR recommendations for the management of Behçet disease. Ann Rheum Dis. 2008; 67(12):1656-62. DOI: 10.1136/ard.2007.080432. View

Uygunoglu U, Pasha M, Saip S, Siva A . Recurrent longitudinal extensive transverse myelitis in a neuro-Behçet syndrome treated with infliximab. J Spinal Cord Med. 2014; 38(1):111-4. PMC: 4293525. DOI: 10.1179/2045772314Y.0000000209. View

10.

Akman-Demir G, Saip S, Siva A . Behçet's Disease. Curr Treat Options Neurol. 2011; 13(3):290-310. DOI: 10.1007/s11940-011-0120-2. View

11.

Yazici H . Behçet's syndrome: an update. Curr Rheumatol Rep. 2003; 5(3):195-9. DOI: 10.1007/s11926-003-0066-9. View

12.

Abalos-Medina G, Sanchez-Cano D, Ruiz-Villaverde G, Ruiz-Villaverde R, Quirosa Flores S, Raya Alvarez E . Successful use of infliximab in a patient with neuro-Behçet's disease. Int J Rheum Dis. 2010; 12(3):264-6. DOI: 10.1111/j.1756-185X.2009.01420.x. View

13.

Coulter I, Huda S, Baborie A, Jacob A . Longitudinally extensive transverse myelitis as the sole presentation of neuro-Behçet's disease responding to infliximab. J Spinal Cord Med. 2012; 35(2):122-4. PMC: 3304557. DOI: 10.1179/2045772311Y.0000000050. View

14.

Kuroda R, Suzuki J, Muramatsu M, Tasaki A, Yano M, Imai N . Efficacy of infliximab in neuro-Behçet's disease presenting with isolated longitudinally extensive transverse myelitis. J Neurol. 2013; 260(12):3167-70. PMC: 3843365. DOI: 10.1007/s00415-013-7150-5. View

15.

Desbois A, Addimanda O, Bertrand A, Deroux A, Perard L, Depaz R . Efficacy of Anti-TNFα in Severe and Refractory Neuro-Behcet Disease: An Observational Study. Medicine (Baltimore). 2016; 95(23):e3550. PMC: 4907644. DOI: 10.1097/MD.0000000000003550. View

16.

Kanemaru H, Makino T, Jinnin M, Yonemitsu A, Makino K, Ihn H . Case of neuro-Behçet's disease successfully maintained a remission using infliximab for 2 years. J Dermatol. 2013; 40(8):632-4. DOI: 10.1111/1346-8138.12203. View

17.

Sterne J, Hernan M, Reeves B, Savovic J, Berkman N, Viswanathan M . ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016; 355:i4919. PMC: 5062054. DOI: 10.1136/bmj.i4919. View

18.

Kalra S, Silman A, Akman-Demir G, Bohlega S, Borhani-Haghighi A, Constantinescu C . Diagnosis and management of Neuro-Behçet's disease: international consensus recommendations. J Neurol. 2013; 261(9):1662-76. PMC: 4155170. DOI: 10.1007/s00415-013-7209-3. View

19.

Uygunoglu U, Siva A . Behçet's Syndrome and Nervous System Involvement. Curr Neurol Neurosci Rep. 2018; 18(7):35. DOI: 10.1007/s11910-018-0843-5. View

20.

Pipitone N, Olivieri I, Padula A, DAngelo S, Nigro A, Zuccoli G . Infliximab for the treatment of Neuro-Behçet's disease: a case series and review of the literature. Arthritis Rheum. 2008; 59(2):285-90. DOI: 10.1002/art.23345. View