Successful treatment of genital ulcers with infliximab in Behçet’s disease

Recently, preliminary results from a double blind, placebo controlled study were presented on the effect of etanercept, another TNF blocking drug, on mucocutaneous manifestations in Behcet's disease. 7 In this 4 week study eight (40%) of the 20 etanercept treated patients achieved clinical remission of mucocutaneous manifestations compared with one (5%) patient in the 20 placebo treated patients. 7 Interestingly, in the case by Estrach et al, 3 the orogenital ulcerations in a patient with Behcet's disease responded dramatically to treatment with infliximab after failure of etanercept. The experience so far with TNFα blocking treatment in Behcet's disease is scarce as recently reviewed by Sfikakis. 8 So far, significant side effects with the use of TNFα blocking drugs in Behcet's disease have not been reported. 8 Further clinical studies, especially double blind, randomised controlled trials designed with sufficient power are warranted before final conclusions can be drawn about the efficacy of treatment with TNFα blocking agents compared with conventional immunosuppressive agents.