{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T03:39:03Z","timestamp":1791085143783,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T00:00:00Z","timestamp":1510099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To test the hypothesis that remission of Beh\u00e7et's disease (<jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>) in patients with severe vital organ involvement is maintained after withdrawal of successful anti\u2013tumor necrosis factor (anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>) treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single\u2010center, retrospective, longitudinal outcomes study focused on consecutive patients with disease refractory to treatment with conventional immunosuppressant agents who responded to add\u2010on long\u2010term anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> treatment that was subsequently discontinued. The end point was the proportion of patients remaining in complete remission for at least 3 years after withdrawal of anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In our <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> cohort comprising 87 patients, 29 were eligible for analysis. All of these patients had disease that was refractory to conventional immunosuppressive therapy and had received successful anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> treatment for a median of 2 years (interquartile range [<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>] 1.1\u20132.0) before treatment discontinuation. Of these patients, 12 (41%) achieved the study end point. The remaining 17 patients experienced a relapse within 1 year (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content> 0.6\u20131.5) after discontinuation. Re\u2010treatment with anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> was safe and effective in 14 (82%) of 17 patients; so far, 4 of these patients also achieved the study end point. Overall, 16 patients have remained in complete remission (median 6.5 years [<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content> 5.5\u20138]). Ten of these patients are in drug\u2010free remission (treated with anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> agents, mainly for sight\u2010threatening disease), and 6 are in azathioprine\u2010maintained remission (treated with anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> agents for ocular, intestinal, or central nervous system involvement). Notably, patients in drug\u2010free remission were significantly younger and had a significantly shorter duration of <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> when anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> treatment was initiated compared to patients receiving azathioprine maintenance treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Drug\u2010free, long\u2010term remission after withdrawal of successful anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> treatment is feasible in patients with severe <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>. Because an anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> agent\u2013induced \u201ccure\u201d cannot be differentiated from spontaneous remission by natural history, prospective studies should examine whether anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> agents should be used as first\u2010line treatment for the induction of remission in every patient with vital organ involvement.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40235","type":"journal-article","created":{"date-parts":[[2017,8,22]],"date-time":"2017-08-22T17:42:38Z","timestamp":1503423758000},"page":"2380-2385","source":"Crossref","is-referenced-by-count":34,"title":["Brief Report: Drug\u2010Free Long\u2010Term Remission in Severe Beh\u00e7et's Disease Following Withdrawal of Successful Anti\u2013Tumor Necrosis Factor Treatment"],"prefix":"10.1002","volume":"69","author":[{"given":"Petros P.","family":"Sfikakis","sequence":"first","affiliation":[{"name":"National and Kapodistrian University of Athens Medical School Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Arida","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens Medical School Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stylianos","family":"Panopoulos","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens Medical School Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalliopi","family":"Fragiadaki","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens Medical School Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Pentazos","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens Medical School Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Laskari","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens Medical School Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Tektonidou","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens Medical School Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikos","family":"Markomichelakis","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens Medical School Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2013.02.010"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27568"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.080432"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kem034"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2010.09.002"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2014.04.042"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2015.06.005"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003863"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2016-000323"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.569"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27581"},{"key":"e_1_2_6_13_1","first-page":"1078","article-title":"Criteria for diagnosis of Beh\u00e7et's disease","volume":"335","author":"International Study Group for Beh\u00e7et's Disease","year":"1990","journal-title":"Lancet"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21233"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)05497-6"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000258"}],"container-title":["Arthritis &amp; 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