{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:39:49Z","timestamp":1788316789403,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,1,24]],"date-time":"2020-01-24T00:00:00Z","timestamp":1579824000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Vascular involvement is one of the major causes of morbidity and mortality in Beh\u00e7et's disease (BD) patients. Immunosuppressive (IS) agents are the mainstay of vascular BD (VBD) treatment; however, up to one\u2010third of patients relapse under conventional ISs. In this case series, we present the results of tumor necrosis factor\u2010alpha (TNF\u03b1) inhibitor use for the treatment of VBD patients who were refractory to conventional ISs and corticosteroids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective multicenter study included 27 refractory VBD patients treated with TNF\u03b1 inhibitor agents. All data were acquired from patient charts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Complete clinical remission was achieved in 22 (80%) patients within 3\u00a0months of the initiation of TNF\u03b1 inhibitors. Infliximab was the first choice of TNF\u03b1 inhibitor in 24 and adalimumab in three patients. The median daily dose of corticosteroids significantly decreased at 3\u00a0months. A trend toward a higher rate of complete remission was observed with concomitant IS use compared to monotherapy of TNF\u03b1 inhibitors (93% vs 67%,\n                      <jats:italic>P<\/jats:italic>\n                      = .09). Serious side effects were observed in two patients (one pneumonia and one tuberculosis).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tumor necrosis factor\u2010alpha inhibitors seem a highly effective option for remission\u2010induction of refractory VBD with an acceptable safety data. Concomitant IS use may achieve higher complete remission rates as compared to TNF\u03b1 inhibitor monotherapy. Comparative efficacy and safety of biological agents for VBD require further prospective, randomized controlled studies with a longer duration of follow\u2010up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.13778","type":"journal-article","created":{"date-parts":[[2020,1,24]],"date-time":"2020-01-24T05:57:03Z","timestamp":1579845423000},"page":"256-261","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Efficacy of TNF\u03b1 inhibitors for refractory vascular Beh\u00e7et's disease: A multicenter observational study of 27 patients and a review of the literature"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8218-7109","authenticated-orcid":false,"given":"Aysun","family":"Aksoy","sequence":"first","affiliation":[{"name":"Division of Rheumatology Department of Internal Medicine School of Medicine Marmara University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2167-4509","authenticated-orcid":false,"given":"Ayten","family":"Yazici","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Internal Medicine School of Medicine Kocaeli University Kocaeli Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Omma","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Ankara Numune Training and Research Hospital Health Sciences University Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayse","family":"Cefle","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Internal Medicine School of Medicine Kocaeli University Kocaeli Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatos","family":"Onen","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Internal Medicine School of Medicine Dokuz Eylul University Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Unal","family":"Tasdemir","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Internal Medicine School of Medicine Dokuz Eylul University Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tulin","family":"Ergun","sequence":"additional","affiliation":[{"name":"Department of Dermatology School of Medicine Marmara University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2598-5806","authenticated-orcid":false,"given":"Haner","family":"Direskeneli","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Internal Medicine School of Medicine Marmara University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6653-1758","authenticated-orcid":false,"given":"Fatma","family":"Alibaz\u2010Oner","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Internal Medicine School of Medicine Marmara University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.37715"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu233"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199910213411707"},{"issue":"6","key":"e_1_2_6_5_1","first-page":"808","article-title":"2018 update of the EULAR recommendations for the management of Behcet's syndrome","volume":"77","author":"Hatemi G","year":"2018","journal-title":"Ann Rheum Dis"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34450"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000494"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/14712598.2017.1328496"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2018.08.004"},{"issue":"8697","key":"e_1_2_6_10_1","first-page":"1078","article-title":"Criteria for diagnosis of Beh\u00e7et's disease. 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