{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:39:50Z","timestamp":1788316790670,"version":"build-2803163510"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Musculoskeletal"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to investigate the efficacy and safety of tocilizumab (TCZ) in severe and refractory parenchymal neuro-Beh\u00e7et\u2019s syndrome (p-NBS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively analyzed five patients with p-NBS treated with TCZ in our center between 2013 and 2020, and six cases from literature research with the index terms \u201cneuro-Beh\u00e7et\u2019s syndrome\u201d and \u201ctocilizumab\u201d on PubMed NCBI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 11 patients with p-NBS were enrolled (5 males, 6 females), with a mean age of 34.5\u2009\u00b1\u20098.0\u2009years at the onset. All the patients had parenchymal neurological lesions, six patients (54.5%) suffered from multiple lesions, and nine patients (81.8%) were disabled. Before TCZ administration, all the patients had failed conventional therapy, eight patients (72.7%) received two or more immunosuppressants, and five patients showed insufficient response or intolerance to other biologics. TCZ was administrated at 8\u2009mg\/kg every 4\u2009weeks, with background glucocorticoids (GCs) and immunosuppressants. After a median follow-up of 13 (interquartile range, 3.5\u201323.5) months, all the patients achieved both clinical and radiological improvements, and the Beh\u00e7et\u2019s Disease Current Activity Form score improved significantly (3 versus 0, median, p\u2009=\u20090.004), the Rankin score also decreased (4 versus 2, median, p\u2009=\u20090.005). Levels of interleukin-6 in the cerebrospinal fluid decreased significantly in five patients (533.4\u2009\u00b1\u2009389.7\u2009pg\/ml versus 34.5\u2009\u00b1\u200927.1\u2009pg\/ml, p\u2009=\u20090.048), after a median of two (interquartile range, 1\u20134) times of TCZ infusions. Furthermore, the GC dosage ( per os) reduced from 69.2\u2009\u00b1\u200916.9\u2009mg\/d to 16.4\u2009\u00b1\u200916.2\u2009mg\/d ( p\u2009=\u20090.000), and immunosuppressants were tapered in number and dosage in seven (63.6%) and four (36.3%) patients, respectively. No serious adverse events or deaths were observed during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>TCZ is well tolerated and effective in severe and refractory p-NBS, with a favorable GC- and immunosuppressant-sparing effect. Cerebrospinal fluid interleukin-6 might be used to monitor the effects of TCZ in p-NBS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1759720x20971908","type":"journal-article","created":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T01:05:52Z","timestamp":1605575152000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Tocilizumab in the treatment of severe and refractory parenchymal neuro-Beh\u00e7et\u2019s syndrome: case series and literature review"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2150-7540","authenticated-orcid":false,"given":"Jinjing","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Rheumatology, Ministry of Education, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, The Second Affiliated Hospital of Soochow University, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhimian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Rheumatology, Ministry of Education, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunjiao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Rheumatology, Ministry of Education, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shangzhu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Rheumatology, Ministry of Education, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Rheumatology, Ministry of Education, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingyi","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Rheumatology, Ministry of Education, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhichun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, The Second Affiliated Hospital of Soochow University, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Rheumatology, Ministry of Education, National Clinical Research Center for Dermatologic and Immunologic Diseases, No. 1 Shuafuyuan, Dongcheng District, Beijing, 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,11,16]]},"reference":[{"key":"bibr1-1759720X20971908","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2020.102421"},{"key":"bibr2-1759720X20971908","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2015.01.005"},{"key":"bibr3-1759720X20971908","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-200301000-00006"},{"key":"bibr4-1759720X20971908","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2019.101906"},{"key":"bibr5-1759720X20971908","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/122.11.2171"},{"key":"bibr6-1759720X20971908","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70015-8"},{"key":"bibr7-1759720X20971908","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-013-7209-3"},{"key":"bibr8-1759720X20971908","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-018-0843-5"},{"key":"bibr9-1759720X20971908","first-page":"808","volume":"77","author":"Hatemi 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