Objectives Treatment response may be variable across organ manifestations of Behçet syndrome (BS). We aimed to determine the frequency of de novo manifestations during adalimumab treatment. Methods We conducted a chart review of all BS patients who received adalimumab in our center between 2008 and 2023. Demographic data, reasons for initiating adalimumab, concurrent medications, previous treatments, and outcomes were recorded. We defined de novo manifestations as new BS manifestations that occurred for the first time during treatment with adalimumab. For patients with vascular involvement, a new vascular event at another vessel was also considered as a de novo manifestation. Results Among the 335 patients, a de novo manifestation developed in 14 (4%) patients. De novo manifestations were vascular involvement in 5 patients, arthritis in 3, anterior uveitis in 2, nervous system involvement in 2, gastrointestinal involvement in 1, and epididymitis in 1 patient. The primary reasons for adalimumab treatment were vascular involvement in 5 patients, uveitis in 4, arthritis in 3, mucocutaneous involvement in 1, and epididymitis in 1 patient. Upon the development of de novo manifestation, adalimumab was switched to another biologic in 4 patients, dose was intensified in 3, colchicine, conventional immunosuppressives, and/or glucocorticoids were added in 5, and topical eye drops were added in 2 patients, leading to remission of de novo manifestations in all patients. Conclusion De novo manifestations were infrequent (4%) among BS patients treated with adalimumab. Of these, 57% were major organ involvement, mainly vascular involvement. None of the patients developed posterior uveitis.

中文翻译：

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阿达木单抗治疗白塞氏综合征期间的新发表现


目标 Behçet 综合征 (BS) 的不同器官表现的治疗反应可能有所不同。我们的目的是确定阿达木单抗治疗期间新发症状的频率。方法 我们对 2008 年至 2023 年间在我们中心接受阿达木单抗治疗的所有 BS 患者进行了图表回顾。记录了人口统计数据、开始使用阿达木单抗的原因、同时用药、既往治疗和结果。我们将新发表现定义为阿达木单抗治疗期间首次出现的新的 BS 表现。对于血管受累的患者，另一条血管的新血管事件也被认为是新生表现。结果 在 335 名患者中，14 名 (4%) 患者出现新发症状。初发表现为血管受累 5 例，关节炎 3 例，前葡萄膜炎 2 例，神经系统受累 2 例，胃肠道受累 1 例，附睾炎 1 例。接受阿达木单抗治疗的主要原因是 5 名患者出现血管受累，4 名患者出现葡萄膜炎，3 名患者出现关节炎，1 名患者出现皮肤粘膜受累，以及 1 名患者出现附睾炎。出现新发症状后，4 名患者改用阿达木单抗，3 名患者加大剂量，5 名患者添加秋水仙碱、常规免疫抑制剂和/或糖皮质激素，2 名患者添加外用滴眼剂，导致所有患者的新发症状均得到缓解。结论 在接受阿达木单抗治疗的 BS 患者中，新发症状很少见 (4%)。其中，57%为主要器官受累，主要是血管受累。没有患者出现后葡萄膜炎。