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Resistant Behçet Disease Responsive to Anakinra

Costantino Botsios, MD, PhD; Paolo Sfriso, MD, PhD; Antonio Furlan, MD; Leonardo Punzi, MD, PhD; and Charles A. Dinarello, MD
[+] Article, Author, and Disclosure Information

From the University of Padova, Padova 35122, Italy, and University of Colorado Health Sciences Center, Denver, CO 80262.

Potential Financial Conflicts of Interest: None disclosed.

Ann Intern Med. 2008;149(4):284-286. doi:10.7326/0003-4819-149-4-200808190-00018
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Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, leukocyte count, and temperature in a patient with Behçet disease taking different medications.

The patient received cyclosporine (CsA) (5 mg/kg) until February 1998, when the treatment was stopped because of nephrotoxicity, and azathioprine (AZA) (150 mg/d) was added. In September 2003, the disease flared up, AZA treatment was stopped, and infliximab (IFN) (5 mg/kg every 6 wk) plus methotrexate (MTX) (10 mg/wk) was given. In September 2005, IFN–MTX treatment was stopped because of development of mucosal abdominal abscesses. At this time, AZA (150 mg/d) plus colchicine (COL) (1–2 mg/d) treatment was started. In May 2006, AZA–COL treatment was stopped and anakinra (100 mg/d) treatment was started. Before this, steroid treatment withdrawal was attempted at various times but failed because of impairment of adrenocortical function. The patient continued taking 5-mg prednisone during anakinra treatment.

* Anakinra treatment started at a daily dose.

† Anakinra treatment was reduced to alternate days.

‡ Anakinra treatment restarted at a daily dose.

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