New Publication from the AIDA Network Registry on Behçet's disease: Exploring Alternatives Beyond Anti-TNF Therapy

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DOI: 10.1093/rheumatology/keag086

Why This Study Matters

Behçet’s disease is a complex, multi-system inflammatory condition that can affect the skin, joints, eyes, nervous system, and other organs. In patients with severe or refractory disease, medications known as TNF-α inhibitors are commonly used and are often effective. However, not all patients respond adequately, and some may experience intolerance or side effects. For these individuals, identifying effective alternative treatments is crucial.

What Did the Study Investigate?

Using real-world data from the AIDA Network Registry, researchers analyzed 65 patients with Behçet’s disease who were treated with biologic agents other than TNF-α inhibitors.

Key Findings

Several biologic treatments targeting different inflammatory pathways showed encouraging results:

• IL-1 inhibitors such as anakinra and canakinumab were particularly effective for joint, eye, and mucocutaneous involvement. Some patients who did not respond to anakinra improved with canakinumab.
• IL-6 inhibition with tocilizumab demonstrated promising results, especially in ocular and neurological involvement.
• IL-17 inhibitors (secukinumab and ixekizumab) were beneficial in patients with mucocutaneous and joint manifestations, particularly in those with axial involvement.
• IL-12/23 inhibition (ustekinumab) and B-cell targeting therapy (rituximab) also showed improvement in selected refractory cases.

Importantly, no new major safety concerns emerged during follow-up.

What Does This Mean for Patients?

This study highlights that targeting inflammatory pathways beyond TNF-α can be a valuable strategy in patients who do not respond to standard biologic therapies.

It also reinforces a key concept in Behçet’s disease management: treatment should be individualized according to the patient’s specific disease phenotype and organ involvement.

The Value of International Collaboration

These findings were made possible thanks to the International AIDA Network Registry, which collects real-life data from multiple centers worldwide. By pooling clinical experience across countries, the Network continues to generate meaningful evidence to guide personalized treatment strategies for rare and complex inflammatory diseases.

We thank all participating centers, clinicians, and patients who contributed to this important research initiative.