314. Emergence of New Manifestations During Infliximab Treatment in Behçet Synome
Creators: name: Tukek1, Nur Beyza
Publisher: name: Zenodo
Year: 2022
Subjects: Vasculitis
ANCA
Abstracts
Giant Cell Arthritis
MPA
GPA
EGPA
Takayasu
IgA vasculitis

description: <strong>Background/ Objectives:</strong> Infliximab (IFX) is being increasingly used for the treatment of severe manifestations of Behçet synome (BS). However, emergence of new manifestations has also been occasionally reported during IFX treatment. We aimed to assess the frequency of new manifestations in our BS patients treated with IFX. <strong>Methods:</strong> A chart review was conducted to identify all BS patients treated with IFX in our clinic between 2004 and 2020. Demographic data, indications for IFX initiation, concomitant treatments, and outcomes were recorded. A new manifestation was defined as the emergence of a new organ involvement or mucocutaneous manifestation developing for the first time during IFX treatment or within 12 weeks after the last infusion of IFX. To better describe our treatment strategies for new manifestations, we categorized new manifestations as major and minor manifestations. Major manifestations included uveitis, vascular involvement other than superficial thrombophlebitis, gastrointestinal, and central nervous system involvement. Minor manifestations included mucocutaneous findings, arthritis, superficial thrombophlebitis, and venous ulcers. <strong>Results:</strong> Among our 282 patients who used IFX, 19 (7%) patients had developed a total of 23 new manifestations during a mean follow-up of 20.0±15.3 months. Vascular lesions (11/23, 48%) were the most common new manifestation and 10/23 (43.5%) were major manifestations. Patients with vascular involvement were more likely to develop a new manifestation (12/19, 63%). Initial manifestations that required IFX were in remission at the time of new manifestation in 14/19 patients. IFX treatment was intensified (n=6) and/or glucocorticoids, immunosuppressives, or colchicine were added to IFX (n=21). IFX was switched to another agent for the remaining manifestations (n=8). These treatment modifications led to remission in 17/19 patients. <strong>Conclusions:</strong> New manifestations developed during IFX treatment in 7% of our patients with BS. The majority of new manifestations, especially minor manifestations that developed during IFX could be managed by intensifying IFX or glucocorticoids, or adding immunosuppressives or colchicine. <strong>Disclosures:</strong> Sinem Nihal Esatoglu has received honorariu for presentations from UCB Pharma, Roche, Pfizer, and Merck Sharp Dohme. Gulen Hatemi has received grant/research support from Celgene and has served as a speaker for AbbVie, Celgene, Novartis, and UCB Pharma. Yesim Ozguler has received honorariu for presentations from UCB Pharma, Novartis, and Pfizer. Emire Seyahi has received honorariu for presentations from Novartis, Pfizer, AbbVie, and Gliead. Ugur Uygunoglu has received advisory board honorariu and speaker fees from F Hoffmann La-Roche, F Hoffmann La-Roche, Bayer, Merck-Serono, Novartis, Teva, and Biogen Idec/Gen Pharma of Turkey. Aksel Siva received honorariu from Bayer-Schering AG, Biogen/Gen Ilac of Turkey, Genzyme, Merck-Serono, and Roche for consulting, fees from Novartis as a consultant and advisory committee member, travel and registration reimbursements from Genzyme, and honorariu from Teva for speaking engagements. Aykut Ferhat Celik has served as a speaker for AbbVie, Takeda, Jansen, and Pfizer, and has received advisory board honorariu from Jansen, AbbVie, and Takeda. Vedat Hamuryudan has received grant/research support from Celgene and has served as a speaker for AbbVie, Celgene, Novartis, and UCB Pharma. No other disclosures were reported.