A double-blind trial of depot corticosteroids in Behçet's syndrome

Mat, Cem; Yurdakul, Sebahattin; Uysal, Serap; Göğüş, Feride; Özyazgan, Yılmaz; Uysal, Ömer; Fresko, İzzet; Yazıcı, Hasan

doi:10.1093/rheumatology/kei165

Cited by 93 publications

(38 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a recent double-blind study of low-dose depot corticosteroids vs placebo, low-dose depot corticosteroids (40 mg of methylprednisolone acetate administered as intramuscular injection, every 3 weeks) were not successful in the treatment of genital ulcers, oral lesions and folliculitis and arthritis; however, they were helpful in controlling erythema nodosum lesions, especially in female patients [94].…”

Section: Corticosteroidsmentioning

confidence: 98%

Behçet's disease – a contemporary review

Mendes

Correia

Barbedo

et al. 2009

Journal of Autoimmunity

270

275

View full text Add to dashboard Cite

Section: Corticosteroidsmentioning

confidence: 98%

Behçet's disease – a contemporary review

Mendes

Correia

Barbedo

et al. 2009

Journal of Autoimmunity

270

275

View full text Add to dashboard Cite

“…76 Although corticosteroids are widely used for Behçet's syndrome, the only placebo-controlled study with methylprednisolone acetate (40 mg intramuscularly, every 3 weeks) was conducted for genital ulcers. 77 Men and women were analyzed separately. The trial showed that depot corticosteroids were useful only for erythema nodosum lesions among women but not in men, whereas there was no effect on genital ulcers, oral ulcerations, folliculitis, or arthritis.…”

Section: Managementmentioning

confidence: 99%

Behçet’s syndrome: Facts and controversies

Mat¹,

Yurdakul²,

Sevim³

et al. 2013

Clinics in Dermatology

View full text Add to dashboard Cite

“…They are reported to be used as first-line drugs for both acute and chronic progressive CNS involvement, for aggressive gastrointestinal lesions and arteritis, for venous thrombosis and uveitis, and as alternative agents in the treatment of persistent mucocutaneous symptoms and arthritis [36,37,Class IV]. There is a single randomized controlled trial with corticosteroid treatment (40 mg intramuscular methylprednisolone depot injections); it showed an effect only on nodular lesions [38,Class I].…”

Section: Pharmacologic Treatmentmentioning

confidence: 99%

Behçet’s Disease

Akman‐Demir

Saıp

Síva

2011

Curr Treat Options Neurol

View full text Add to dashboard Cite

Neurologic involvement in Behçet's disease (BD) is seen in about 5% to 10% of all BD patients. Clinical and imaging data suggest that neurologic involvement in BD presents in two major forms. The first, central nervous system (CNS) parenchymal involvement with a predilection to brainstem-diencephalic regions, is seen in the majority of patients with neuro-BD (NBD). The second form is cerebral venous sinus thrombosis (CVST), which is seen in up to 20% of cases. BD is very rare in children, but when it does occur, the patterns are reversed: most children with NBD present with CVST. Other syndromes such as spinal cord involvement, arterial CNS involvement, optic neuritis, aseptic meningitis, and peripheral neuropathies may be seen, but are rare. Venous sinus thrombosis in BD has a significantly better neurologic prognosis than parenchymal CNS involvement. There is no Class I evidence regarding treatment of parenchymal CNS involvement or CVST in BD. Current treatment applications are based largely on expert opinion; none are evidence-based. Acute parenchymal CNS involvement should be treated with high-dose intravenous methylprednisolone (IVMP), 1 g per day, for 5 to 10 days, followed by either a prolonged oral taper or intermittent IVMP pulses with a low oral dose between the pulses, over 6 months. After treatment of the acute attack, long-term maintenance with immunosuppressive agents should be considered in patients with parenchymal CNS involvement, as this form may follow a relapsing or secondary progressive course and may result in significant physical and cognitive deficits leading to severe neurologic disability. A number of randomized controlled studies have tested treatments for systemic manifestations of BD. Colchicine was found to be effective for mucocutaneous symptoms, thalidomide was found to be effective in erythema nodosum-like skin lesions, azathioprine and cyclosporine were shown to be effective in BD uveitis, and cyclophosphamide was shown to be effective for major vascular involvement. More recently, interferon alfa and anti-TNF agents were also shown to be effective in BD uveitis. Although randomized controlled studies have not been performed in NBD, the most widely used long-term therapeutic agent is azathioprine. Recent observations suggest that the addition and long-term use of azathioprine in NBD could be associated with a more favorable course. A growing number of case reports in recent years suggest that anti-TNF agents may be an effective alternative in NBD, but current experience with these agents is limited. CVST in BD is also treated with steroids. The addition to glucocorticoids of anticoagulation, including short-term fractionated heparin, is controversial, as these patients have a higher probability of harboring pulmonary or other aneurysms, which may be associated with an increased risk of bleeding. Long-term oral anticoagulation is unnecessary. Interestingly, the prognosis of CVST due to BD seems to be much more favorable than the prognosis of CVST due to other causes, with much les...

show abstract

A double-blind trial of depot corticosteroids in Behçet's syndrome

Abstract: Low-dose depot corticosteroids did not have any beneficial effect on genital ulcers. However, it was useful in controlling erythema nodosum lesions, especially among the females.

Cited by 93 publications

References 9 publications

Behçet's disease – a contemporary review

Behçet's disease – a contemporary review

Behçet’s syndrome: Facts and controversies

Behçet’s Disease

Contact Info

Product

Resources

About