<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0872-671X</journal-id>
<journal-title><![CDATA[Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Medicina Interna]]></abbrev-journal-title>
<issn>0872-671X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0872-671X2021000400003</article-id>
<article-id pub-id-type="doi">10.24950/rspmi.o.13.4.2021</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Biologics Drugs in Behçet&#8217;s Disease: A Single Centre Experience]]></article-title>
<article-title xml:lang="pt"><![CDATA[Terapêutica Biológica na Doença de Behçet: A Experiência de um Centro]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pinto]]></surname>
<given-names><![CDATA[Luísa Serpa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pires]]></surname>
<given-names><![CDATA[Sara Xavier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carvalheiras]]></surname>
<given-names><![CDATA[Graziela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A3"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Campar]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A3"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marinho]]></surname>
<given-names><![CDATA[António]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A3 "/>
<xref ref-type="aff" rid="Af4"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Farinha]]></surname>
<given-names><![CDATA[Fátima]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A3"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vasconcelos]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A3 "/>
<xref ref-type="aff" rid="Af4"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Correia]]></surname>
<given-names><![CDATA[João Araújo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A3"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar e Universitário do Porto Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro Hospitalar e Universitário do Porto Unidade de Imunologia Clínica ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Ciências Biomédicas Abel Salazar Unidade Multidisciplinar de Investigação Biomédica ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Sociedade Portuguesa de Medicina Interna Núcleo de Estudos de Doenças Auto-Imunes ]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>28</volume>
<numero>4</numero>
<fpage>3</fpage>
<lpage>11</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0872-671X2021000400003&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0872-671X2021000400003&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0872-671X2021000400003&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Behçet´s disease (BD) is a systemic vasculitis of unknown cause. Several cytokines, such as tumor necrosis factor-alpha (TNF-&#945;), appear to play a substantial role. Therefore, biologics such as anti-TNF-&#945; agents are rising to control severe or refractory BD´s manifestations. We aimed to describe the biological therapy´s outcomes in BD patients.  Methods:  A longitudinal, prospective, unicentric cohort study with patients followed in a specialized outpatient clinic. We collected data regarding BD´s manifestations, treatments, and outcomes during follow-up.  Results:  Our cohort includes 243 patients, of whom 31% were male. During follow-up, 20 patients (8%) were treated with biological drugs. Patients who received biological therapies were younger (p = 0.030), had less frequently genital aphthosis (p = 0.009), and more frequently erythema nodosum (p = 0.009), polyarthritis (p = 0.002), spondyloarthritis (p = 0.024), retinal vasculitis (p = 0.011) and gastrointestinal manifestations (p = 0.024), namely gastroduodenal ulcer (p = 0.035), digestive bleeding from ulcers (p = 0.002), and bowel perforation (p = 0.004). Anti-TNF-&#945; agents were used in all of these patients, most frequently infliximab. Patients started biologicals after classical immunosuppressors failure, and most went into remission (93%). Three patients developed tuberculosis during treatment, regardless of regular screening tests. It was possible to stop biological therapy in five patients, so far, without recurrence, with 33 months of mean follow-up time after suspension.  Discussion:  Anti-TNF-&#945; agents are highly effective for re-fractory BD´s manifestations, although they are not innocuous. Little is known about the optimal duration of these therapies, regarding when and how to stop these drugs. This issue is essential not only to avoid relapses but also to reduce therapy side-effects.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução: A doença de Behçet (DB) é uma vasculite sistémica de causa indeterminada. Várias citocinas, como o TNF-&#945;, parecem desempenhar um papel na patogénese. Desde modo, o uso de biológicos como fármacos anti-TNF-&#945; têm aumentado, no controle das manifestações graves ou refratárias da DB. Este estudo teve como objetivo a descrição dos resultados obtidos com biológicos na DB.  Material e Métodos:  Estudo longitudinal, prospectivo, uni-cêntrico de doentes seguidos em consulta especializada. Recolhemos dados relativamente às manifestações, tratamentos e resultados obtidos durante o seguimento.  Resultados:  A coorte inclui 243 doentes, 31% homens. Vinte doentes (8%) realizaram biológicos. Os doentes que foram submetidos a biológicos são mais novos (p = 0,030), têm menos aftose genital (p = 0,009), e mais frequentemente eritema nodoso (p = 0,009), poliartrite (p = 0,002), espondiloartrite (p = 0,024), vasculite retiniana (p = 0,011) e manifestações gastrointestinais (p = 0,024), nomeadamente úlcera gastroduodenal (p = 0,035), hemorragia digestiva (p = 0,002), e perfuração intestinal (p = 0,004). Foram usados fármacos anti-TNF-&#945; em todos os doentes, mais frequentemente infliximab. Os biológicos foram iniciados após falência de resposta aos imunossupressores clássicos, e a maioria dos doentes entrou em remissão da doença após (93%). Três doentes desenvolveram tuberculose durante o tratamento, apesar de efetuarem testes de rastreio regulares. Foi possível parar o biológico em cinco doentes até então, sem recorrência, com um período médio de seguimento de 33 meses desde a suspensão.  Discussão:  Os biológicos anti-TNF-&#945; são altamente eficazes nas manifestações da DB refratária, embora não sejam inócuos. Pouco se sabe relativamente à duração ótima destas terapêuticas, quando e como parar. Isto é importante não só para evitar recidivas, mas também para reduzir os efeitos secundários.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Fator de Necrose Tumoral alfa/antagonistas e inibidores]]></kwd>
<kwd lng="pt"><![CDATA[Produtos Biológicos/uso terapêutico]]></kwd>
<kwd lng="pt"><![CDATA[Resultado do Tratamento]]></kwd>
<kwd lng="pt"><![CDATA[Síndrome de Behçet/tratamento farmacológico.]]></kwd>
<kwd lng="en"><![CDATA[Behcet Syndrome/drug therapy]]></kwd>
<kwd lng="en"><![CDATA[Biological Products/therapeutic use]]></kwd>
<kwd lng="en"><![CDATA[Treatment Outcome]]></kwd>
<kwd lng="en"><![CDATA[Tumor Necrosis Factor-alpha/antagonists &amp; inhibitors.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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