Novel approaches to Behcet's disease

Behcet's disease is a systemic inflammatory disorder. The patients have rep eated exacerbations and remissions of the symptoms. This disease may produc e a wide variety of symptoms. In mild cases, mucocutaneous lesions are only the symptoms during the whole clinical course, whereas ocular lesions, whi ch occur in about 70% of the patients, can cause blindness. Involvement of the gastrointestinal tract, CNS and large vessels is less frequent, but som etimes life-threatening. Colchicine, NSAIDs, corticosteroids and immunosupp ressants are employed for the treatment of Behcet's disease with therapies tailored to individual patients depending on clinical manifestations. Cyclo sporin A is the most effective drug for ocular lesions at the present, but its neurotoxicity, which occurs in 20 - 30% of patients receiving cyclospor in A, restricts usage of the agent. Many patients are still suffering from a severe form of uveitis and serious neurological symptoms, which are resis tant to any conventional therapies. New drugs have been investigated for Be hcet's disease. IFN-ce therapy has shown significant efficacy for common sy mptoms including ocular lesions without any serious adverse effects. Thalid omide and its analogues also appear to be applicable to this disease. Monoc lonal antibody to TNF-alpha, is now in clinical trials. These novel therape utic approaches may provide much needed treatment options for patients with Behcet's disease.