Moots, R.J., Fortune, F., Jackson, R. et al. (6 more authors) (2024) Infliximab versus interferon-alpha in the treatment of Behçet’s Syndrome: Clinical data from the BIO-BEHÇET’S randomised controlled trial. Rheumatology. keae585. ISSN 1462-0324
Abstract
Objectives
Whilst biologic therapy is used for Behçet’s Syndrome of all subtypes refractory to first-line immunomodulation, there has been an absence of high-quality evidence—and no predictive biomarkers to optimally inform choice. BIO-BEHÇET’S was a randomised, controlled, head-to-head clinical trial comparing the two most frequently used biologics in active refractory Behçet’s.
Methods
Bayesian-designed, pragmatic, standard of care, two-arm, parallel head-to-head trial at four UK centres. Patients with active disease randomised to infliximab or interferon-α2a, and received follow-up with symptom-directed examination at Weeks 12 and 24. Primary outcome was Behçet’s Disease Activity Index (BDAI) at 12 weeks. Secondary outcomes included BDAI at 24 weeks and significant improvement in individual organ systems, including ocular symptoms, oral and genital ulcers, arthritis pain, quality of life, disease activity, and steroid use. Biomarkers were also investigated but are reported elsewhere.
Results
79 patients were recruited. Both treatments were equally effective, with a mean difference of 0.13 in BDAI (80% CI: –0.19, 0.46). No significant differences were observed for secondary outcomes, though there were clinically significant within-group reductions for each over time. A modest steroid-sparing effect was observed, with complete cessation of steroids in 20% and 44% of those randomised to infliximab and interferon-α2a, respectively. There was a trend for minor benefit in favour of infliximab in terms of tolerability and persistence.
Conclusion
In this first reported, high-quality, head-to-head trial of two biologics in Behçet’s, both infliximab and interferon-α2a showed comparable short-term clinical efficacy and safety in refractory active disease of all subtypes.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Keywords: | Behçet’s, randomised controlled clinical trial, infliximab, interferon, biologic therapy |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Discovery & Translational Science Dept (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 20 Feb 2025 15:39 |
Last Modified: | 20 Feb 2025 15:39 |
Status: | Published online |
Publisher: | Oxford University Press (OUP) |
Identification Number: | 10.1093/rheumatology/keae585 |
Related URLs: | |
Sustainable Development Goals: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:219824 |