Manifestations oculaires de la maladie de Behçet
Informations
D. Saadoun, N. Cassoux, B. Wechsler, D. Boutin, C. Terrada, P. Lehoang, B.
La Revue de Médecine Interne
Volume 31, Issue 8, August 2010, Pages 545–550
Résumé
L’atteinte oculaire de la maladie de Behçet (MB) est fréquente et grave, mettant en jeu le pronostic visuel des patients. L’inflammation intraoculaire peut être antérieure, postérieure ou totale (panuvéite). L’âge au début se situe entre 20 et 30 ans. L’atteinte oculaire peut être inaugurale de la maladie dans 20 % des cas ou se manifester deux à trois ans après le début des signes extraoculaires. Le risque de cécité à cinq ans est de l’ordre de 15 à 25 %. Les objectifs thérapeutiques dans les uvéites de la MB sont la résolution rapide de l’inflammation oculaire, la prévention des rechutes et la conservation de la vision. L’atteinte oculaire, lorsqu’il existe des signes de gravité (hypopion, hyalite majeure, atteinte postérieure), nécessite un traitement associant des corticoïdes et des immunosuppresseurs. Les anti-TNF et l’interféron-α semblent des alternatives thérapeutiques efficaces et bien tolérées. Des études contrôlées sont nécessaires pour préciser la place de ces nouveaux agents immunomodulateurs dans l’arsenal thérapeutique.
Azathioprine in severe uveitis of Behçet’s disease
Informations
Saadoun D, Wechsler B, Terrada C, Hajage D, Le Thi Huong D, Resche-Rigon M, Cassoux N, Le Hoang P, Amoura Z, Bodaghi B, Cacoub P.
Arthritis Care Res (Hoboken), 2010 Dec
62(12):1733-8
Objective
To investigate the efficacy and tolerance of azathioprine in severe uveitis related to Behçet’s disease (BD).
Methods
We reported 157 consecutive patients with severe uveitis (active posterior uveitis or panuveitis) fulfilling the international criteria for BD and treated with corticosteroids (0.5-1 mg/kg/day) and azathioprine (2.5 mg/kg/day). Long-term outcome and factors associated with complete remission were assessed.
Results
Mean±SD age at diagnosis was 29.9±10.1 years, with 71.3% men. At baseline, 59 patients (37.6%) had loss of useful vision, 54 (34.4%) had retinal vasculitis, 66 (42.0%) had panuveitis, and 132 (84.1%) had bilateral uveitis. Following azathioprine therapy, 81 patients (51.6%) were complete responders, 65 (41.4%) were partial responders, and 11 (7%) were nonresponders. The visual acuity significantly improved (P<0.001), and a significant decrease in the mean oral prednisone dosage (55.3 to 10.5 mg/day; P<0.001) was observed after therapy. Patients with retinal vasculitis (odds ratio [OR] 0.45 [95% confidence interval (95% CI) 0.2-0.9], P=0.02) and severe visual loss (OR 0.28 [95% CI 0.2-0.7], P<0.0001) at diagnosis were less likely to be complete responders. Azathioprinewas well tolerated, with only 3 withdrawals due to hepatotoxic effects (n=2) and bacterial septicemia (n=1).
Conclusion
Azathioprine represents an effective and safe therapy in patients with severe uveitis of BD.
Pour obtenir la version PDF : david.saadoun@psl.aphp.fr
Management of major organ involvement of Behçet’s syndrome: a systematic review for update of the EULAR recommendations.
Informations
Ozguler Y, Leccese P, Christensen R, Esatoglu SN, Bang D, Bodaghi B, Çelik AF, Fortune F, Gaudric J, Gul A, Kötter I, Mahr A, Moots RJ, Richter J, Saadoun D, Salvarani C, Scuderi F, Sfikakis PP, Siva A, Stanford M, Tugal-Tutkun I, West R, Yurdakul S, Olivieri I, Yazici H, Hatemi G.
Rheumatology (Oxford). 2018 Dec 1
57(12):2200-2212. doi: 10.1093/rheumatology/key242
Management of skin, mucosa and joint involvement of Behçet’s syndrome: A systematic review for update of the EULAR recommendations for the management of Behçet’s syndrome.
Informations
Leccese P, Ozguler Y, Christensen R, Esatoglu SN, Bang D, Bodaghi B, Celik AF, Fortune F, Gaudric J, Gül A, Kötter I, Mahr A, Moots RJ, Richter J, Saadoun D, Salvarani C, Scuderi F, Sfikakis PP, Siva A, Stanford M, Tugal-Tutkun I, West R, Yurdakul S, Olivieri I, Yazici H, Hatemi G.
Semin Arthritis Rheum. 2018 May 19.
pii: S0049-0172(18)30240-3. doi: 10.1016/j.semarthrit.2018.05.008.
Neuro-ophthalmological manifestations of Behçet’s disease
Informations
Alghamdi A, Bodaghi B, Comarmond C, Desbois AC, Domont F, Wechsler B, Depaz R, Le Hoang P, Cacoub P, Touitou V, Saadoun D.
Br J Ophthalmol. 2019 Jan
103(1):83-87. doi: 10.1136/bjophthalmol-2017-311334. Epub 2018 Apr 26.
Update of the EULAR recommendations for the management of Behçet’s syndrome
Informations
Hatemi G, Christensen R, Bang D, Bodaghi B, Celik AF, Fortune F, Gaudric J, Gul A, Kötter I, Leccese P, Mahr A, Moots R, Ozguler Y, Richter J, Saadoun D, Salvarani C, Scuderi F, Sfikakis PP, Siva A, Stanford M, Tugal-Tutkun I, West R, Yurdakul S, Olivieri I, Yazici H.
Ann Rheum Dis. 2018 Jun
77(6):808-818. doi: 10.1136/annrheumdis-2018-213225. Epub 2018 Apr 6.
Ocular manifestations in Behçet’s disease
Informations
Desbois AC, Terrada C, Cacoub P, Bodaghi B, Saadoun D.
Rev Med Interne. 2018 Sep
;39(9):738-745. doi: 10.1016/j.revmed.2018.02.022
doi: 10.1080/09273948.2018.1455876.
Fluorescein and OCT Angiography Features of Takayasu Disease
Informations
Chotard G, Diwo E, Coscas F, Butel N, Saadoun D, Bodaghi B.
Ocul Immunol Inflamm. 2018 Apr 19:1-7
doi: 10.1080/09273948.2018.1455876.
Old and New Challenges in Uveitis Associated with Behçet’s Disease
Informations
Gueudry, J ; Leclercq, M ; Saadoun, D ; Bodaghi, B
J. Clin Med, 2021
Critical role of neutrophil extracellular traps (NETs) in patients with Behcet’s disease
Informations
Le Joncour, A ; Martos, R ; Loyau, S ; Lelay, N ; Dossier, A ; Cazes, A ; Saadoun, D & all
Ann Rheum Dis, 2019, 78, 1274-1282
Long-Term Outcome of Ustekinumab Therapy for Behçet’s Disease
Informations
Le Joncour, A ; Martos, R ; Loyau, S ; Lelay, N ; Dossier, A ; Cazes, A ; Saadoun, D & all
Arthritis Rheumatol, 2019, 71, 1727-1732
Neuro-ophthalmological manifestations of Behçet’s disease
Informations
Alghamdi, A ; Bodaghi, B ; Comarmond, C ; Desbois, AC ; Domont, F ; Wechsler, B & Saadoun, D.
Br J Ophthalmol, 2019, 103, 83-87
Des questions ?
Pr David SAADOUN
Service de Médecine Interne 2. Hôpital Pitié Salpêtrière – 75013 Paris
Pour toute information relative à la Maladie de Behçet, vous pouvez joindre le professeur David Saadoun à l’adresse suivante : david.saadoun@aphp.fr.