Behcet’s disease treatment.


Abstract: There is not yet an effective treatment for all lesions of Behcet's disease and for all patients with Behcet's disease. The highest morbidity is from the ocular lesions. The mortality, although rare, is due to neurological and pulmonary involvement. Thrombosis of the large veins and arteries, also rare, may lead to morbidity and mortality. In daily practice, the best treatment for muco cutaneous lesions is colchicine. Thalidomide may be efficient in refractory cases however it is an experimental drug not for use for the everyday practice. For ocular lesions cytotoxic drugs or c,yclosporine A with medium dose steroids (0.5 mg prednisolone/kg/body weight) is the only effective treatment. The best choice for cytotoxic drugs is pulse cyclophosphamide or weekly low dose methotrexate, although other cytotoxic drugs such as azathioprine and chlorambucil may be used. Cyclosporine A is better left for intractable cases. In systemic and life threatening vasculitis medium to high dose steroids with cytotoxic drugs are necessary.