A controlled trial of azathioprine in Behcet's syndrome

Article Abstract:

Behcet's syndrome is a condition in which ulcers repetitively occur in the mouth and on the genitals. The ulcers are usually round or oval in shape, red in color and have a white rim. Patients also develop pustules of the skin, inflammation of joint membranes, irritation of vessels, arterial aneurysms (a ballooning of the wall of arteries), and inflammation of the brain and its surrounding membranes (meningoencephalitis). A serious complication of Behcet's syndrome is inflammations of the eye, including the development of pus within the anterior chamber (the fluid-filled cavity between the cornea and the iris). The origin of Behcet's syndrome remains unknown but the disease resembles autoimmune conditions such as rheumatoid arthritis. Azathioprine is an immunosuppressive drug (diminishing the body's ability to produce antibodies) that has been reported to be useful in the treatment of Behcet's syndrome. The current study examines the use of this drug in two groups of male patients. Group one contained 25 Behcet's patients who had not developed any of the disabling eye conditions which are associated with the disease. Group two was composed of 48 patients who had developed eye disease. Both groups were divided into two subgroups, one of which received azathioprine while the other received an inactive placebo. Six patients were removed from the study because they developed severe eye problems that required additional attention; all six patients had been in a placebo subgroup. This finding was highly statistically significant, and is strongly suggestive that azathioprine prevents or reduces the development of serious eye infections in Behcet's patients who have not shown evidence of eye disease. Those patients in group two also had fewer episodes of serious infections of the vascular layer of the eyeball (uveitis, inflammation of the uveal layer). The treatment of Behcet's disease by azathioprine offers benefit particularly in controlling the progression of the disease and in reducing the effects of inflammations of the eye. However, the long-term effects of this treatment remain unknown. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects

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Behcet's syndrome

Article Abstract:

Behcet's syndrome is a condition in which ulcers repetitively occur in the mouth and on the genitals. The ulcers are usually round or oval in shape, and red with a white rim. Patients also develop pustules of the skin, inflammation of joint membranes and vessels, arterial aneurysms (a ballooning of the wall of arteries), and inflammation of the brain and its surrounding membranes (meningoencephalitis). A serious complication of Behcet's syndrome is inflammation of the eye, including the development of pus within the anterior chamber (the fluid-filled cavity between the cornea and the iris). The origin of Behcet's syndrome remains unknown but it resembles autoimmune conditions such as rheumatoid arthritis. Although found in both sexes throughout the world, the condition is most common in Mediterranean countries and in Asia. Behcet's syndrome occurs most severely in young men living in these areas and is a leading cause of blindness. When the condition is seen in Europe and North America it is usually less severe and occurs twice as frequently in women as in men. The rate of incidence in the United States is approximately five cases for every 100,000 or approximately 15,000 cases in total. In the February 1, 1990 issue of 'The New England Journal of Medicine' an article describes the effective treatment of Behcet's syndrome with azathioprine, an immunosuppressive drug that reduces the body's immune response and antibody production. The study is based on the treatment of 73 patients over a two-year period. Azathioprine appears to be helpful in preventing the progression of Behcet's syndrome, particularly with regard to the avoidance of serious eye complications. Although the mechanism of the drug's action is not known, physicians should carefully consider using azathioprine as its potential benefits appear to outweigh its uncertainties and risks. (Consumer Summary produced by Reliance Medical Information, Inc.)

editorial

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Thalidomide in the treatment of the mucocutaneous lesions of the Behcet syndrome: a randomized, double-blind, placebo-controlled trial

Article Abstract:

The drug thalidomide may be effective in some patients with Behcet syndrome. This syndrome is characterized by the formation of ulcers and other skin lesions as well as other symptoms. Researchers randomly assigned 96 men with Behcet syndrome to take 100 milligrams of thalidomide per day, 300 milligrams, or a placebo for 24 weeks. Six percent of those on 100 milligrams and 16% of those on 300 milligrams responded to the drug compared to none in the placebo group. The effects wore off when the drug was discontinued and several patients taking thalidomide developed peripheral nerve disease.

Thalidomide

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