No cure exists for Behcet's disease. If your signs and symptoms of Behcet's disease are mild, your doctor may offer medications to control temporary flares in pain and inflammation. You may not need to take medication between flares. But if your signs and symptoms are more severe, your doctor may advise medications to control the signs and symptoms of Behcet's disease throughout your body, in addition to medications for the temporary flares. Several factors, including your age and sex, may influence the specific treatment your doctor recommends.
Treatments for individual signs and symptoms of Behcet's disease
Behcet's disease may come and go on its own in periods of flares and remissions. Your doctor works to control any signs and symptoms you experience during flares with medications such as:
- Skin creams, gels and ointments. Topical medicines are applied directly to skin and genital sores in order to reduce inflammation and pain. These types of medications usually contain a corticosteroid drug that reduces inflammation or an anesthetic to relieve pain.
- Mouth rinses. Special mouthwashes that contain corticosteroids and other agents to reduce the pain of mouth sores may ease your discomfort.
- Eyedrops. Eyedrops containing corticosteroids or other anti-inflammatory medicines can relieve pain and redness in your eyes if inflammation is mild.
Systemic treatments for Behcet's disease
If topical medications don't help control skin rashes, or oral or genital ulcers, a medication called colchicine (Colcrys) is often recommended. Arthritis symptoms also may improve with colchicine.
Severe cases of Behcet's disease require treatments to control damage from the disease between flares. If you have moderate to severe Behcet's disease, your doctor may prescribe:
- Corticosteroids to control inflammation. Corticosteroids, such as prednisone, in combination with other medications may reduce the inflammation caused by Behcet's disease. The signs and symptoms of Behcet's disease tend to recur when corticosteroids are used alone, so doctors often prescribe them with another medication to suppress the activity of your immune system (immunosuppressives). Side effects of corticosteroids include weight gain, persistent heartburn, high blood pressure and bone thinning (osteoporosis).
- Medications that suppress your immune system. Immunosuppressive drugs suppress your immune system, which overreacts in Behcet's disease. By stopping your immune system from attacking normal, healthy tissues in your body, immunosuppressive drugs reduce the inflammation that your immune system causes. Immunosuppressive drugs that may play a role in controlling Behcet's disease include azathioprine (Imuran, Azasan), cyclosporine (Gengraf, Neoral, Sandimmune) and cyclophosphamide (Cytoxan). Since these medications suppress the actions of your immune system, they may increase your risk of infection. Other possible side effects include liver and kidney problems, low blood counts, and high blood pressure.
Medications that alter your immune system's response. Interferon alfa-2b (Intron A) regulates the activity of your immune system to control inflammation. It may help control skin sores, joint pain and eye inflammation in people with Behcet's disease. Side effects include flu-like signs and symptoms, such as muscle pain and fatigue. Interferon alfa-2b may be combined with other medications.
Medications that block a substance called tumor necrosis factor (TNF), such as infliximab (Remicade) and etanercept (Enbrel), are effective in treating some of the manifestations of Behcet's, especially for people who have more-severe or resistant symptoms. Side effects may include headache, skin rash and an increased risk of upper respiratory infections.
Other drugs that have been used to treat Behcet's disease include thalidomide (Thalomid), mycophenolate mofetil (CellCept) and chlorambucil (Leukeran).
Mar. 08, 2013
- Saadoun D, et al. Behcet's disease. Orphanet Journal of Rare Diseases. 2012;7:1.
- Questions and answers about Behcet's disease. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Behcets_Disease/default.asp. Accessed Nov. 15, 2012.
- Mendes D, et al. Behcet's disease — A contemporary review. Journal of Autoimmunity. 2009;32:178.
- Ambrose NL, et al. Differential diagnosis and management of Behcet syndrome. Nature Reviews Rheumatology. In press. Accessed Jan. 13, 2013.
- Okada AA, et al. Multicenter study of infliximab for refractory uveoretinitis in Behcet disease. Archives of Ophthalmology. 2012;130:592.
- Arida A, et al. Anti-TNF agents for Behcet's disease: Analysis of published data on 369 patients. Seminars in Arthritis and Rheumatism. 2011;41:61.
- Benitah NR, et al. The use of biologic agents in the treatment of ocular manifestations of Behcet's disease. Seminars in Ophthalmology. 2011;26:295.