From the Guidelines
The treatment for Behçet's disease should be individualized according to age, gender, type and severity of organ involvement, and patients' preferences, with the goal of promptly suppressing inflammatory exacerbations and recurrences to prevent irreversible organ damage. The management of Behçet's disease requires a multidisciplinary approach, taking into account the relapsing and remitting nature of the condition, as well as the differences in natural course of different types of organ and system involvement 1. Key considerations in treatment include:
- The potential for serious damage and even death from untreated eye, vascular, nervous system, and gastrointestinal system involvement
- The need for vigorous treatment to prevent oropharyngeal narrowing and obliterative and deforming genital scarring in cases of chronic oral and genital ulceration
- The importance of rapidly suppressing inflammation and preventing relapses in patients with organ involvement, often requiring immunosuppressives 1
- The potential for disease manifestations to ameliorate over time, allowing for treatment to be tapered and even stopped during the course of the disease 1. In patients with only skin, mucosa, and joint involvement, treatment can be tailored according to the patient's need and how much the symptoms impact on their quality of life compared with the risks associated with adverse effects of any medication used 1. Overall, a personalized treatment approach, guided by the principles outlined in the 2018 update of the EULAR recommendations for the management of Behçet's syndrome, is essential for optimizing outcomes in patients with this condition 1.
From the Research
Treatment Options for Behçet's Disease
The treatment for Behçet's disease, as observed in patients with MAGIC syndrome, includes:
- Oral colchicine followed by prednisolone, which was effective in treating a patient with MAGIC syndrome 2
- Methotrexate and pentoxifylline, which controlled oral ulcers, erythema nodosum, and arthritis in a patient with MAGIC syndrome 3
- Intensive immunosuppression, which was necessary for a patient with MAGIC syndrome complicated by aneurysmal aortitis 4
Management of MAGIC Syndrome
The management of MAGIC syndrome, which shares clinical features with Behçet's disease, involves:
- Monitoring for the possible development of inflammatory aortic aneurysms 4
- Cardiothoracic surgical referral if an aortic aneurysm is detected 4
- Close monitoring for enlargement of the aneurysm and intensification of immunosuppressive therapy if necessary 4
Disease Association and Treatment
The association between MAGIC syndrome, Behçet's disease, and relapsing polychondritis is still unclear, and further research is needed to understand the pathogenic relationship between these conditions 2, 5, 3, 4, 6