Can Behçet's Disease Be Cured?
Behçet's disease cannot be cured, but it is a treatable condition that typically follows a relapsing-remitting course with disease manifestations often ameliorating over time, allowing for potential tapering and even discontinuation of treatment during the disease course. 1, 2
Disease Course and Long-Term Outlook
Behçet's disease runs a chronic relapsing and remitting pattern rather than a progressive course, with symptoms typically improving as patients age. 2
The disease manifestations usually abate over time, which means treatment can be tapered and potentially stopped during the course of the disease, though this does not constitute a cure. 2
Some patients with severe ocular disease treated with anti-TNF therapy combined with azathioprine for 2 years may achieve drug-free, long-term remission after withdrawal of treatment. 3
Treatment Goals
The primary goal is to promptly suppress inflammatory exacerbations to prevent irreversible organ damage, not to cure the disease. 2
Treatment must be individualized based on organ involvement severity, as ocular, vascular, neurological, and gastrointestinal manifestations can cause serious damage or death if left untreated. 1, 2
Treatment Approach by Severity
Mild Mucocutaneous Disease
- Topical corticosteroids for isolated oral and genital ulcers serve as first-line therapy. 3
- Colchicine (1-2 mg/day) is effective for erythema nodosum and mild mucocutaneous lesions. 3
Severe Organ-Threatening Disease
- Systemic corticosteroids combined with immunosuppressants (particularly azathioprine 2.5 mg/kg/day) are required for major organ involvement. 3
- High-dose intravenous methylprednisolone (1 g/day for 3-7 days) followed by oral prednisolone with gradual tapering over 6-12 months is standard for acute severe attacks. 1
- TNF-alpha inhibitors, particularly infliximab, are recommended for refractory cases that fail conventional therapy. 1, 3