TY - JOUR
T1 - The 2nd edition of consensus statements for the diagnosis and management of intestinal Behçet's disease
T2 - Indication of anti-TNFα monoclonal antibodies
AU - Hisamatsu, Tadakazu
AU - Ueno, Fumiaki
AU - Matsumoto, Takayuki
AU - Kobayashi, Kiyonori
AU - Koganei, Kazutaka
AU - Kunisaki, Reiko
AU - Hirai, Fumihito
AU - Nagahori, Masakazu
AU - Matsushita, Mitsunobu
AU - Kobayashi, Kenji
AU - Kishimoto, Mitsumasa
AU - Takeno, Mitsuhiro
AU - Tanaka, Masanori
AU - Inoue, Nagamu
AU - Hibi, Toshifumi
N1 - Funding Information:
This work was supported in part by grants from the project of Research Committee for small bowel inflammation of unknown etiology and Behçet’s Disease Research Committee, Health Labour Sciences Research Grant, Research on Measures for Intractable Diseases, Japan.
PY - 2014/1
Y1 - 2014/1
N2 - Background: Clinical evidence regarding intestinal Behçet's disease (BD) management is lacking and intestinal lesions are a poor prognostic factor. In 2007, the Japan consensus statement for diagnosis and management of intestinal BD was developed. Recently, the efficacy of anti-tumor necrosis factor (TNF)α monoclonal antibodies (mAbs), and infliximab (IFX) was reported and adalimumab (ADA) was approved for intestinal BD in Japan. This study renewed consensus-based practice guidelines for diagnosis and treatment of intestinal BD focusing on the indication of anti-TNFα mAbs. Methods: An expert panel of Japanese gastroenterology and rheumatology specialists was involved. Clinical statements for ratings were extracted from the literature, a professional group survey, and by an expert panel discussion, which rated clinical statements on a nine-point scale. After the first round of ratings, a panelist meeting discussed areas of disagreement and clarified areas of uncertainty. The list of clinical statements was revised after the panelist meeting and a second round of ratings was conducted. Results: Fifteen relevant articles were selected. Based on the first edition consensus statement, improved clinical statements regarding indications for anti-TNFα mAbs use were developed. After a two-round modified Delphi approach, the second edition of consensus statements was finalized. Conclusions: In addition to standard therapies in the first edition, anti-TNFα mAbs (ADA and IFX) should be considered as a standard therapy for intestinal BD. Colchicines, thalidomide, other pharmacological therapy, endoscopic therapy, and leukocytapheresis were deemed experimental therapies.
AB - Background: Clinical evidence regarding intestinal Behçet's disease (BD) management is lacking and intestinal lesions are a poor prognostic factor. In 2007, the Japan consensus statement for diagnosis and management of intestinal BD was developed. Recently, the efficacy of anti-tumor necrosis factor (TNF)α monoclonal antibodies (mAbs), and infliximab (IFX) was reported and adalimumab (ADA) was approved for intestinal BD in Japan. This study renewed consensus-based practice guidelines for diagnosis and treatment of intestinal BD focusing on the indication of anti-TNFα mAbs. Methods: An expert panel of Japanese gastroenterology and rheumatology specialists was involved. Clinical statements for ratings were extracted from the literature, a professional group survey, and by an expert panel discussion, which rated clinical statements on a nine-point scale. After the first round of ratings, a panelist meeting discussed areas of disagreement and clarified areas of uncertainty. The list of clinical statements was revised after the panelist meeting and a second round of ratings was conducted. Results: Fifteen relevant articles were selected. Based on the first edition consensus statement, improved clinical statements regarding indications for anti-TNFα mAbs use were developed. After a two-round modified Delphi approach, the second edition of consensus statements was finalized. Conclusions: In addition to standard therapies in the first edition, anti-TNFα mAbs (ADA and IFX) should be considered as a standard therapy for intestinal BD. Colchicines, thalidomide, other pharmacological therapy, endoscopic therapy, and leukocytapheresis were deemed experimental therapies.
KW - Anti-TNFα mAb
KW - Consensus statements
KW - Intestinal Behçet's disease
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U2 - 10.1007/s00535-013-0872-4
DO - 10.1007/s00535-013-0872-4
M3 - Article
C2 - 23955155
AN - SCOPUS:84895076984
SN - 0944-1174
VL - 49
SP - 156
EP - 162
JO - Journal of Gastroenterology
JF - Journal of Gastroenterology
IS - 1
ER -