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Case Reports in Rheumatology
Volume 2016, Article ID 1467583, 5 pages
http://dx.doi.org/10.1155/2016/1467583
Case Report

Successful Discontinuation of Infliximab in a Refractory Case of Vasculo-Behçet Disease

1Department of Internal Medicine and Rheumatology, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka 810-8563, Japan
2Department of Genetics and Development, Krembil Research Institute, University Health Network, Toronto, ON, Canada M5T 2S8

Received 6 January 2016; Accepted 15 February 2016

Academic Editor: Suleyman Serdar Koca

Copyright © 2016 Akihiro Nakamura et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Reports have shown that antitumor necrosis factor alpha (anti-TNF-α) agents including infliximab (IFX) can dramatically suppress the disease activity of refractory vasculo-Behçet disease (vasculo-BD). However, it is completely unknown whether we can discontinue anti-TNF-α agents under clinical remission. A 31-year-old patient with vasculo-BD was initially treated with a high dose of steroid and intravenous cyclophosphamide therapy. Six months later, however, the disease recurred. IFX was administered and immediately the disease activity was reduced. Fortunately, we could discontinue IFX after 18-month remission and no recurrence has been observed. Based on previous reports and our patient, all patients who could discontinue IFX sustained clinical remission for at least one year, continued taking immunosuppressive agents such as methotrexate and azathioprine, and had vascular involvements only in non-life-threatening major vessels such as leg or arm arteries/veins. This is a report suggesting the possibility of discontinuation of IFX in vasculo-BD.