Switching to Etanercept in Intestinal Behcet's Disease Complicated by Secondary Non-response to Anti-TNF-α Antibodies

The efficacy of anti-TNF-α antibodies including infliximab and adalimumab for refractory intestinal Behcet's disease has recently been demonstrated in a series of case reports. The efficacy of switching to a different kind of anti-TNF-α agent in the face of refractoriness to one kind of anti-TNFα agent, a common practice of proven efficacy in rheumatoid arthritis, has yet not been reported for intestinal Behcet's disease. In the present study, we report a case of 52-year-old female patient with intestinal Behcet's disease, who lost initial good response to infliximab, and was refractory to subsequent administrations of adalimumab. Her recent relapse of intestinal lesions could be successfully treated with etanercept. This case suggests that switching to etanercept might be a reasonable therapeutic option in case of intestinal Behcet's disease with secondary non-response to anti-TNF-α antibodies that is most likely to be mediated by anti-drug antibody.