Correspondence on 'A pilot study of tofacitinib for refractory Behcets syndrome

We carefully read the recent study by Liu et al on the effectiveness of tofacitinib for refractory Behçet’s syndrome (BS).1 In total, 13 patients with BS were enrolled, including 5 cases with vascular involvement, 7 with gastrointestinal (GI) ulcers and one suffering polyarthritis. As an add-on approach, tofacitinib improved the outcomes in all patients with vascular lesions, but unchanged or worsened in 5/7 GI involvement cases. Their observation give support to the hypothesis that BS is not an independent disease, but a heterogeneous and multisystemic complex syndrome.2 Different major organ involvements, vascular and GI involvement could link to its unique underlying immunopathological mechanisms, which led to radical treatment responses.3 In their study, the only manifestation of ocular involvement was scleritis in one patient with polyarthritis, which is not a specific ophthalmological feature of BS. Notably, uveitis is one of the specific features of ocular involvement in patients with BS,4 which may lead to visual loss in up to 25% of patients in spite of biological agents.5 Here, we reported the efficacy and safety profile …

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