Use of gevokizumab for the treatment of Behçet's disease

Introduction: Behcet's disease is a rare systemic autoinflammatory disorder of unknown aetiology. The hetereogenous clinical presentation makes treatment with standardised regimes a challenge and routine immunosuppressant therapies may render patients susceptible to relapse episodes. Amongst various manifestations caused by the chronic relapsing vasculitis indicative of this disease, ocular inflammation is potentially the most damaging with the risk of permanent loss of vision. Elevated levels of systemic IL-1 beta proinflammatory cytokine have been implicated in the development of many autoinflammatory disorders including Behcet's disease. Areas covered: Gevokizumab is a humanised monoclonal antibody that antagonises IL-1 beta activity through a novel mode of action and is currently in Phase III clinical trials following promising initial results. The aim of this review is to cover the potential for using gevokizumab to resolve uveitis associated with Behcet's disease with a focus on the clinical trial data posted to date. These data will be considered for efficacy alongside the current recommended guidelines for the treatment of Behcet's disease and other novel biological agents being evaluated to treat Behcet's disease based on the immunopathogenesis of this disease including alternative IL-1 beta antagonists. Expert opinion: Data from an open-label pilot trial in Behcet's disease with uveitis complications suggest that gevokizumab is an efficient compound in the treatment of ocular inflammation. Taken alongside data from pre-clinical studies and early-phase trials in other IL-1 beta mediated conditions, gevokizumab's efficacy and mode of action appears well suited to offer advantages such as low-dosage concentrations and extended dosing intervals. Phase III clinical trials currently underway in Behcet's disease will hope to confirm these observations.