Behçet syndrome biologic therapy — SCE Rheumatology MCQ

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HardVasculitisBehçet syndrome biologic therapySCE Rheumatology

A 29-year-old woman with Behçet syndrome has recurrent posterior uveitis and retinal vasculitis despite azathioprine and corticosteroids. Infection and lymphoma have been excluded. Ophthalmology documents new macular oedema. A biologic is being considered urgently to protect vision. What is the most appropriate biologic?

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Correct answer: E — Infliximab

Explanation lettering: B = shown as A · C = shown as B · D = shown as C · A = shown as D

Infliximab is best because anti-TNF monoclonal antibodies such as infliximab are used for severe ocular Behçet with retinal vasculitis. A is less suitable because etanercept is less preferred for severe ocular Behçet compared with monoclonal anti-TNF therapy; B is less suitable because denosumab treats osteoporosis; C is less suitable because mepolizumab targets eosinophilic disease such as EGPA; D is less suitable because belimumab is an SLE biologic. Clinical pearl: posterior uveitis in Behçet is an emergency because relapses can cause cumulative visual loss.

Reference: BSR-BAD Behçet living guideline 2025; EULAR Behçet recommendations