title: The 2nd edition of consensus statements for the diagnosis and management of intestinal Behçet's disease: indication of anti-TNFα monoclonal antibodies.
abstract: BACKGROUND
  Clinical evidence regarding intestinal Behçet's disease (BD) management is lacking and intestinal lesions are a poor prognostic factor. In 2007, the Japan consensus statement for diagnosis and management of intestinal BD was developed. Recently, the efficacy of anti-tumor necrosis factor (TNF)α monoclonal antibodies (mAbs), and infliximab (IFX) was reported and adalimumab (ADA) was approved for intestinal BD in Japan. This study renewed consensus-based practice guidelines for diagnosis and treatment of intestinal BD focusing on the indication of anti-TNFα mAbs.
  
  
  METHODS
  An expert panel of Japanese gastroenterology and rheumatology specialists was involved. Clinical statements for ratings were extracted from the literature, a professional group survey, and by an expert panel discussion, which rated clinical statements on a nine-point scale. After the first round of ratings, a panelist meeting discussed areas of disagreement and clarified areas of uncertainty. The list of clinical statements was revised after the panelist meeting and a second round of ratings was conducted.
  
  
  RESULTS
  Fifteen relevant articles were selected. Based on the first edition consensus statement, improved clinical statements regarding indications for anti-TNFα mAbs use were developed. After a two-round modified Delphi approach, the second edition of consensus statements was finalized.
  
  
  CONCLUSIONS
  In addition to standard therapies in the first edition, anti-TNFα mAbs (ADA and IFX) should be considered as a standard therapy for intestinal BD. Colchicines, thalidomide, other pharmacological therapy, endoscopic therapy, and leukocytapheresis were deemed experimental therapies.
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan, hisamachi@a7.keio.jp.
authors: Tadakazu
authors: T
authors: Hisamatsu
authors: Fumiaki
authors: F
authors: Ueno
authors: Takayuki
authors: T
authors: Matsumoto
authors: Kiyonori
authors: K
authors: Kobayashi
authors: Kazutaka
authors: K
authors: Koganei
authors: Reiko
authors: R
authors: Kunisaki
authors: Fumihito
authors: F
authors: Hirai
authors: Masakazu
authors: M
authors: Nagahori
authors: Mitsunobu
authors: M
authors: Matsushita
authors: Kenji
authors: K
authors: Kobayashi
authors: Mitsumasa
authors: M
authors: Kishimoto
authors: Mitsuhiro
authors: M
authors: Takeno
authors: Masanori
authors: M
authors: Tanaka
authors: Nagamu
authors: N
authors: Inoue
authors: Toshifumi
authors: T
authors: Hibi
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001528:Behcet Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D003697:Delphi Technique; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000188:drug therapy; D017410:Practice Guidelines as Topic; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha
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