American Board of Internal Medicine (ABIM) Certification Practice Exam

Which therapy has been noted for use in recalcitrant cases of Behçet syndrome?

1. Monoclonal antibodies against TNF-α

2. Corticosteroids alone

3. Antihypertensive agents

4. Acetaminophen

The correct answer is: Monoclonal antibodies against TNF-α

Monoclonal antibodies against TNF-α have been recognized as a significant therapeutic option for recalcitrant cases of Behçet syndrome. Behçet syndrome is characterized by recurrent oral and genital ulcers, uveitis, and systemic manifestations, and it can be challenging to treat, particularly in patients who do not respond to conventional therapies. The autoimmune and inflammatory nature of Behçet's ties directly to the role of tumor necrosis factor-alpha (TNF-α) in promoting inflammatory processes. TNF-α inhibitors work by specifically targeting and neutralizing this cytokine, leading to reduced inflammatory activity and symptom relief in patients. Clinical studies have demonstrated the efficacy of these monoclonal antibodies in improving symptoms and reducing the frequency of relapses in individuals with severe forms of Behçet syndrome. Corticosteroids are often used in the management of Behçet syndrome, but their long-term use can lead to significant side effects, and they may not be effective in all patients. Antihypertensive agents and acetaminophen do not address the underlying inflammatory process of Behçet syndrome and are typically not utilized as primary treatments for this condition. Thus, monoclonal antibodies against TNF-α are especially valuable