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The Long Silk Road

Jason Liebowitz, MD, FACR  |  Issue: August 2025  |  July 28, 2025

Gold standard tests that aid diagnosis of Behçet’s disease beyond the recognition of clinical symptoms and signs need to be established. Standardized treatment algorithms that can be broadly applied throughout the world need to be developed, and the application of uniform response criteria in clinical trials needs improvement.

Dr. Piga’s presentation was inspiring and helped the audience better understand this heterogeneous and complex condition. Whether you live near or far from what was once the Silk Road, we should keep these insights into Behçet’s disease in mind and, as Dr. Piga noted, keep an open eye for the condition wherever it may be lurking.

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Jason Liebowitz, MD, FACR, is an assistant professor of medicine in the Division of Rheumatology at Columbia University Vagelos College of Physicians and Surgeons, New York.

References

  1. Leonardo NM, McNeil J. Behcet’s disease: Is there geographical variation? a review far from the silk road. Int J Rheumatol. 2015;2015:945262.
  2. Ortiz-Fernández L, Sawalha AH. Genetics of Behçet’s disease: Functional genetic analysis and estimating disease heritability. Front Med (Lausanne). 2021 Feb 12;8:625710.
  3. Emmi G, Bettiol A, Hatemi G, et al. Behçet’s syndrome. Lancet. 2024 Mar 16;403(10431):1093–1108.
  4. Wang Q, Ma J, Gong Y, et al. Sex-specific circulating unconventional neutrophils determine immunological outcome of auto-inflammatory Behçet’s uveitis. Cell Discov. 2024 May 4;10(1):47.
  5. Saadoun D, Maalouf G, Vieira M, et al. Infliximab versus cyclophosphamide for severe Behçet’s syndrome. NEJM Evid. 2024 Nov;3(11):EVIDoa2300354.
  6. Moots RJ, Fortune F, Jackson R, et al. Infliximab vs. interferon-α in the treatment of Behçet’s syndrome: Clinical data from the BIO-BEHÇET’S randomized controlled trial. Rheumatology (Oxford). 2025 May 1;64(5):2882–2891.
  7. Zhong Z, Deng D, Gao Y, et al. Combinations of immunomodulatory agents for prevention of uveitis relapse in patients with severe Behçet’s disease already on corticosteroid therapy: A randomised, open-label, head-to-head trial. Lancet Rheumatol. 2024 Nov;6(11):e780–e790.
  8. Talarico R, Italiano N, Emmi G, et al. Efficacy and safety of infliximab or adalimumab in severe mucocutaneous Behçet’s syndrome refractory to traditional immunosuppressants: A 6-month, multicentre, randomised controlled, prospective, parallel group, single-blind trial. Ann Rheum Dis. 2024 Oct 17:ard-2024-226113.
  9. Peñuelas Leal R, Labrandero Hoyos C, Peñuelas Ruiz JA, et al. Treatment of Behçet disease with oral roflumilast: An observational study. Clin Exp Dermatol. 2024 Dec 23;50(1):62–68.

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Filed under:ConditionsEULAR/OtherMeeting Reports Tagged with:Behçet’s diseaseEULAR 2025Uveitis

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