Behcet’s s yndrome (BS) is a multisystem vasculitis with frequent mucocutaneous, joint, eye
and visceral organ involvement. From early 2000s, biologic drugs have been increasingly used in the
management of BS, enabling rapid and complete remission in most cases with critical organ involvement.
Despite the current experience with steroids and traditional immunosuppressives, biologics are exceptionally
promising for treatment of resistant cases. Among the biologics used in BS, TNF-alpha antagonists
are the oldest and their efficacy has been proven in recalcitrant ocular, vascular, gastrointestinal and neurologic
involvements. These drugs have significantly reduced morbidity and mortality in BS and they have an acceptable
safety profile. Tocilizumab, an IL6 receptor antibody, has been shown to be effective in BS patients with neurologic involvement
and amyloidosis, and IL1β antagonists such as anakinra, canakinumab, gevokizumab were effective in the
management of ocular involvement. Studies investigating the efficacy of daclizumab, IL2 receptor antibody, and secukinumab,
IL17 monoclonal antibody, in the management of BS with eye involvement failed to demonstrate significant clinical
improvement and both studies were halted. A monoclonal vascular endothelial growth factor antagonist, bevacizumab,
was shown to be effective in BS-related macular edema. Alemtuzumab and ustekinumab are among other biologics which
were effective in controlling disease symptoms. In this review, we discuss the efficacy and safety of various recently developed
biologic agents targeting different pathways involved in the pathogenesis of BS.