New and emerging pharmacological solutions for Behçet's syndrome.

Abstract

Introduction: Behçet's syndrome is a chronic multisystem inflammatory disease characterized by mucocutaneous lesions, ocular inflammation, and major-organ involvement. Treatment aims to prevent irreversible organ damage and maximize health-related quality of life.

Areas covered: This review summarizes current therapeutic approaches based on the 2025 update of the European Alliance of Associations for Rheumatology recommendations for Behçet's syndrome. Core recommended therapies, including colchicine, glucocorticoids, apremilast, conventional immunosuppressants, and TNF inhibitors, are selected for individual organ involvement depending on severity. The updated recommendations refine treatment strategies and emphasize individualized management rather than substantially expanding therapeutic options. This review also examines emerging non-TNF biologics targeting IL-1, IL-6, IL-17, and IL-12/23, and Janus kinase inhibitors. PubMed was searched from database inception through August 2026.

Expert opinion: The rarity of Behçet's syndrome and the lack of standardized assessment tools remain major obstacles to conducting high quality clinical trials. In addition, several anti cytokine therapies may be associated with organ-specific or paradoxical manifestations in Behçet's syndrome. Further evidence is required to clarify both the efficacy and safety profiles of new therapeutic agents, and prospective controlled studies will be essential to establish their roles in clinical practice.