Cyclophosphamide and Adalimumab Combination Therapy as Steroid-Free Induction in Acute Neuro-Behcet?s Diseases on Cambodian patients: A Case Report

Kosal Kang

Abstract: Neuro-Behcet's diseases (NBD) represents a significant complication "Behcet's syndromes", potentially leading to elevated mortality and disability rates. The standard treatment for parenchymal NBD typically entails administering high-dose corticosteroid to prompt rapid-onset effects, coupled with immunosuppressant to prevent subsequent relapse. This case report describes a corticosteroid-free induction strategy for neuro-Behcet's diseases (NBD), a severe complication association with high morbidity. A 43-year-old male with a history of NBD presented with progressive dysarthria and new brain MRI lesions. Due to steroid-induced intraocular hypertension worsening pre-existing glaucoma, standard high-dose corticosteroid therapy was contraindicated. The patient received a combination of cyclophosphamide and adalimumab as induction therapy, followed by mycophenolate mofetil for maintenance. Clinical symptoms improved within two weeks, and serial MRI scans at 3 and 10 months showed resolution of lesions with no new activity. The patient remained relapse-free at 17 months. This case suggests that cyclophosphamide-adalimumab combination may serve as an alternative steroid-free induction approach in selected NBD patients. Further studies are needed to validate efficacy and safety.

Keywords: Neuro-Behcet's disease, Cyclophosphamide, Adalimumab, Central nervous system, Steroid-free therapy

How to Cite?: Kosal Kang, "Cyclophosphamide and Adalimumab Combination Therapy as Steroid-Free Induction in Acute Neuro-Behcet?s Diseases on Cambodian patients: A Case Report", Volume 15 Issue 4, April 2026, International Journal of Science and Research (IJSR), Pages: 799-801, https://www.ijsr.net/getabstract.php?paperid=SR26410120932, DOI: https://dx.doi.org/10.21275/SR26410120932

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