The mucocutaneous and articular clinical phenotype is the most common presentation of Behçet’s disease (BD).1 Current treatment modalities, such as colchicine and apremilast, have debatable efficacy or inconsistent tolerability. There remains a need for a safe and effective treatment for refractory mucocutaneous and articular BD.

Genetic predisposition in BD identified interleukin (IL)-23R and IL-12RB2 as BD susceptibility loci.2 Increased expression of IL-23 messenger RNA has been demonstrated in BD skin lesions.3 Guselkumab is a human anti-IL-23 monoclonal antibody approved for the management of psoriasis and psoriatic arthritis.4

We conducted a multicentric observational retrospective study between 2019 and 2023 to evaluate the effectiveness and safety of guselkumab for the treatment of patients with refractory mucocutaneous and articular BD.

All adult patients met the criteria of the International Study Group for BD and were initially treated with 100 mg of guselkumab subcutaneously at weeks 0 and 4, then every 8 weeks.

The primary efficacy end point was the proportion of responders at week 12.

The response was defined as complete for patients who had no oral ulcers in the previous 4 weeks in addition to …