Abstract
Purpose::
To evaluate the frequency and duration of long-term remission in patients with severe ocular Behçet's Disease (BD) who were treated with interferon (IFN) alpha-2a and who completed a follow-up of at least 5 years.
Methods::
For this analysis consecutive 23 patients (41 affected eyes) with complete BD were treated with IFN alpha-2a. The dosage was 6 mio IU per day for at least 2 weeks, stepwise (depending on the course) reduction to a maintenance dose of 3 mio IU 2x/week, finally discontinued if possible. Previous immunosuppressive treatment was stopped one day before start of IFN, steroids reduced to 10 mg prednisolone per day gradually. In case of recurrences IFN was reinstituted in the same way.
Results::
There was a response in all 23 patients. Sixty months after begin of the IFN-treatment, 16 patients (69.6%) were without treatment. Two of these patients had a relapse after the first course of IFN, but came into complete remission after reinstitution of IFN. One of these 2 experienced a second relapse. All other 14 patients (60.9%) remained free of recurrences after the first IFN course, leading to remission of at least 2 years in 43.5% and at least 3 years in 21.7%. In 7 patients IFN treatment was ongoing after 5 years. In 4 patients we were unable to stop IFN. Analysing all patients after complete follow-up of mean 7.1 years (5.0-11.0 years) the relapse free-time was 60.9% (at least 2 years), 52.2% (at least 3 years), and 26.1% (at least 6 years).
Conclusions::
In this study 69.6% of patients were free of recurrences after one course of IFN during a 5-years study period. This has not been reported for any other drug for BD and represents a clear advantage to other anti-inflammatory drugs.
Keywords: inflammation • uveitis-clinical/animal model • immunomodulation/immunoregulation