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M. Zierhut, N. Stübiger, A.K. Eckstein, R. Vonthein, T. Ness, I. Guenaydin, B. Grimbacher, S. Blaschke, W. Meyer-Riemann, I. Kötter; Human Recombinant Interferon-alpha2a in the Treatment of Behcet's Disease with Sight Threatening Retinal Vasculitis . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2012.
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Purpose: To study the efficacy of interferon-alpha2a (IFNa2a) in patients with sight-threatening posterior uveitis and retinal vasculitis. Methods: Fifty patients were included in an open pilot study. Interferon-alpha2a was applied at a dose of 6 Million units daily. Dose reduction was performed according to a decision tree until discontinuation. Disease activity was evaluated every second week by the Behcet’s Disease Activitiy Scoring System and the Uveitis Scoring System. For statistical analysis ANCOVA was performed. Results: Response rate of the ocular manifestations was 92 % (3 non-responder, 1 incomplete response). Visual acuity rose significantly from 0.56 to 0.84 at week 24 (p<0.0001). Posterior uveitis score of the affected eyes fell by 46 % every week (p<0.001). All (n=77) affected eyes reached remission of the score by week 24. Mean Behcet’s Disease Activity Score fell from 6.6 to 3.1 at week 24 and further to 1.8 at week 52. After a mean observation period of 36.4 months (range 12 - 74), 20 patients (40 %) are off treatment and disease free for 7 to 58 months (mean 29.5). In the other patients, maintenance dosage is 3 Million units 3 times weekly. The side effects were mostly dose dependent and relatively mild. Conclusions: IFNa2a is effective in severe ocular Behcet’s Disease, leading to significant improvement of vision and complete remission of ocular vasculitis. The mode of action is still unknown. It may be superior to the standard immunosuppressive treatment with respect to the possibility of complete tapering without relapse.
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