Efficacy and Safety of Interferon Alfa-2a in Intractable Behçet’s Disease-associated Uveitis

Abstract

Abstract: : Purpose: To evaluate the visual outcome of patients presenting with a severe form of Behçet’s disease-associated uveitis treated with interferon alfa-2a. Methods: The medical records of patients presenting with Behçet’s disease uveitis (fulfilling the criteria of the International Study Group), between May 1995 and November 2001, and relapsing despite corticosteroids and immunosuppressive agents were analyzed. Ophthalmological examination, fluorescein angiography and laboratory tests were performed at regular intervals. Interferon alfa (3 millions units thrice a week) was injected subcutaneously. Results: 22 patients (34 eyes) were included. The mean age was 31.6 years (11.5-58 y). The mean evolution time of uveitis before referral was 44.9 months (6-167 m) and patients presented with an average of 3 relapses (0-9) before inclusion. All patients required corticosteroids before IFN therapy and an immunosuppressive regimen was necessary in 18 cases (81.8%). IFN alfa was efficient in 20 cases (90.9 %) with a mean follow-up period of 26.4 months (3-77 m). A two-line improvement of the VA was observed in 11 cases (50%). Steroids were tapered from a mean dosage of 23.8 to 11 mg/d. Treatment was discontinued in 7 cases with a mean follow-up of 16.3 mo (2-27 m). However, 3 patients relapsed between 2 and 7 months after the end of IFN therapy. IFN alfa was stopped in one case for a severe depression. Transient flu-like syndrome was observed in all cases. Conclusions: IFN-alfa can be a safe and effective alternative for the management of intractable forms of uveitis during Behçet’s disease, allowing a reduction of steroid dosage. However, discontinuation seems to be difficult to achieve without consecutive relapses.

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