[The use of interferon alfa-2r in the treatment of autoimmune uveitis (primary or associated with Behçet's disease)].
BACKGROUND
The improvement in ocular inflammation in patients with cyclosporine A resistant Behçet disease (CyA) during therapy of severe aphthosis with recombinant interferon-alpha 2b (IFN alpha) prompted its evaluation for treatment of refractory autoimmune uveitis.


METHODS
IFN alpha was used in 18 patients with posterior uveitis, nine with Behçet disease and nine with primary uveitis (mean evolution time 3.8 years) previously treated with corticosteroids (18), CyA (16) and azathioprine (1). The dose was 5 MU/day (4 weeks) and then twice weekly (12 weeks) maintaining the previous therapy. Evaluations were made at the start of the study, two weeks and two months and a cross-sectional study in February 1995.


RESULTS
At the early phase both vitreal cellularity (p = 0.01) and macular edema (p = 0.003) improved; at the late phase improvements were noted in vitreal cellularity (p < 0.0001), macular (p < 0.0001) and papillar edema (p = 0.04) and visual acuity (p = 0.006). In February 1995 (mean evolution time 30 months), ten patients (56%) remain without treatment with inactive disease, six (33%) with CyA and two (11%) with CyA and IFN alpha. Improvements in vitreal cellularity (p = 0.0001), macular edema (p = 0.0001) and visual acuity (p = 0.013) were still present although macular ischemia was more severe than at the beginning (p = 0.035). The most important adverse reactions (late reactions) included depression (three cases) and thyroid changes (two cases).


CONCLUSIONS
IFN alpha is an important therapeutic alternative for posterior uveitis refractory to corticosteroid therapy (included CyA).
Sánchez Román
J
J
Unidad de Colagenosis, Hospital Universitario Virgen del Rocío, Sevilla.
Pulido Aguilera
M C
MC
Castillo Palma
M J
MJ
Ocaña Medina
C
C
Toral Peña
A
A
López-Checa
F
F
Wichmann
I
I
D000293:Adolescent; D000328:Adult; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000628:therapy*; D001528:Behcet Syndrome / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011994:Recombinant Proteins; D018709:Statistics, Nonparametric; D014605:Uveitis / Q000175:diagnosis / Q000628:therapy*
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins
Utilización de interferón alfa 2r en el tratamiento de las uveítis autoinmunes (primarias o asociadas a enfermedad de Behçet).