Efficacy of interferon alfa-2a in severe and refractory uveitis associated with Behçet's disease.
OBJECTIVE
To evaluate the efficacy of interferon alfa-2a (IFN alfa) in severe uveitis associated with Behçet's disease, that is refractory to steroids and conventional immunosuppressive agents.


METHODS
Patients with Behçet's disease (according to the International Study Group criteria), who relapsed despite steroids and immunosuppressive agents, were included in this retrospective study. Ophthalmological examination, laser flare photometry, and fluorescein angiography associated with laboratory tests were performed at regular intervals. IFN alfa (3 millions units thrice a week) was injected subcutaneously.


RESULTS
Eight patients (sex ratio: 1) were included between May 1995 and January 1999. The mean age was 29.1 years (14-54 years) and the disease was present between 11 and 167 months before the administration of IFN alfa. IFN alfa was efficient in all cases with a mean follow-up of 22 months (10-55 months). Steroids were tapered from a mean dosage of 47 mg/d to a mean dosage of 8.5 mg/d. Ocular inflammation was controlled and visual acuity improved in all cases. Treatment was generally well tolerated despite a constant but transient flu-like syndrome. IFN alfa was tapered in three patients and stopped in one case without any relapse after five months.


CONCLUSIONS
Within the limitations of this retrospective study, low-dose IFN alfa seems to be well tolerated, promising in the management of refractory forms of uveitis due to Behçet's disease, and effective in allowing a reduction of steroid dosage. A prospective controlled study is necessary to confirm these preliminary results.
Department of Internal Medicine, Hôpital Pitié-Salpêtrière, Paris, France. bertrand.weschler@psl.ap-hop-paris.fr
B
B
Wechsler
B
B
Bodaghi
D L
DL
Huong
C
C
Fardeau
Z
Z
Amoura
N
N
Cassoux
J C
JC
Piette
P
P
LeHoang
D000293:Adolescent; D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D001528:Behcet Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D003937:Diagnosis, Differential; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011994:Recombinant Proteins; D012160:Retina / Q000473:pathology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015866:Uveitis, Posterior / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D014792:Visual Acuity; D014822:Vitreous Body / Q000473:pathology*
D020533:Angiogenesis Inhibitors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins