title: Long-term efficacy and safety of low-dose interferon alpha2a therapy in severe uveitis associated with Behçet disease.
abstract: OBJECTIVE
  To investigate long-term responsiveness of patients with severe uveitis associated with Behçet disease to interferon alpha2a (IFN-alpha2a).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Thirty-two patients with sight-threatening uveitis associated with Behçet disease who relapsed despite corticosteroids and immunosuppressive agents were included. IFN-alpha2a was administered subcutaneously (three million units thrice a week). Ophthalmologic examination and fluorescein angiography associated with laboratory tests were performed at regular intervals. Main outcome measures were visual acuity and recurrence of uveitis attacks before, during, and after initiation of IFN-alpha2a therapy.
  
  
  RESULTS
  Control of inflammation was achieved in 28 of 32 patients (88%). Mean observation period of the 28 responder patients was 70.6 months (range, 30.3 to 129.2 months). Median visual acuity improved from 0.52 to 0.33 (logarithm of the minimum angle of resolution units; P = .005) two years after initiation of IFN-alpha2a therapy. The relapse rate decreased significantly during IFN-alpha2a treatment from 1.68 +/- 1.22 relapses/patient/year to 0.11 +/- 0.20 relapses/patient/year (P < .0001). IFN-alpha2a was discontinued in 19 of 28 patients (68%) after 32 months of treatment (range, 16 to 50 months). Mean follow-up after IFN-alpha2a discontinuation was 43 months (range, 11 to 84 months). After IFN-alpha2a discontinuation, the relapse rate increased from 0.08 +/- 0.21 relapse/person/year to 0.74 +/- 1.40 relapse/person/year (P = 0.04).
  
  
  CONCLUSIONS
  IFN-alpha2a is efficient and safe for the long-term management of severe uveitis associated with Behçet disease. Meanwhile it seems to be a suspensive therapeutic strategy, even though long-term remission is possible in some patients.
authors.affiliation: Department of Ophthalmology, University of Paris VI, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Gueudry
authors.forename: Bertrand
authors.initials: B
authors.lastname: Wechsler
authors.forename: Céline
authors.initials: C
authors.lastname: Terrada
authors.forename: Gaël
authors.initials: G
authors.lastname: Gendron
authors.forename: Nathalie
authors.initials: N
authors.lastname: Cassoux
authors.forename: Christine
authors.initials: C
authors.lastname: Fardeau
authors.forename: Phuc
authors.initials: P
authors.lastname: Lehoang
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Piette
authors.forename: Bahram
authors.initials: B
authors.lastname: Bodaghi
mesh_terms: D000293:Adolescent; D000328:Adult; D001528:Behcet Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D055104:Infusions, Subcutaneous; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011994:Recombinant Proteins; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014605:Uveitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011241:Prednisone; D008775:Methylprednisolone