| Abstract | BACKGROUND: Behçet's disease is a multisystem vasculitis of unknown origin. Standard treatment mainly comprises systemic immunosuppressive agents. Ocular involvement, mostly posterior uveitis with retinal vasculitis, leads to blindness in 20-50% of the involved eyes within 5 years. The efficacy of interferon alfa-2a was studied in patients with sight threatening posterior uveitis or retinal vasculitis. METHODS: 50 patients were included in this open, non-randomised, uncontrolled prospective study. Recombinant human interferon alfa-2a (rhIFNalpha-2a) was applied at a dose of 6 million units subcutaneously daily. Dose reduction was performed according to a decision tree until discontinuation. Disease activity was evaluated every 2 weeks by the Behçet's disease activity scoring system and the uveitis scoring system. RESULTS: Response rate of the ocular manifestations was 92% (three non-responder, one incomplete response). Mean 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). Remission of retinal inflammation was achieved by week 24. Mean Behçet's disease activity score fell from 5.8 to 3.3 at week 24 and further to 2.8 at week 52. After a mean observation period of 36.4 months (range 12-72), 20 patients (40%) are off treatment and disease free for 7-58 months (mean 29.5). In the other patients maintenance IFN dosage is three million units three times weekly. CONCLUSIONS: rhIFNalpha-2a is effective in ocular Behçet's disease, leading to significant improvement of vision and complete remission of ocular vasculitis in the majority of the patients. |
| Authors | I Kötter, M Zierhut, A K Eckstein, R Vonthein, T Ness, I Günaydin, B Grimbacher, S Blaschke, W Meyer-Riemann, H H Peter, N Stübiger
(Affiliation: University Hospital, Departments of Internal Medicine II (Hematology, Oncology, Immunology and Rheumatology) and Ophthalmology, Tübingen, Germany. ina.koetter at med.uni-tuebingen.de)
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| Journal | The British journal of ophthalmology
(Br J Ophthalmol)
Vol. 87
Issue 4
Pg. 423-31
(Apr 2003)
ISSN: 0007-1161 England |
| PMID | 12642304
(Publication Type: Journal Article)
|
| Chemical References |
- Angiogenesis Inhibitors
- Interferon Alfa-2a
|
| Topics |
- Adult
- Angiogenesis Inhibitors
(adverse effects, therapeutic use)
- Behcet Syndrome
(complications, drug therapy)
- Female
- Humans
- Interferon Alfa-2a
(adverse effects, therapeutic use)
- Male
- Middle Aged
- Panuveitis
(drug therapy, etiology)
- Patient Compliance
- Prospective Studies
- Recurrence
- Remission Induction
- Retinal Vasculitis
(drug therapy, etiology)
- Software Design
- Treatment Outcome
- Uveitis, Anterior
(drug therapy, etiology)
- Uveitis, Posterior
(drug therapy, etiology)
- Visual Acuity
|
