Behçet disease is a systemic vasculitis that frequently causes ocular manifestations, including uveitis, macular edema and retinal vasculitis. Interferon (IFN)-α is a highly effective treatment in patients with ocular manifestations, yielding high (>90%) rates of response and remission. In a retrospective study, Deuter et al. assessed the frequency of long-term, treatment-free remission in patients with Behçet disease and severe eye inflammation.
The analysis included 53 patients (41 men) at a single institution who received IFN-α-2a and for whom at least 2 years of follow-up data were available. IFN-α-2a was administered at a starting dose of 6 × 106 IU per day subcutaneously for at least 2 weeks, which was tapered to a maintenance dose of 3 × 106 IU twice per week and discontinued if possible, depending on disease activity.
Overall, 52 (98.1%) of 53 patients responded to therapy and achieved remission, of whom 47 were able to discontinue treatment with IFN-α-2a. Of these 47 patients, 20 relapsed and required an additional course of treatment during a median follow-up period of 6.0 years (range 2.0–12.6 years). The median duration of IFN-α-2a therapy in responders was 22.4 months, and tended to be shorter in women than in men. Women also seemed to have a reduced relapse rate. Visual acuity was improved or stabilized at the end of follow-up compared to baseline in 91 (94.8%) of the 96 affected eyes in the study.
The authors conclude that IFN-α-2a therapy is associated with a high rate of long-term, treatment-free remission, and seems to outperform standard immunosuppressive drugs and tumor necrosis factor antagonists in this regard.
ORIGINAL RESEARCH PAPER
Deuter, C. M. E. et al. Long-term remissions after cessation of interferon alpha treatment in patients with severe uveitis due to Behçet's disease. Arthritis Rheum. doi:10.1002/art.27581
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Warde, N. Behçet uveitis: good results for IFN-α-2a. Nat Rev Rheumatol 6, 437 (2010). https://doi.org/10.1038/nrrheum.2010.115
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DOI: https://doi.org/10.1038/nrrheum.2010.115
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