Safety and effectiveness of interferon alpha-2a in treatment of patients with behet's uveitis refractory to conventional treatments
Ophthalmology, cilt.117, sa.7, ss.1430-1435, 2010 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 117 Sayı: 7
- Basım Tarihi: 2010
- Doi Numarası: 10.1016/j.ophtha.2009.11.022
- Dergi Adı: Ophthalmology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.1430-1435
- Sağlık Bilimleri Üniversitesi Adresli: Hayır
Özet
Purpose: To evaluate the intermediate-term safety and effectiveness of interferon alpha-2a (IFNα2a) in patients with Behçets uveitis (BU) refractory to corticosteroids and immunosuppressive agents. Design: Open, nonrandomized, uncontrolled, interventional, prospective study. Participants: Fifty-three patients (106 eyes) with active, vision-threatening BU who failed to respond to conventional treatments. Intervention: In 53 patients, acute inflammation was suppressed with effective prednisolone dosage (12 mg/kg/day, tapered to 10 mg within 46 weeks). The patients were treated with IFNα2a 4.5 million international units (MIU) 3 times per week for the first 3 months followed by IFNα2a 3 MIU 3 times per week for the next 3 months. Observation or other treatment methods were performed according to the decision tree developed for this study. Main Outcome Measures: Remission and complete response (primary outcome measures), frequency of uveitis attacks, visual acuity (VA), and adverse effects (secondary outcome measures). Results: During 2 years of follow-up (median 65 months, range 12130 months), compliance with the therapy was excellent. At the end of 1-year follow-up, treatment response was obtained in 45 of 53 patients (84.9%). The mean attack rate of 3.6±1.1 per year (range, 28) decreased to 0.56±0.75 (range, 04) per year (P=0.001). Visual acuity improved (≥0.2 logarithm of the minimum angle of resolution units from initial VA) in 30 eyes (28.3%) and worsened in 12 eyes (11.3%). Five patients (9.4%) did not respond to the initial treatment, and 3 patients (5.6%) developed severe adverse effects, including psoriasis, epileptic seizure, and extreme tiredness. Fifteen patients (28.3%) were off treatment for all the medications and disease free for 28±13.1 months (range, 1250 months). Conclusions: These results suggest that IFNα2a may be a valuable treatment option in BU that is refractory to corticosteroids and conventional immunosuppressive agents. The possible role of IFNα2a as a first-line agent in BU should be validated in randomized controlled clinical trials against newly described biologic agents. © 2010 by the American Academy of Ophthalmology.