TREATMENT OF OCULAR SYMPTOMS OF BEHCETS-DISEASE WITH INTERFERON ALPHA(2A) - A PILOT-STUDY

Aim-To study long term effects of interferon alpha(2a) (IFN alpha(2a)) on panuveitis in seven patients with Behcet's disease in a prospectiv e, open clinical trial. Methods-Seven patients were treated with IFN a lpha(2a) for a mean of 23.6 months (14-37 months). They received an in itial dose of IFN alpha(2a) of 6 x 10(6) IU/day, followed by 3 x 10(6) IU/day after 1 month and 3 x 10(6) IU every other day after 3 months. Two patients received low dose prednisolone (between 0.2 and 0.4 mg/k g/body weight) additionally at the beginning of the therapy. Complete cessation of IFN alpha(2a) was possible in three patients (observation period 22, 6, and 4 months). Results-Marked improvement occurred in s ix patients who had ocular manifestations of Behcet's disease for the first time or with minor damage during their course of chronic relapsi ng panuveitis. In one patient with advanced ocular Behcet's disease, n ew relapses were prevented. Retinal infiltrates resolved within 2 week s; vasculitis, macular oedema, infiltration of the anterior chamber an d vitreous resolved within 4 weeks. Mean posterior uveitis score befor e treatment (nine affected eyes) was 6.6, 4 weeks after IFN it was red uced to 0.4, The mean observation period is 27.6 months, ranging from 14 to 42 months. Conclusion-Treatment of ocular symptoms of Behcet's d isease with IFN alpha(2a) alone or in combination with low dose steroi ds led to complete remission of ocular vasculitis in all patients trea ted in this open, uncontrolled trial. Treatment with IFN alpha(2a), ma y prevent permanent retinal or optic nerve damage due to vascular occl usion. No severe side effects occurred. Controlled randomised studies are warranted in order to prove the efficacy of IFN alpha(2a) in ocula r Behcet's disease and to compare it with other, established treatment s such as azathioprine or cyclosporin A.