LONG-TERM EFFECTIVENESS AND SAFETY OF RECOMBINANT HUMAN INTERFERON-GAMMA THERAPY FOR ATOPIC-DERMATITIS DESPITE UNCHANGED SERUM IGE LEVELS

Objective: To assess the long-term effects of recombinant human interf eron gamma treatment of atopic dermatitis (AD). Design: Case series. P atients were treated for up to 24 months. Setting: University dermatol ogy outpatient clinics in Ann Arbor, Mich, and Portland, Ore. Patients : Twenty-four of 32 eligible patients who participated in a previously reported, 12-week, double-blind, placebo-controlled study of recombin ant human interferon gamma treatment for AD were enrolled. Interventio n: Patients self-administered recombinant human interferon gamma, 50 m u g/m(2), by daily subcutaneous injection. Main Outcome Measures: Over all response; body surface area of involvement; clinical severity scor es for pruritus, erythema, edema, excoriations, dryness, scaling, and lichenification; other atopic symptoms; and laboratory parameters, inc luding serum IgE levels, were monitored at quarterly visits. Results a t 1 and 2 years were compared with baseline values. Results: All effic acy parameters improved (P<.05). For example, pruritus was reduced by 50% after both 1 (n = 24, P<.001) and 2 (n = 16, P =.005) years. Aller gic conjunctivitis and allergic rhinitis also improved (P<.01). Eosino phil counts decreased significantly (P<.001). IgE levels increased. Cl inical improvement more closely correlated with changes in eosinophil counts (r=0.3-0.5) than.with changes in IgE levels (r=0.0-0.2). Only 1 patient discontinued therapy because of adverse effects (flulike symp toms). Conclusions: The initial efficacy and adverse effects reported For recombinant human interferon gamma treatment of patients with AD w ere maintained after 2 years of long-term use. Recombinant human inter feron gamma seems to be a well-tolerated and effective agent in the lo ngterm therapy of patients with AD. Therapies that correct cellular im mune defects, but not humoral immune defects, may be effective in the treatment of patients with AD.