Efficacy of interferon alfa-2a in severe and refractory uveitis associatedwith Behcet's disease

Purpose: To evaluate the efficacy of interferon alfa-2a (IFN alfa) in sever e uveitis associated with Behcet's disease, that is refractory to steroids and conventional immunosuppressive agents. Patients and methods: Patients w ith Behcet's disease (according to the International Study Group criteria), who relapsed despite steroids and immunosuppressive agents, were included in this retrospective study. Ophthalmological examination, laser flare phot ometry, and fluorescein angiography associated with laboratory tests were p erformed at regular intervals. IFN alfa (3 millions units thrice a week) wa s injected subcutaneously. Results: Eight patients (sex ratio: 1) were incl uded between May 1995 and January 1999. The mean age was 29.1 years (14-54 years) and the disease was present between 11 and 167 months before the adm inistration of IFN alfa. IFN alfa was efficient in all cases with a mean fo llow-up of 22 months (10-55 months). Steroids were tapered from a mean dosa ge of 47 mg/d to a mean dosage of 8.5 mg/d. Ocular inflammation was control led and visual acuity improved in ll cases. Treatment was generally well to lerated despite a constant but transient flu-like syndrome. IFN alfa was ta pered in three patients and stopped in one case without any relapse after f ive months. Conclusions: Within the limitations of this retrospective study , low-dose IFN alfa seems to be well tolerated, promising in the management of refractory forms of uveitis due to Behcet's disease, and effective in a llowing a reduction of steroid dosage. A prospective controlled study is ne cessary to confirm these preliminary results.